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COLEGIUL NAIONAL DE MEDICIN I FARMACIE R.

PACALO
CATEDRA OBSTETRIC I GINECOLOGIE

GHIDUL
Leciilor practice
La disciplina ASISTENA MEDICAL N OBSTETRIC I GINECOLOGIE

Al elevei/ului anul___ gr.____


Specialitatea Medicina general
Calificarea Asistent medical
Nume, Prenume_____________________

Profesorul___________________
1

Planul tematic
Semestrul IV
Nr.
d/o
1.
2.
3.
4.
5.
6.

Data

Subiectele de studiu

Locul
desfurrii

Nr.
ore

Gestoze precoce.
Stri hipertensive n sarcin.
Hemoragii n sarcina precoce.
Hemoragii n sarcina tardiv.
Hemoragii n natere.
Anemiile i sarcina.

4
4
4
4
4
4

Afeciunile sistemului urinar i sarcina.


Afeciunile sistemului CVS i sarcina.
Diabetul zaharat, obezitatea i sarcina.
Insuficiena fetoplacentar n sarcin.
Incompatibilitatea sanguin fetomatern.
Infecia HIV/SIDA i sarcina.

4
4
4
4

15.

Infecia HIV/SIDA i sarcina. Stigma i


discriminarea gravidelor care triesc cu HIV.
Sifilisul, gonoreea i sarcina. Herpesul genital.
Citomegalovirusul i sarcina.
Candidamicoza, tricomoniaza, vaginoza bacterian i
sarcina.
Prezentaia pelvian.

16.
17.

Bazin strmtat.
Prezentaiile transverse i oblice. Sarcina multipl.

4
4

18.

Naterea prematur, sarcina supramaturat, naterea


ntrziat.

7.
8.
9.
10.
11.
12.
13.
14.

Total ore

4
4
4

72
ore

Tema 1
Subiectul: ngrijirea gravidelor cu gestoze precoce.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire a
gravidelor cu gestoze precoce.
ABILITI :
1. Aprecierea strii generale a gravidei.
2. Determinarea vrstei sarcinii, datei naterii.
3. Aprecierea maselor vomitate.
4. Determinarea masei corporale a gravidei.
5. ngrijirea gravidelor cu gestoze precoce.
6. Realizarea convorbirii Alimentaia gravidelor cu vom.
Desfurarea leciei practice:
1. nlocuii cuvintele lips n definiia gestozelor:
Gestozele gravidelor ___________________, este _______________________de
_________________________________ ce apare n _______________, complica
__________________ei i se termin ___________________________________.
2. Descriei clasificarea gestoselor.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
____________________________________________
3. n primele luni ale sarcinii dravidele, mai ales primipare au dimineaa
greuri, vrsturi. Se consider gestoz sau nu?(ncercuii rspunsul
corect)
DA
NU
4. Vrsturile ce se repet de cteva ori pe zi chiar i dup luarea mesei,
sunt considerate gestose:
a) da
b) nu
5. Denumii formele clinice de vom gravidic:
__________________________________________
__________________________________________
__________________________________________
6. Voma uoar se repet de:
a) 2 4 ori/zi
b) 7 15 ori/zi
c) 20 24 ori/zi
3

7. Voma grav se repet de:


a) 2 4 ori/zi
b) 7 15 ori/zi
c) 20 24 ori/zi
8. Voma moderat se repet de:
a) 2 4 ori/zi
c) 7 15 ori/zi
d) 20 24 ori/zi
9. Descriei tabloul clinic al vomei uoare
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________

10. Descriei tabloul clinic al vomei moderate


_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
11. Descriei
tabloul clinic al vomei grave
________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
_________________________________________________________
12. Principii
de conduit i tratament al vomei
________________________
Uoar
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
__

Moderat
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________

Grav
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
______________________
_

INTEROGAREA GRAVIDEI
Nume ______________Prenume____________________________________________
Data naterii____________________________________________________________
Domiciliul______________________________________________________________
Profesia ________________________________________________________________
Condiiile de munc______________________________________________________
Starea civil__________________Anul prezentei cstorii______________________
Condiii de trai__________________________________________________________
Sntatea tatlui
Vrsta ________________
Relaii de rudenie ntre soi ________________________________________________
Antecedente familiale_____________________________________________________
Antecedente personale ____________________________________________________
Grupa sanguin _____________________Factorul Rh__________________________
Examen radiologic_______________________________________________________
Antecedente n familie i personale la mam _________________________________
_______________________________________________________________________
Funcia Menstrual
vrsta, cnd a aprut prima menstruaie i caracterul ei (cu dureri sau nu, durata menstrei
i cantitatea de snge pierdut
_______________________________________________________________________
felul ciclului menstrual (regulat, neregulat) dup ce perioad de timp sa stabilit ciclul
menstrual regulat
_______________________________________________________________________
modificrile ciclului menstrual dup nceputul vieii conjugale, dup avorturi,
natere_________________________________________________________________
data ultimei menstruaii normale________________________________________
Funcia de reproducere
_____________________________________________________________________________
_________________________________________________________________
Luat n eviden la ______________________________________________________
Prima micare a ftului___________________________________________________
Vizite efctuate la medicul de familie_________________________________________
Examen obiectiv
starea general____________________________________
TA (S)__________ (D)____________ puls _____________
Greutatea _______________________
Talia___________________________
Diametrul bispinos________________
Diametrul bicrest_________________
Diametrul bitrohanterian___________
Conjugata externa________________
nlimea fundului uterin__________
Cicumferina abdomenului_________
Btile cordului fetal_________________________________________
Vrsta sarcinii la ziua de azi: ___________________Saptmni de sarcin:
Prima zi a ultimei menstruaii__________
Prima vizit la medic ____________________

