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SANITARĂ,,HENRI
SANITARĂ,,HENRI COANDĂ”
COAND Ă” FELDRU
LUCRARE DE DIPLOMĂ
PARTICULARITĂŢI DE ÎNGRIJIRE ŞI
TRATAMAENT LA PACIENTUL CU DIABET
ZAHARAT TIP. I
COORSONATOR: ABSOLVENT:
As.Med. Pr MUREŞAN VERONICA BOTA MARCELA
1
CAPITOLUL I:
INTRODUCERE
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CAPITOLUL II:
MEMORIU EXPLICATIV
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CAPITOLUL III:
ANATOMIE ŞI FIZIOLOGIE
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11
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d(6e$u# de ($ur$($e 0(re es$e &*r( *64!u$) ( d(6e$u#u
8(;(r($ 0u &re03e!'( +!$re ?? (!
d(6e$u# 6)$r5!#*r, 0u e3*#u'e #u!"), d(r 6e!"!).
Du%) 0r$er e$(6*#0e se de*se6es0:
d(6e$u# "r(s s(u 6e!"!
d(6e$u# s#(6 s(u 0*!su%$3 0u e3*#u'e 4 %r*"!*s$0 se3ere.
EVOLUŢIE. PROGNO8TIC. COMPLICAŢII
D(6e$u# 8(;(r($ es$e * 6*(#) 0r*!0), !e3!de0(6#). Cu u! $r($(e!$
0*!dus 0*re0$, 3('( 6*#!(3u#u es$e de!$0) 0u ( *(e!#*r !*r(#. !
(see!e( s$u(', d(6e$u# r)5!e ( u#$ * J!&r$($e” de05$ * 6*(#).
Su!$ 0(8ur +! 0(re %r*"!*s$0u# %*($e & ("r(3($ %r! (%(r'( u!*r
0*%#0(' +! e3*#u'( 6*#. A0es$e( %*$ & "r(3e 4 se0u!d(re. C*%#0('#e
"r(3e su!$: 0*(, ($er*s0#er*8( 3(s0u#(r), $u6er0u#*8( %u#*!(r).
Coma diabetică: 0*( se!&0) %erdere( 0u!*4$!'e, ( *6#$)' 4 (
se!s6#$)' 0u %)s$r(re( res%r('e 4 ( 0r0u#('e. C*( es$e e0;3(#e!$u#
0#!0 (# s$)r de 0e$*(0d*8) de0*%e!s($). !(!$e de 3ree, 05!d !su#!(
!u er( 0u!*s0u$), 0*( er( s&5r4$u# !e2*r(6# (# *r0)ru 6*#!(3. E( (%)re(
0( * &($(#$($e +! &('( 0)re( !u se %u$e( #u%$(. As$)8 0*( es$e e2$re de r(r)
<@ , d(r !s$(#(re( e (re * "r(3$($e de*se6$). De (0ee( $re6ue
re0u!*s0u$), %e!$ru ( %u$e( & %re3e!$) 4 0*6)$u$) #( $%. A3er$se!$u#
es$e d($ de (%(r'( 4 !s$(#(re( (!*re2e #( u! d(6e$0, 0(re de *60e es$e
%*#&(". Res%r('( de3!e ds%!e0) uss*u#, 0u r*s de (0e$*!) s(u
ere %u$rede. Se ( %*$ (d)u"( 0e&(#ee, (e'e#, 0*#0, s*!*#e!').
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C5!d 0*( es$e !s$(#($), 0ee( 0e %res*!e(8) es$e #%s( de 0u!*4$!')
( 6*#!(3u#u. E2(e!u# de #(6*r($*r (r($) "#0e( %es$e <@ " , s0)dere(
re8er3e (#0(#!e su6 <> 3(#. CO< %#(s), ;e*0*!0e!$r('e %r!
des;dr($(re 1>@?.??? de #eu0*0$e, "#0*8ure (re.
