8/20/2019 130225031 Ingrijirea Pacientilor Cu Hepatita

1/36

ŞCOALA POSTLICEALĂ FUNDAŢIA ECOLOGICĂ “GREEN” BRAŞOV

PROIECT DE PRACTICĂ ROLUL ASISTENTEI MEDICALE ÎN ÎNGRIJIREA

PACIENŢILOR CU HEPATITĂ VIRALĂ

BRAŞOV 2011

1

8/20/2019 130225031 Ingrijirea Pacientilor Cu Hepatita

2/36

CUPRINS

CAPITOLUL I.....................................................................................................................3 ANATOMIA ŞI FIZIOLOGIA FICATULUI...................................................................3

1. 1. ANATOMIA FICATULUI...................................................................................3 1. 2. STRUCTURA FICATULUI................................................................................4 1. 3. VASCULARIZATIA FICATULUI......................................................................4 1. 4. INERVATIA FICATULUI...................................................................................5 1. 5. FUNCTIILE FICATULUI..................................................................................5

CAPITOLUL II....................................................................................................................7 HEPATITELE VIRALE ACUTE..................................................................................7

2. 1. DEFINIŢIE..........................................................................................................72. 2. CLASIFICAREA HEPATITELOR VIRALE....................................................7 2. 3. ETIOLOGIE SI EPIDEMIOLOGIE..................................................................8 2. 4. CONDIŢII FAVORIZANTE..............................................................................8 2. 5. ANATOMIA PATOGENICA.............................................................................. 2. !. SIMPTOMATOLOGIE.....................................................................................1" 2. 7. FORME CLINICE............................................................................................14 2. 8. DIAGNOSTIC...................................................................................................1! 2. . EVOLUŢIE........................................................................................................17 2. 1". COMPLICAŢIILE ŞI SECHELELE HEPATITEI VIRALE TIP A...........18 2. 11. E#PLORĂRI ŞI INFORMATII PARACLINICE........................................18

2. 12. PROGNOSTIC................................................................................................12. 13. TRATAMENT..................................................................................................2" CAPITOLUL III................................................................................................................23

ROLUL ASISTENTEI MEDICALE $N $NGRI%IREA &OLNAVULUI CU HEPATITĂ VIRALĂ........................................................................................................................23

3. 1. ROLUL PROPRIU............................................................................................24 3. 2. ROLUL DELEGAT...........................................................................................25 3. 3. DESCRIEREA A DOUĂ TEHNICI..................................................................2!

CAPITOLUL IV................................................................................................................3" STUDIU DE CAZ.........................................................................................................3"

4. 1. CULEGEREA DATELOR.................................................................................3" 4. 2. GRILA DE STA&ILIRE A GRADULUI DE DEPENDENŢĂ.........................31 4. 3. PLAN DE INGRI%IRE......................................................................................33 4. 4. EVALUARE FINALĂ.......................................................................................35

&I&LIOGRAFIE................................................................................................................3!

2

8/20/2019 130225031 Ingrijirea Pacientilor Cu Hepatita

3/36

CAPITOLUL I

 ANATOMIA ŞI FIZIOLOGIA FICATULUI 

1. 1. ANATOMIA FICATULUI

F'()*+, -*- (-) /)' /)0- ,)) ' (0+, +/).

  Aş!"# $ E*- '*+)* 6 ()'*)*-) )/'),) 9 -*):+, +0)/-;(,'( 6 )0*-)

+-0')0) 0-)*'()* - +/-@*- ,:) -)*'().

  C%&'()*#"+(" ,-#&" $

 A0- >0/) ++' -/''= )@-;)* *0)-0), 6 )/-=

(+ ,+'/-) - )0B'/)*' 28 (/= ')/-*0+, )*-0*-0'0 - 18 (/= 6-*- 

". F"+" /*#(%"# ')>0)/)*'(),('>0/. L+, 0-* 0-;'*< '/0-'+-) )0(+,+' (*),= ')0 (-, *?

6*'

8/20/2019 130225031 Ingrijirea Pacientilor Cu Hepatita

4/36

-) 0*)= +(*+, -)*'(= ,'/>)*'(-,- @' -0''.

  A(-*- @)+0' -,'/'*-);< )*0+ ,'  0-*= *?= ()+), @' ), ,+' S'--,.