_____________________
_____________________
5

Prima micare a ftului___________________


USG______________________________
Examen obiectiv_____________________

____________________
_____________________
_____________________

Concediu prenatal__________________________________________________
Data naterii_______________________________________________________
Masa aproximativ a ftului
1/20 parte din greutatea gravidei______________________________________
FU x CA _________________________________________________________
(FU + CA + Talia + Greutatea) x 10___________________________________
(FU + CA) x 100___________________________________________________
4
Diagnosticul n ziua examinrii_____________________________________________
_______________________________________________________________________

Nr.
d/o
1.
2.
3.
4.
5.

Evaluarea cantitativ a deprinderilor preactice realizate


DENUMIREA DEPRINDERII
CANTITATEA
SEMNTURA
PRACTICE

Concluzii:_____________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________
Semntura profesorului ____________________

Tema 2
Subiectul: ngrijirea gravidelor cu stri hipertensive n sarcin.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire a
gravidelor cu stri hipertensive n sarcin.
ABILITI :
1. Caracterizarea strilor hipertensive n sarcin.
2. Aprecierea strii generale a gravidei.
3. Msurarea nlimii fundului uterin.
4. Determinarea masei corporale a gravidei.
5. Determinarea vrstei sarcinii, datei naterii.
6. ngrijirea gravidelor cu stri hipertensive n sarcin.
7. Decrierea:
semnelor preeclampsiei;
fazelor crizei eclamptice.
10. Prevenirea convulsiilor.
11. Acordarea primului ajutor n criz eclamptic.
12. ngrijirea gravidelor cu preeclampsie i eclampsie.
13. Realizarea convorbirii Semnele de urgen care indic declanarea crizei
eclamptic

Desfurarea leciei practice:


1. Definii HTA n sarcin.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
2. Enumerai factorii de risc pentru apariia HTA n sarcin.
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
___________________________

3. Descrii clasificarea HTA n sarcin.


Clasificarea
HTA cronic
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________

HTA indus de sarcin


fr proteinurie
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________

HTA indus de sarcin


______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
______________________________________________
_
Preeclampsia
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
_______________________
___

Form uoar
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________

Eclampsia
_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
_____________________
_

Form sever
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________
______________________________

4. Riscul fetal n HTA indus de sarcin este urmtorul cu exepia:


a. Prematuritatea
b. Macrosomia
c. Hipotrofia
d. Decesul in utero
e. Moarte neonatal
5. Eclampsia este caracterizat prin:
a. HTA 140/90 mmHg sau mai mare
b. Apariia convulsiilor la o gravid cu preeclampsie
c. HTA cronic de orice cauz
d. HTA tranzitorie
e. Creterea TA sistolice cu 30mm Hg sau mai mult
8

6. Preeclampsia este caracterizat prin:

a. Apariia HTA dup 20 spt. de sarcin


b. Proteinurie
c. Edeme generalizate
d. Creterea ponderal cu 20kg sau mai mult
e. Toate acestea
7. Semnele de alarm pentru accesul eclamptic sunt urmtoarele, cu exepia:
a. Cefalee n casc
b. Tulburri vizuale
c. Durere epigastric
d. Miciune imperioas
e. Grimase
8. Riscurile materne asociate HTA gravidice sunt urmtoarele, cu excepia:
a. Ruptura uterin
b. Hemoragie cerebral
c. Eclampsia
9. HTA indus de sarcin este o complicaie a:
a. Primei luni de sarcin
b. Primului trimestru de sarcin
c. Celui de-al doilea trimestru de sarcin
d. Celui de-al treilea trimestru de sarcin
e. Ultimei luni de sarcin
10. n HTA indus de sarcin cel mai important semn clinic este reprezentat de:
a. Edeme generalizate
b. HTA
c. Proteinurie
d. Creterea n greutate cu peste 2kg pe lun
e. Asocierea edemelor cu proteinuria
11. Descriei studiul de caz.

Studiu de caz
La medicul de familie s-a adresat gravida M., 28 ani. Vrsta sarcinii 32
sptmini. TA 160/110mmHG, ps 78b/min. Proteine n urin 3g/l. Acuz
dureri de cap, dureri n epigastru, muculie naintea ochilor.
Descriei conduita ulterioar a gravidei.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

12. Rezolvai rebusul.

1. Boala netratata corect care trece in


preeclampsia.
2. Schimbare calitativa aparuta in urina dupa
20 saptamini de sarcina.
3. Faza de inceput a crizei eclamptice.
4. Manifestare clinica in forma severa a
preeclamsiei.
5. Miscari involuntare a muschilor extensori si
flexori aparuta ca complicatie a eclampsiei.
6. Preparat antihipertensiv din grupa Badrenoblocante.
7. Preparat de selectie in convulsii.
8. Complicatie ce aparare in faza comatoasa.
9. Presiune arteriala sistolica si diastolica mai
mare de 140/90mmHg appreciate la 2
masurari separate cu intervalul de 4 ore.
10. Principal cauza care provoaca moartea in
urma eclampsiei.
11. Tablou clinic al preeclampsiei se
caracterizeaza prin
12. Stadiu culminant de evolutie a
preeclampsiei.