D("!*s$0u# 0*e #( u! d(6e$0 0u!*s0u$ !u es$e "reu %e 6(8(
se!e#*r de ( sus. Es$e ( d&0# #( u! d(6e$0 !e0u!*s0u$, 05!d $re6ue
de*se6$) de (#$e 0*e ;e*r("0), !e*%#(80), ;e%($0), ure0), (#0**#0),
e$0.. Tr($(e!$u# $re6ue s) &e e!er"0, !s$$ure( #u (35!d re8u#$($e %*8$3e
+! %es$e ? d! 0(8ur.
Ateroscleroza 3(s0u#(r) r)5!e (s$)8 %*($e 0e( ( &re03e!$) 4
%*r$(!$) 0*%#0('e ( d(6e$u#u, d($ &!d s0)dere( +! &re03e!') ( 0*e
d(6e$0e.
D!$re #*0(#8)r#e ($er*s0#er*8e, 0e#e ( 0u!*s0u$e su!$:
A$er*s0#er*8( 0ere6r(#) 0(re %*($e de$er!( (00de!$e
0ere6r(#e 3(s0u#(re
A$er*s0#er*8( 0*r*!(r(!) 0(re se (!&es$) %r! 6*##e
0*r*!(re#*r (!"!( %e0$*r(#), !&(r0$u# *0(rd0, 0(u8e redu$(6#e 4
%r*3*0($*(re &re03e!$ de e2$us #( 6*#!(3 d(6e$0
A$er*s0#er*8( 3(s0u#(r) %er&er0) 0(re du0e #( (r$er*%($#e
%er&er0e d(6e$0e. U!( d!$re 0e#e ( "r(3e 0*%#0(' d! (0es$ "ru% es$e
"(!"re!( d(6e$0) #( +!0e%u$ us0($), u#$er*r, %r! su%r(!&e0$(re, ued).
Tuberculoza pulmonară: d(6e$u# 8(;(r($ es$e * 6*(#) 0(re +! "e!er(#
&(3*r8e(8) !&e0'#e. Tu6er0u#*8( %u#*!(r) 0(%)$) u! (s%e0$ 0#!0 0(3$(r,
0u e3*#u'e "r(3).
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C*%#0(' se0u!d(re: * sere de 0*%#0(' ( %u'! "r(3e 4 0(re
&re03e!$ 0*!s$$ue 4 se!e %r! 0(re 6*(#( +4 (!u!') %re8e!'( su!$:
0*%#0(' 0u$(!($e: &uru!0u#*8), &uru!0u#u# (!$r(0*d, e$0.
0*%#0(' d"es$3e: (#3e*#$) e2%u#83), %*ree de!$(r), e$0.
0*%#0(' re!(#e: s0#er*8) re!(#), e$0.
0*%#0(' !er3*(se: !e3r(#", !e3r$e s0($0e +!de*se6,
%*#!e3r$), !e3r$) (0us$0), (%($e, 0(%(0$($e de u!0) redus)
(#$e 0*%#0(': re$!$) d(6e$0), 0($(r(0$).
TRATAMENT
Tr($(e!$u# es$e 0ur($3 4 %r*&#(0$0. Tr($(e!$u# 0ur($3 es$e: "e!*
de$e$0, ed0(e!$*s 4 6(#!e*&8*$er(%u$0.
Tratamentul igienodietetic: (0$3$($e( &80), 3('( +! 40(re 0( 4
re"u# (#e!$(r, (0es$e( su!$ *6#"($*r, 0;(r +!(!$e de ( (d!s$r(
6*#!(3u#u !su#!).
A#e!$('( 6*#!(3u#u 3( & (d(%$($) "reu$)' 0*r%*r(#e 4 u!0 s(#e,
de0 0;e#$ue##*r e!er"e$0e (#e *r"(!su#u s)u.
<=
Poate fi diabetul ţinut sub control?
Des"ur. C*!0e!$r('( 8(;)ru#u +! s5!"e 0u!*s0u$) 4 su6 !ue#e de
glicemie %*($e & e!'!u$) +! #$e !*r(#e 0;(r 4 de 0)$re 0e 0(re
(u &*s$ d("!*s$0(' 0u d(6e$ de $% II d(0) (0e4$( se ;r)!es0 s)!)$*s,
&(0 su&0e!$) 40(re &80) 4 +4 %)s$re(8) "reu$($e( 0*r%*r(#) 05$
( (%r*(%e de de(#.