3. F"+" %/-#(%"#  (*'+< - (-) +-0')0< @' '- 6 0)0* (+ -0-*-,-

 *-0'0 ), ()'*)'' )/'),- ,) '-,+, -0*-0-,0 T7T11.

M(45%"3 6 '(,"# $  +* 0-0-;-*)*- - ,')/-*-= -) ()) '>-0')0< @'

 -'(+,+, -)*'(.

1. 2. STRUCTURA FICATULUI

L) -B*-0'0= >'()*+, -*- )(-0'* - -0'*-+, '(-0),. S+ -0'*-+, '(-0), -

)>,) ()+,) >'0)) ) >'()*+,+' ()+,) G,'. D- +- ,-)(< -*+0' (:+(*'

)(+,)0-= ()0- +('),- ),- >'()*+,+'. L+,'' +* ';'',' (+ ('+, ,'-0.

L+,+, -)*'( -*- >0/)* ' (-,+,- -)*'(- -)*('*-= ' ()',)0-

'+'-= ' -) (-*0,+,)0) 0- ()0- (-0 '+'-,- ' ' ()'(+,-,- ',')0-

'*0),+,)0-.

C-,+,-,- -)*'(- +* '+- ' )'+ + >0/) +0 ,)(' )+ ,)/-= >0/)*-

'*0+ '+0 0? - (-,+,-. I 0'/-) +-' ,)/- - >0/-);< ()'(+,-,- ',')0-

'*0),+,)0-. C-,+,-,- -)*'(-= -)*('*-,-= +* 0-,)*' /)0'= - >0/) ,'-0'() @'

))0 - -('+- + )-(* ,'),. C-,+,) -)*'(< )*- '- '

()'(+,-,- ',')0- -(0-') -B(0')= >'- ' '+'- -(0-') -(0').

1. 3. VASCULARIZATIA FICATULUI

F'()*+, )0-  +,< )(+,)0';)'- +*0'*'< @' >+('),)*'(-,- >'()*+,+' ):+ ' ),''' ' ',+, >'()*+,+' ),''' ',)0'= @' -

)'(' ' ),''' (-,')('.

4

8/20/2019 130225031 Ingrijirea Pacientilor Cu Hepatita

5/36

1. 4. INERVATIA FICATULUI

I-0)') >'()*+,+' -*- )'+0)*< - ,-B+, -)*'( >0/)* ' >'0- '/)*'(- @'

 )0)'/)*'(-. P,-B+, -)*'( - -0'- ' ,-B+, (-,')(.

C(5 (5("# +* (+(*- 0' ()0- ',)= -(0-*)*< (*'++ - (-,+,- -)*'(-=

):+- ' +- +/)' )*+(' (? ):+ )'(' 0+@'' '-*'-' )*0'(-. C)) '(-0),< ) >'()*+,+'. A0- >0/< - )0>-0 @' (-,+,-,0 -)*'(-. &',) - 

8/20/2019 130225031 Ingrijirea Pacientilor Cu Hepatita

6/36

• F*&3+(" 8-"%5(3 9 - 0->-0) ,) *)*- +*)-,- +*0'*'-

    glicogenetica 9 '*-*';-);< ,'(-+, ' ,+(;)= ('-);< ,'(-+, '

,+(;)= >0/-);< ,'(- ' 0'()* - -;'*-);< 0'0'-+, @'

 0*0/') (+ 0, ' ()+,)0-J

   >+(') ureogenă ) >'()*+,+' 9 (*< ' ) >)0'() +0-- ' )(';' )/'*' '

-B(-= +;)' )+ ->,'' ' '*-;-J

   '*-0'- ' /-*),'/+, /'-0),-,0  C,= N)= = C+= F-= -*- -;'* - >'-0J

   0, ' /-*),'/+, )-'= 0-,? '+0-;) 0' -+*0),';)0-) +0 0/'

+0)0-),'= -*0-'= )*''+0-*'(-J

   -*- depozit  - '*)/'- ,',+',- @' '0,+',-. F'()*+, 0-0-;'*< (-, /)'

 )* -;'* - '*)/') A ' 0)'/= )0B'/)*' 5KJ

    sintetizează fermenţii 9 )0');)= +0-);)= ()0- '*-0' ' 0(--,- +0-- '

>'()*J *0'+*'0);)= ()0- '*-0'- ' )0-0',- )(';',0 0)@'J >>)*);-,- @' >>0',);-