Cudntul codat
_____________________________________

13. Completai gravidograma.


DINAMICA TENSIUNII ARTERIALE I BTILOR CORDULUI FETAL
Data, luna. Anul
8 sptmni

Btile cordului
fetal

Terminul sarcinii

16 sptmni

22 sptmni

30 sptmni

36sptmni

38 sptmni

180
160
140
120
100
80
200
180
160
140

120
100
80
60
40

EVOLUIA SARCINII I NATERII N CONFORMITATE CU NLIMEA FUNDULUI UTERIN(cm)


45

40

35

30

25

20

15
17

18

19

20 21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

10

Greutatea iniial (Kg) Adaus la greutate (Kg)

DINAMICA GREUTII PE PARCURSUL SARCINII


20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
-1
-2
-3
4

12

16

20

24

28

32

36

40

Evaluarea cantitativ a deprinderilor preactice realizate


Nr.
d/o
1.
2.
3.
4.
5.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________

Semntura profesorului ____________________

11

Tema 3
Subiectul: ngrijirea gravidelor cu hemoragii n sarcina precoce.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire a
gravidelor cu hemoragii n sarcina precoce.
ABILITI :
1.
2.
3.
4.
5.
6.
7.
8.

Caracterizarea factorilor etiologici ai avortului spontan.


Descrierea evoluiei avortului spontan.
Aprecierea strii generale a gravidei.
Determinarea vrstei sarcinii, datei naterii, datei concediului prenatal.
Caracterizarea factorilor etiologici ai sarcinii extrauterine.
Descrierea evoluiei sarcinii extrauterine.
Acordarea tratamentului urgent prespitalicesc.
Proiectarea i realizarea convorbirii Semnele de urgen n sarcina precoce.

Desfurarea leciei practice:


1. Clasificai hemoragiile n sarcin conform timpului instalrii lor.
I.____________________________
1.____________________________
2.____________________________
3.____________________________

II.____________________________
1.____________________________
2.____________________________
___________________________

2. Descriei definiia avortului.


_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

3. Caracterizai urmtoarele tipuri de avort.

Avortul provocat

Avortul criminal

Avortul spontan

__________________________________________________
__________________________________________________
__________________________________________________

__________________________________________________
__________________________________________________
__________________________________________________

__________________________________________________
__________________________________________________
__________________________________________________
12

Avortul precoce

Avortul tardiv

__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________
__________________________________________________

4. Descriei perioadele de evoluie a avortului spontan.


1.______________________________________
2.______________________________________
3.______________________________________
4.______________________________________
5.______________________________________
6.______________________________________
7.______________________________________

5. Denumii strile patologice care pot provoca avortul.


2. Strile patologice genitale
ale organismului matern:
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
__
4. Strile patologice genitale ale
produsului de concepie:
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
__

1. Strile patologice
extragenitale ale
organismului matern:
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
__
3. Factorii imunitari:
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
13

5. Factori de mediu :
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
_____________________
6. Descriei tabloul clinic al avortului imminent.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
7. Descriei tabloul clinic al avortului incipient.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
8. Descriei tabloul clinic al avortului progredient.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
9. Descriei tabloul clinic al avortului incomplet.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
10. Descriei tabloul clinic al avortului febril.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
11. Avortul poate fi cauza urmtoarelor complicaii:
_____________________________
_________________________________
_________________________________
_________________________________

12. Definii sarcina extrauterin.


__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
14

13. Rezolvai studiul de caz.


STUDIU DE CAZ

Bolnava A., 30 ani, acuz reinerea menstrei timp de 1 sptmn,


grea, tumefierea glandelor mamare, apariia durerilor acute n partea stng
inferioar a abdomenului cu iradiaie n rect, vertij, pierdere de contiin de
scurt durat.
OBIECTIV:
Ps 100 b/ min, slab, TA 90/60 mm/Hg.
Abdomenul balonat, nu particip n actul de respiraie, dureros la palpare.
La examenul vaginal se observ culoarea cianotic a intrrii n vagin, eliminri
brune din canalul cervical. Deplasrile colului uterin snt foarte dureroase,
fornixul promineaz, uterul i trompele nu se contureaz din cauza durerii.
1. Diagnostcul.
2. Tactica medical.
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
14. Completai enunul cu cuvinte omise.
_______________________se caracterizeaz prin transformarea specific a
vilozitilor coriale ce se transform n ______________________________de
mrime diferit de la un bob de mei pn la o bobi de poam.
15. Descriei tabloul clinic al molei hidatiforme.
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
Evaluarea cantitativ a deprinderilor preactice realizate
Nr.
d/o
1.
2.
3.
4.
5.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului ____________________
15

Tema 4
Subiectul: ngrijirea gravidelor cu hemoragii n sarcin tardiv.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire a
gravidelor cu hemoragii n sarcin tardiv.
ABILITI :
1.
2.
3.
4.
5.
6.
7.
8.