<-
ATENŢIE? A0e(s$( es$e * 3(r(!$( ( %r(de (#e!$('e 0(re !0#ude
0(r!e. Es$e %re&er(6# s( re!u!'(' #( (0es$ (#e!$, +!$ru05$ 0(r!e( !u es$e
!ds%e!s(6#( u!e (#e!$(' s)!)$*(se d%*$r3), e( 0*!'!e !uer*(se
su6s$(!'e d)u!)$*(re s)!)$)'. V) re0*(!d s) s$ud(' * 3(r(!$) 3e"e$(r(!)
( %r(de . N. $r.
C*!su(' (#e!$e d&er$e d! &e0(re "ru%) +! &e0(re 8. S$ud(' e2e%#u#
de ( 9*s %e!$ru ( 3ede( 0u se %*($e re(#8( (0es$ #u0ru.
Zi+% 0 Zi+% @
F#+!'5 )r %(r)
%*r$*0(#) 6(!(!(
V'#d'+#i5 3(r8( s(#($(
&(s*#e 3erde
Cereale şi amidonoase
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&e0(re (s). U! *(e! 3) 3*r s%u!e 0) !u e 6!e s) 5!0(' %re(
u#$ d! (s$&e# de (#e!$e, d(r (0es$ s&($ !u ( es$e 0*re0$. C*!suu#
de (#e!$e 6*"($e +! (d*! s( d*3ed$ ( & s)!)$*s %e!$ru $*($)
#ue(, !0#us3 %e!$ru 0e 0(re su&er) de d(6e$.
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@ P*r':
Verdeţuri
@1
Verde'ur#e su!$ (#e!$e s)!)$*(se %e!$ru $*', !0#us3 %e!$ru d(6e$0. C*!su('
+! &e0(re 8 3erde'ur 4 #e"ue 0rude 4 ")$$e. E#e 3) *&er) 3$(!e, !er(#e 4
&6re, 0u &*(r$e %u'!e 0(#*r.
Nu)ru# de %*r' %e 0(re (r $re6u s) #e 0*!su +! &e0(re 8 de%!de de
Ne0es(ru# $)u de 0(#*r
Cu +' +!"r9e4$ d(6e$u#.
Cât de mult este o porţie de verdeţuri?
1 P*r'e:
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@ P*r':
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P*' 5!0( u!(, d*u) s(u $re %*r' de 3erde'ur #( * (s). D(0) 0*!su
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de 3erde'ur s(u ( ser3 d*u) s(u $re %*r' d! (0e#(' $% de 3erde'ur.
Fructe
@@
Fru0$e#e su!$ s)!)$*(se %e!$ru $*($) #ue(, !0#us3 %e!$ru d(6e$0.
Fru0$e#e !e d(u e!er"e, 3$(!e, !er(#e 4 &6re.
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@
Cum ar trebui să mănânc fructele?
P*' 5!0( &ru0$e#e +! s$(re 0rud), su6 &*r) de su0 &)r) (d(us
de 8(;)r s(u 0*!ser3($e +! sr*% %r*%ru *r %r! us0(re.
Cu%)r(' &ru0$e de de!su! ( 0.
C*!su(' de %re&er!') &ru0$e#e !$e"r(#e +! #*0 s) 6e'
d*(r su0u# #*r. Pe #5!") (#$e (3(!$(9e, 3) 3e' s)$ur( (
re%ede.
Cu%)r(' !u( su0ur de &ru0$e 0(re 0*!'! 1?? su0
!($ur(# de &ru0$e, &)r) (d(us de 8(;)r.
Be' su0u# de &ru0$e +! 0(!$$)' 0.
P)s$r(' deser$ur#e d! &ru0$e 0u 0*!'!u$ 0res0u$ de 8(;)r
4 "r)se %r)9$ur( de ere, de 0re4e e$0. %e!$ru *0(8
0u $*$u# s%e0(#e.
Lapte şi iaurt
@>
Nu)ru# de %*r' %e 0(re $re6ue s) #e 0*!su +! &e0(re 8
de%!de de
Ne0es(ru# $)u de 0(#*r.
Cu +' $r($e8 d(6e$u#.
No"5 D(0) su!$e' * &eee +!s)r0!($) s(u (#)%$(', 0*!su('
%($ru s(u 0!0 %*r' de #(%$e s(u (ur$ +! &e0(re 8.
@
V) re0*(!d s) s$ud(' * 3(r(!$) 3e"e$(r(!) ( %r(de . N.
$r.
A#e!$e#e %r*$e0e su!$ u$#e *r"(!su#u %e!$ru ( 0#)d
'esu$ur 4 u40;. De (see!e(, e#e &ur!8e(8) 3$(!e 4
!er(#e.
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Pe!$ru ( d( * (r*) ( 6u!), &*#*s' su0 de #)5e, s*s
de s*(, e$0;u%, r*de! 4 0*!de!$e 3e"e$(#e.
G)$' *u)#e 0u * 0(!$$($e 0) de "r)se.
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răsimi şi uleiuri
Dulciuri
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Cât este o porţie de dulciuri?
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1
TRATAMENTUL IN8ULINIC
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P#'$%#%',' d' i&3+,i&" o,o3i'
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P5!) +! (!u# 1-? (u &*s$ &*#*s$e e20#us3 %re%(r($e !su#!0e
%r*3e!$e de #( %*r0!e 4 6*3!e. A0es$e( +! %re8e!$ su!$ &*#*s$e d! 0e +! 0e
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CONDIŢII ŞI TEHNICĂ DE ADMINI8TRARE A IN8ULINELOR
IN8ULINELOR
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VSH 7 @? M
LIPIDE 7 =>? "
GLUCIDE 7 << "d# *r( 1-,??
1 6"d#
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GLUCIDE 7 1-1 "0#
UREEA 7 @<,1 "0#
CREA 7 ,=> "0#
Examene paraclinice
!lectrocardiogramă
Ve!$.r($e 7 = 6%
>=
PR !$ 7 1< s
]RS dur 7 s
]T]TC !$. 7 @-1 s
P]RST (2s 7 @=@>=°
RV >SV 1 (% 1,<>?,==? V
RV > SV 1 (% <.?> V
11?? s!us r;$;
11? ^^ !*r(# ECG^^
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>-
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>
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(!*$%u#u. A0*rd) ($e!'e (s%e0$u#u e2$er*r.
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u4ur!') "5!dur#e, de#e, e*'#e.
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* %ers*(!) re(#8($) +! 3(').
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))#") @? !u$e +!(!$e(
- alimente permise necântărite : ese d*8( de
0(r!e( 4 der3($e#e d! 0(r!e, !su#!)
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#e"ue 0u > "#u0de, 3(r8(,
0*!*%d(, r*4#e, &(s*#e( 3erde.
D! (#e!$('( 8#!0) !u $re6ue
s) #%se(s0) *u#, 0(r!e(, %e4$e#e
- ca îndulcitor se va folosi za+arina
PLAN DE ÎNGRIJIRE
Nue: B.A
V5rs$(: >< (!
D($( !(4$er: 11.?@.1?
D*0#u# : N)s)ud s$r. V Cru0. Nr. 1?
O0u%('e: %e!s*!(r)
N('*!(#$($e : r*5!(
Se2 : &e!!
S$(re 03#) 3)du3)
C*!d' de 3(') : 0*res%u!8)$*(re, !u &ue(8), !u 0*!su) (#0**#
Gru%( s(!"u!): A.II
A#er" : !u %re8!$)
A!$e0ede!$e %ers*!(#e: e!(r;( #( 1@ (!
< !(4$er, < (3*r$ur
e!*%(u8( #( >? (!
H.T.A. de @ (!
A!$e0ede!$e ;ered*0*#($er(#e : !u su!$
D($( !$er!)r: ?=.?<.<?1<
M*$3e#e !$er!)r :
(e'e#, $u#6ur)r de e0;#6ru
3(#*r "#0e0e 0res0u$e.
D("!*s$0: d(6e$ 8(;(r($ $% I de8e0;#6r(!$
re(0'e de%res3).
Istoricul bolii.