Caracterizarea hemoragiilor n sarcina tardiv, formele.


Descrierea tabloulului clinic al hemoragiilor n sarcina tardiv.
Aprecierea strii generale a gravidei.
Auscultaia btilor cordului fetal.
Determinarea vrstei sarcinii, datei naterii, datei concediului prenatal.
Efectuarea examenului n valve.
Acordarea tratamentului urgent prespitalicesc.
Proiectarea i realizarea convorbirii Semnele de urgen n sarcina tardiv.

Desfurarea leciei practice:


1. Completai enunurile cu cuvinte omise.
1.1 Placenta praevia sau prezentaie placentar este o complicaie grav a
sarcinii, n care _________________________________________________
______________________________________________________________.
n mod normal placenta se insereaz n ____________________________ pe faa
anterioar sau posterioar.
2. Caracterizai urmtoarele varietide prezentaie placentar.
________________________________________________
________________________________________________
________________________________________________
________________________________________________

Placenta praevia
lateral (80%)

________________________________________________
________________________________________________
________________________________________________
________________________________________________

Placenta praevia
marginal (18%)

________________________________________________
________________________________________________
________________________________________________
________________________________________________

Placenta praevia
central (2%)
16

________________________________________________
________________________________________________
________________________________________________
________________________________________________

Inseria joas a
placentei

________________________________________________
________________________________________________
________________________________________________
________________________________________________

Placenta praevia
cervical

3. Descriei factorii etiologici n dezvoltarea placentei praevia.


__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
4. Explicai conduita.
4.1 Gravida B., 21 ani ,vrsta sarcinii 24 sptmni. Acuz hemoragie din cile
genitale, fr dureri. S-a trezit noaptea ntr-o bltoac de snge. La momentul
sosirii medicului hemoragia lipsete. Gravida este palid, TA 100/60 105/65
mmHg, PS 90 bti/min.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
4.2 La al doilea examen medical Gravida C., 20 ani a prezentat medicului de
familie rezultatul examenului ultrasonor unde s-a stabilit inseria joas a placentei.
Vrsta sarcinii 18 sptmni.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
5. Definii decolarea prematur a placentei normal localizate.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
6. Descriei cauzele DPPNL.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
17

7. Caracterizai cele 3 grade de decolare prematur a placentei.


GR.I
____________________
____________________
____________________
____________________
____________________
____________________
____________________
____________________
____________________
_

GR.II
____________________
____________________
____________________
____________________
____________________
____________________
____________________
____________________
____________________
_

GR.II
____________________
____________________
____________________
____________________
____________________
____________________
____________________
____________________
____________________
_

8. Explicai conduita.
S-a prezentat gravida S., 20 ani. Vrsta sarcinii 8 sptmni. Prezint acuze:
- dureri de traciune n regiunea inferioar a abdomenului;
- eliminri obinuite cu imprimri de snge.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
INTEROGAREA GRAVIDEI
Nume ______________Prenume____________________________________________
Data naterii____________________________________________________________
Domiciliul______________________________________________________________
Profesia ________________________________________________________________
Condiiile de munc______________________________________________________
Starea civil__________________Anul prezentei cstorii______________________
Condiii de trai__________________________________________________________
Sntatea tatlui
Vrsta ________________
Relaii de rudenie ntre soi ________________________________________________
Antecedente familiale_____________________________________________________
Antecedente personale ____________________________________________________
Grupa sanguin _____________________Factorul Rh__________________________
Examen radiologic_______________________________________________________
Antecedente n familie i personale la mam _________________________________
_______________________________________________________________________
Funcia Menstrual
vrsta, cnd a aprut prima menstruaie i caracterul ei (cu dureri sau nu, durata menstrei
i cantitatea de snge pierdut
_______________________________________________________________________
felul ciclului menstrual (regulat, neregulat) dup ce perioad de timp sa stabilit ciclul
menstrual regulat
_______________________________________________________________________
modificrile ciclului menstrual dup nceputul vieii conjugale, dup avorturi,
natere_________________________________________________________________
18

data ultimei menstruaii normale________________________________________


Funcia de reproducere
_____________________________________________________________________________
_________________________________________________________________
Luat n eviden la ______________________________________________________
Prima micare a ftului___________________________________________________
Vizite efctuate la medicul de familie_________________________________________
Examen obiectiv
starea general____________________________________
TA (S)__________ (D)____________ puls _____________
Greutatea _______________________
Talia___________________________
Diametrul bispinos________________
Diametrul bicrest_________________
Diametrul bitrohanterian___________
Conjugata externa________________
nlimea fundului uterin__________
Cicumferina abdomenului_________
Btile cordului fetal_________________________________________
Vrsta sarcinii la ziua de azi: ___________________Saptmni de sarcin:
Prima zi a ultimei menstruaii__________
Prima vizit la medic ____________________
Prima micare a ftului___________________
USG______________________________
Examen obiectiv_____________________

_____________________
_____________________
____________________
_____________________
_____________________

Concediu prenatal__________________________________________________
Data naterii_______________________________________________________
Diagnosticul n ziua examinrii_____________________________________________
_______________________________________________________________________

Evaluarea cantitativ a deprinderilor preactice realizate


Nr.
d/o
1.
2.
3.
4.
5.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului ____________________
19

Tema 5
Subiectul: ngrijirea a parturientelor cu hemoragii n natere.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de acordarea ajutorului
de urgen i ngrijire a parturientelor cu hemoragii n natere.
ABILITI :
1.
2.
3.
4.
5.
6.
7.
8.