P(0e!$( +! 35rs$) de >< (! 0u!*s0u$) 0u d(6e$ 8(;(r($ $% I, su6
$r($(e!$ 0u !su#!) se !$er!e(8) %e!$ru 3(#*r "#0e0e 0res0u$e ,
(e'e#, $u#6ur)r de e0;#6ru.
=
Examinări de laborator.
\BC 7 1>,< u#
NEU 7 11,= ==,? N BAND
L[M 7 <,1 1>,- L
MONO 7 .=1 ,? M
EOS 7 .@ <,< E
BASO 7 .?= . -> B
RBC 7 ,<? MuL
HGB 7 1<, "dL
HCT 7 @=,
MCV 7 -,? &#
MCH 7 <,> %"
MCHC 7 @@,1 "dL
RD\ 7 1@,?
PLT 7 @-? uL
MPV 7 =,> &#
PCT 7 <-=
PD\ 7 1-,@ 1? GSD
VSH 7 1 M
COBAS M 1@.?
BIL !e"
URG < "#
ET !e"
ASC !e"
GLU 1??? "d#
SG 1.?<>
PRO @? "d#
BLD !e"
%H
NIT !e"
LEU <> Leuu#
-
COBAS M 1>.?
BIL !e"
URG !*r
ET !e"
ASC !e"
GLU 1??? "d#
SG 1.?<?
PRO !e"
BLD !e"
%H >
NIT !e"
LEU !e"
Examene paraclinice
!lectrocardiogramă
E2(e! %s;($r0 Re(0'e de d*#u
Re0. C(r6*(8e%! ? 7 ? 1
Ecografie abdominală
VB 0u * ("!e ;%ere0*"e!) de << 0 0u 0*! de u6r( %*s$er*r. F0($
)r$ de 3*#u 0u e0*"e!$($e s$r)#u0$*(re !e**"e!). CBP, VP de
de!su! !*r(#e. P(!0re(s e0*"r(&0 !*r(#. S%#!( e0*!*r(#.
R!0; dr. e0*!*r(#. R!0; s$5!" 0u (s%e0$ de 0r*#$(8). Ve80(
ur!(r) +! seu%#ere !u %*($e & (%re0($).
C+,'4'#'% d%',o# ,% &i:',+, !',o#
0 N':oi F+&d%9'&%,'
0(rd*3(s0u#(r %(0e!$( %re8!$) AMP +! #$e !*r(#e, 8"**$e 0(rd(0e
r$0e, 6!e 6)$u$e.
T.A. 1?-? H".
Res%. Q 1= res%.!
Pu#s Q =< %u#s!
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- es( de ur!) se e&e0$ue(8) 0u d&0u#$($e d! 0(u8( durer#*r 3*#e!$e
+! #*9e#e re!(#e 0u r(dere +! 3e80( ur!(r)
- %re8!$) u! s0(u! #( 1@ 8#e
- !u %re8!$) 3)rs)$ur
- d(&*re8( es$e +! #$e !*r(#e.
=?
*. #evoia
#evoia de
de a dormi
dormi $i
$i a se
se odi+ni
odi+ni..
P(0e!$( !u se %*($e *d;! , su&er) de !s*!e d*(re 0( <@
*re %e !*(%$e
,. #evoia
#evoia de
de a se îmbrăc
îmbrăca
a $i dezb
dezbrăc
răca.
a.
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4 (!*$%u#u. A0*rd) %*r$(!') (s%e0$u#u e2$er*r.
-. #evoia
#evoia de a$i men%in
men%inee temperatur
temperatura
a corpului
corpului în limite
limite normal
normalee
P(0e!$( es$e (&e6r#). Pe dur($( s%$(#8)r $e%er($ur( 0*r%*r(#)
( &*s$ 0u%r!s) +!$re @, 7 @= °C.
. #evoia
#evoia de a$i men%in
men%inee tegumentel
tegumentelee curate $i
$i integre
integre..
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+!"r9$).
/. #evoia
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evita peri
pericol
colele
ele..
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s)4 (s"ure (0e(s$) !e3*e.
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CONCLUZII
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BIBLIOGRAFIE
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