Culegerea anamnezei la parturiente.


Aprecierea strii generale a parturientei.
Completarea fiei obstetricale.
Auscultaia btilor cordului fetal.
Aprecierea semnelor de decolare a placentei.
Aplicarea procedeelor de expulsie a placentei.
Examinarea placentei.
Determinarea cantitii de snge pierdut n natere.
Desfurarea leciei practice:
1. Numii perioada naterii, care cel mai frecvent se complic cu
hemoragii.
______________________________________________________

2. Completai fraza.
n dezlipirea si expulzia fiziologica a placentei parturienta pierde ___________ ml
de singe. O hemoragie mai abundenta, care depaseste cantitatea de _______ ml, e
tratata ca o hemoragie patologica. Pierderea de singe de la ____________ ml pina
la _______ml se trateaza ca limitrofa.
3. Denumii cauzele hemoragilor cu caracter patologic in perioada de
delivrenta.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
4.

Descriei formele patologice de insertie a placentei.

Placenta aderenta

20

Placenta acreta

Plcenta increta

Placenta percreta

Placenta transcreta

5. Descriei manifistrile clinice a inseriei patologice a placentei.


__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
6. Relatai msurile urgente in cazurile cid hemoragia a depit
parametrii fiziologici 250 ml.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Evaluarea cantitativ a deprinderilor preactice realizate
Nr.
d/o
1.
2.
3.
4.
5.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului ___________________
21

Tema 6
Subiectul: ngrijirea gravidelor cu anemiile n sarcin.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire a
gravidelor cu anemiile n sarcin.
ABILITI :
9. Culegerea anamnezei la gravide.
10.Aprecierea strii generale a gravidei.
11.Depistarea sindromului anemic i sideropenic la gravide.
12.Supravegherea i ngrijirea gravidelor cu anemii.
13.Descrierea tratamentului curativ i profilactic conform Protocolului Clinic
Naional.
14.Administrarea preparatelor de fier.
15.Promovarea alimentaiei corecte.
16.Proiectarea i realizarea convorbirii Profilaxia anemiilor la gravide,
alimentaia corect n sarcin.
Desfurarea leciei practice:
1. Completeaz cuvintele lips n definiie:
Anemia reprezint_________________, care se caracterizeaz prin
micorarea____________ i numrului___________ntr-o unitate de volum
a____________________.
2. Citete ntrebarea i variantele de rspuns. Alege litera corespunztoare
variantelor de rspuns corecte (rspuns multiplu).
2.1 Manifestrile clinice ale anemiei feriprive includ urmtoarele sindroame:
a) gastrointestinal
b) anemic
c) sideropenic
d) neurologic
2.2 Anemia B12 deficitar include urmtoarele sindroame:
a) anemic
b) neurologic
c) sideropenic
d) gastroenterologic
22

2.3 n anemia feripriv prin analiza general a sngelui se poate determina:


a) micorarea coninutului de hemoglobin i a numrului de eritrocite
b) micorarea trombocitelor
c) mrirea leucocitelor
d) fierul seric este micorat
3. Scriei 4 semne caracteristice sindromului anemic la gravide:
__________________________________________________________________
__________________________________________________________________
____________________________________________________________
4. Descriei 5 factori predispozani pentru deficitul de fier la gravide:
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
5. La gravida cu vrsta sarcinii 28 sptmni cu nivelul hemoglobinei 110g/l se
determin:
a) anemie gradul I
b) hemodiluie fiziologic
c) anemie prin deficit de acid folic
6.Uscciune n cavitatea bucal cu dereglarea masticaiei i formrii bolului
alimentar caracterizeaz urmtorul sindrom:
a) anemic
b) neurologic
c) sideropenic
7. Metoda de baz a tratamentului anemiei feriprive este:
a) administrarea acidului folic
b) administrarea preparatelor de fier
c) administrarea produselor vegetale
INTEROGAREA GRAVIDEI
Nume ______________Prenume____________________________________________
Data naterii____________________________________________________________
Domiciliul______________________________________________________________
Profesia ________________________________________________________________
Condiiile de munc______________________________________________________
Starea civil__________________Anul prezentei cstorii______________________
Condiii de trai__________________________________________________________
Sntatea tatlui
Vrsta ________________
Relaii de rudenie ntre soi ________________________________________________
Antecedente familiale_____________________________________________________
Antecedente personale ____________________________________________________
Grupa sanguin _____________________Factorul Rh__________________________
Examen radiologic_______________________________________________________
23

Antecedente n familie i personale la mam _________________________________


_______________________________________________________________________
Funcia Menstrual
vrsta, cnd a aprut prima menstruaie i caracterul ei (cu dureri sau nu, durata menstrei
i cantitatea de snge pierdut
_______________________________________________________________________
felul ciclului menstrual (regulat, neregulat) dup ce perioad de timp sa stabilit ciclul
menstrual regulat
_______________________________________________________________________
modificrile ciclului menstrual dup nceputul vieii conjugale, dup avorturi,
natere_________________________________________________________________
data ultimei menstruaii normale________________________________________
Funcia de reproducere
_____________________________________________________________________________
_________________________________________________________________
Luat n eviden la ______________________________________________________
Prima micare a ftului___________________________________________________
Vizite efctuate la medicul de familie_________________________________________
Examen obiectiv
starea general____________________________________
TA (S)__________ (D)____________ puls _____________
Greutatea _______________________
Talia___________________________
Diametrul bispinos________________
Diametrul bicrest_________________
Diametrul bitrohanterian___________
Conjugata externa________________
nlimea fundului uterin__________
Cicumferina abdomenului_________
Btile cordului fetal_________________________________________
Vrsta sarcinii la ziua de azi: ___________________Saptmni de sarcin:
Prima zi a ultimei menstruaii__________
Prima vizit la medic ____________________
Prima micare a ftului___________________
USG______________________________
Examen obiectiv_____________________

_____________________
_____________________
____________________
_____________________
_____________________

Concediu prenatal__________________________________________________
Data naterii_______________________________________________________
Masa aproximativ a ftului
1/20 parte din greutatea gravidei______________________________________
FU x CA _________________________________________________________
(FU + CA + Talia + Greutatea) x 10___________________________________
(FU + CA) x 100___________________________________________________
4
Diagnosticul n ziua examinrii_____________________________________________
______________________________________________________________________
24

17. Completai gravidograma.


DINAMICA TENSIUNII ARTERIALE I BTILOR CORDULUI FETAL
Data, luna. Anul
8 sptmni

16 sptmni

22 sptmni

30 sptmni

36sptmni

38 sptmni

180

Btile cordului
fetal

Terminul sarcinii

160
140
120
100
80
200
180
160
140

120
100
80
60
40
EVOLUIA SARCINII I NATERII N CONFORMITATE CU NLIMEA FUNDULUI UTERIN(cm)
45

40

35

30

25

20

15
17

18

19

20 21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

Greutatea iniial (Kg) Adaus la greutate (Kg)

DINAMICA GREUTII PE PARCURSUL SARCINII


20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
-1
-2
-3
4

12

16

20

24

28

32

36

Evaluarea cantitativ a deprinderilor preactice realizate


Nr.
d/o
1.
2.
3.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

40

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului _________________
25

Tema 7
Subiectul: ngrijirea gravidelor cu afeciuni ale sistemului urinar n sarcin.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire gravidelor
cu afeciuni ale sistemului urinar n sarcin.
ABILITI :
1. Caracterizarea factorilor etiologici i favorizani n dezvoltarea maladiilor
sistemului urinar la gravide.
2. Examinarea gravidelor bolnave cu recunoaterea semnelor de boal.
3. Colectarea urinei pentru analiza general, proba Zimnichi, Neciporenco, la
sterilitate.
4. Conduita gravidelor bolnave n viziunea Protocoalelor Clinice Naionale n
vigoare.
5. Argumentarea tratamentului i prevenirea complicaiilor.
6. Proiectarea i realizarea convorbirii Profilaxia maladilor sistemului urinar.
Desfurarea leciei practice:
1. Denumii formele clinice de afeciuni urinare n sarcin.
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
____________________________________
_

2. Denumii factorii favorizani.


_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
3. Enumerai agenii patogeni ce provoac afeciunele urinare n sarcin.

,
,
,
_____________________________________________________________
_____________________________________________________________

26

4. Completai defeniia cu cuvintele omise.


Bacteriuria
asimptomatic se definete prin prezena unei
____________________________________cu peste ____________ de
germeni/ml de ____________evideniat la________________________, n
absena _______________________de infecie a tractului urinar. Mai frecvent
testul este pozitiv ntre a 9 i 17 sptmn de sarcin.
5. Descrii conduita unei gravide cu bacteriuria asimptomatic n sarcin.
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
6. Care din semnele numite, cu excepia unuia se pot ntlni n cistita acut
la gravid?
A. Polachiurie.
B. Disurie.
C. Febr.
D. Dureri n regiunea suprapubian.
E. Hematurie terminal.
7. Care sunt semnele de debut ale pielonefritei acute n sarcin?
A. Febr de 39-40 C.
B.Cefalee.
C. Greuri.
D. Alternarea strii generale.
E. Dureri lombare provocate.
8. Care stri patologice pot masca pielonefrit cronic gestaional, cu
excepia?
A. Disgravide precoce sau tardive.
B.Iminena de avort sau natere prematur.
C.Apendicit cut.
E. Anemie.
9. Care dintre infecii urinare se pot manifesta prin oc toxico-infecios?
A. Cistita acut.
B. Pielonefrit acut purulent.
C. Abcese renale.
D. Abcese perirenale.
E. Bacteriurie asimptomatic.
10. Care semne de laborator pot fi prezentate n pielonefrita acut
gestaional:
A. Anemie hipocrom, coninutul hemoglobinei mai jos de 10 g/l.
B. Leucocitoz, mai mult de 11,3x 103 cel/ml.
C. Piurie, bacteriurie,
D. Proteiurie sub 1,0 g/l.
E. Toate acestea.
11. Msurile profilactice ale infeciilor tractului urinar la gravide includ:
A. Regimul igienic i dietic
27

B. Asanarea focarelor de infeie.


C. Sporirea rezistenei nespecifice a organismului.
D. Depistarea precoce a gravidelor cu risc de dezvoltare a infeciilor urinare n
perioada gestaiei i cu pielonefrita cronic .
E. Toate acestea.
12. Care este perioada sarcinii caracterizat prin risc major de dezvoltare a
infeciilor tractului urinar?
A. Pn la 12 sptmni.
B. 12-28 sptmni
C. 24-30 sptmni.
D. 28-34 sptmni.
E. Dup 30 sptmni.
INTEROGAREA GRAVIDEI
Nume ______________Prenume____________________________________________
Data naterii____________________________________________________________
Domiciliul______________________________________________________________
Profesia ________________________________________________________________
Condiiile de munc______________________________________________________
Starea civil__________________Anul prezentei cstorii______________________
Condiii de trai__________________________________________________________
Sntatea tatlui
Vrsta ________________
Relaii de rudenie ntre soi ________________________________________________
Antecedente familiale_____________________________________________________
Antecedente personale ____________________________________________________
Grupa sanguin _____________________Factorul Rh__________________________
Examen radiologic_______________________________________________________
Antecedente n familie i personale la mam _________________________________
_______________________________________________________________________
Funcia Menstrual
vrsta, cnd a aprut prima menstruaie i caracterul ei (cu dureri sau nu, durata menstrei
i cantitatea de snge pierdut
_______________________________________________________________________
felul ciclului menstrual (regulat, neregulat) dup ce perioad de timp sa stabilit ciclul
menstrual regulat
_______________________________________________________________________
modificrile ciclului menstrual dup nceputul vieii conjugale, dup avorturi,
natere_________________________________________________________________
data ultimei menstruaii normale________________________________________
Funcia de reproducere
_____________________________________________________________________________
_________________________________________________________________
Luat n eviden la ______________________________________________________
Prima micare a ftului___________________________________________________
Vizite efctuate la medicul de familie_________________________________________
Examen obiectiv
starea general____________________________________
TA (S)__________ (D)____________ puls _____________
28

Greutatea _______________________
Talia___________________________
Diametrul bispinos________________
Diametrul bicrest_________________
Diametrul bitrohanterian___________
Conjugata externa________________
nlimea fundului uterin__________
Cicumferina abdomenului_________
Btile cordului fetal_________________________________________
Vrsta sarcinii la ziua de azi: ___________________Saptmni de sarcin:
Prima zi a ultimei menstruaii__________
Prima vizit la medic ____________________
Prima micare a ftului___________________
USG______________________________
Examen obiectiv_____________________

_____________________
_____________________
____________________
_____________________
_____________________

Concediu prenatal__________________________________________________
Data naterii_______________________________________________________
Masa aproximativ a ftului
1/20 parte din greutatea gravidei______________________________________
FU x CA _________________________________________________________
(FU + CA + Talia + Greutatea) x 10___________________________________
(FU + CA) x 100___________________________________________________
4
Diagnosticul n ziua examinrii_____________________________________________
______________________________________________________________________

Evaluarea cantitativ a deprinderilor preactice realizate


Nr.
d/o
1.
2.
3.
4.
5.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului ____________________

29

Tema 8
Subiectul: ngrijirea gravidelor cu afeciuni ale sistemului cardiovascular n
sarcin.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijirea gravidelor
cu afeciuni ale sistemului cardiovascular n sarcin.
ABILITI :
1. Caracterizarea factorilor etiologici i favorizani n dezvoltarea maladiilor
sistemului cardiovascular la gravide.
2. Examinarea gravidelor bolnave cu recunoaterea semnelor de boal.
3. Pregtirea gravidei pentru examenele paraclinice.
4. Supravegherea i ngrijirea gravidelor cu afeciuni ale sistemului cardiovascular.
5. Proiectarea i realizarea convorbirii Profilaxia reumatismului.
Desfurarea leciei practice:
1. Enumerai cele mai frecvente patologii cardiace ntlnite le gravide.
1______________________________
2______________________________
3______________________________
4______________________________
5______________________________
2. Care sunt perioadele critice de acutizare a reumatismului?

3. Descrii evoluia sarcinii la gravide cu reumatism.


_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
4. Care este conduita gravidelor cu reumatism?
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
5. HTA la gravide se consider mrirea tensiunei arteriale de la:
120/80 mm Hg

140/90 mm Hg

160/95 mm Hg

30

6. Caracterizai stadiile HTA conform OMS.

STADIUL I

___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________

STADIUL II

___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________

STADIUL III

___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________
___________________________________________________

7. Descrii eviluia sarcinii la gravide cu HTA.


_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
8. Caracterizai 3 grade de risc n HTA.
Gradul I HTA uoar
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________

Gradul II HTA moderat


_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________

Gradul II HTA moderat


_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________
_________________________

9. Completai enunul .
Hipotonie arterial este n cazul n care tensiunea arterial este egal sau mai
mic de ________________mm Hg.
31

10. Descriei conduita gravidelor cu hipotonia arterial n sarcin.


________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
INTEROGAREA GRAVIDEI
Nume ______________Prenume____________________________________________
Data naterii____________________________________________________________
Domiciliul______________________________________________________________
Profesia ________________________________________________________________
Condiiile de munc______________________________________________________
Starea civil__________________Anul prezentei cstorii______________________
Condiii de trai__________________________________________________________
Sntatea tatlui
Vrsta ________________
Relaii de rudenie ntre soi ________________________________________________
Antecedente familiale_____________________________________________________
Antecedente personale ____________________________________________________
Grupa sanguin _____________________Factorul Rh__________________________
Examen radiologic_______________________________________________________
Antecedente n familie i personale la mam _________________________________
_______________________________________________________________________
Funcia Menstrual
vrsta, cnd a aprut prima menstruaie i caracterul ei (cu dureri sau nu, durata menstrei
i cantitatea de snge pierdut
_______________________________________________________________________
felul ciclului menstrual (regulat, neregulat) dup ce perioad de timp sa stabilit ciclul
menstrual regulat
_______________________________________________________________________
modificrile ciclului menstrual dup nceputul vieii conjugale, dup avorturi,
natere_________________________________________________________________
data ultimei menstruaii normale________________________________________
Funcia de reproducere
_____________________________________________________________________________
_________________________________________________________________
Luat n eviden la ______________________________________________________
Prima micare a ftului___________________________________________________
Vizite efctuate la medicul de familie_________________________________________
Examen obiectiv
starea general____________________________________
TA (S)__________ (D)____________ puls _____________
Greutatea _______________________
Talia___________________________
Diametrul bispinos________________
Diametrul bicrest_________________
Diametrul bitrohanterian___________
Conjugata externa________________
nlimea fundului uterin__________
32

Cicumferina abdomenului_________
Btile cordului fetal_________________________________________
Vrsta sarcinii la ziua de azi: ___________________Saptmni de sarcin:
Prima zi a ultimei menstruaii__________
Prima vizit la medic ____________________
Prima micare a ftului___________________
USG______________________________
Examen obiectiv_____________________

_____________________
_____________________
____________________
_____________________
_____________________

Concediu prenatal__________________________________________________
Data naterii_______________________________________________________
Masa aproximativ a ftului
1/20 parte din greutatea gravidei______________________________________
FU x CA _________________________________________________________
(FU + CA + Talia + Greutatea) x 10___________________________________
(FU + CA) x 100___________________________________________________
4
Diagnosticul n ziua examinrii_____________________________________________
_______________________________________________________________________

11. Completai gravidograma.


DINAMICA TENSIUNII ARTERIALE I BTILOR CORDULUI FETAL
Data, luna. Anul
8 sptmni

Btile cordului
fetal

Terminul sarcinii

16 sptmni

22 sptmni

30 sptmni

36sptmni

38 sptmni

180
160
140
120
100
80
200
180
160
140

120
100
80
60
40
EVOLUIA SARCINII I NATERII N CONFORMITATE CU NLIMEA FUNDULUI UTERIN(cm)
45

40

35

30

25

20

15
17

18

19

20 21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

33

Greutatea iniial (Kg) Adaus la greutate (Kg)

DINAMICA GREUTII PE PARCURSUL SARCINII


20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
-1
-2
-3
4

12

16

20

24

28

32

36

40

Evaluarea cantitativ a deprinderilor preactice realizate


Nr.
d/o
1.
2.
3.
4.
5.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Obiecii____________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului ____________________

34

Tema 9
Subiectul: ngrijirea gravidelor cu diabet zaharat i obezitate n sarcn.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire a
gravidelor cu diabet zaharat i obezitate n sarcn.
ABILITI :
1. Caracterizarea factorilor etiologici i favorizani n dezvoltarea diabetului
zaharat la gravide.
2. Examinarea gravidelor bolnave cu recunoaterea semnelor de boal.
3. Colectarea urinei pentru determinarea glucozuriei.
4. Conduita gravidei bolnave n viziunea Protocolului Clinic Naional n vigoare.
5. Argumentarea tratamentului i prevenirea complicaiilor.
6. Prescrierea regimului alimentar gravidelor bolnave.
7. Acordarea asistenei de urgen n coma diabetic i hipoglicemic.
8. Proiectarea i realizarea convorbirii Dieta i regimul n diabetul zaharat.
Desfurarea leciei practice:
1. Completai definiia cu cuvinte omise.
Diabetul zaharat reprezint o_________________________, caracterizat prin
deficit _____________________________de secreie a __________________n
organism, determinnd dereglarea________________________________, dar, n
primul rnd, a celui__________________.
2. Enimerai factorii de risc n apariia diabetului zaharat.
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
_________________________________________
3. Descriei
evoluia diabetului zaharat la gravide.
_________________________________________
________________________________________________________________
_________________________________________
________________________________________________________________
________________________
35

________________________________________________________________
________________________________________________________________
4. Descriei evoluia sarcinii la gravide cu diabet zaharat.
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
5. Enumerai contraindicaii pentru sarcin.
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
________________________________________________________
6. Numii________________________________________________________
forme de obezitate
________________________________________________________
________________________________________________________
____________

20%

10%

70%

7. Completai enunul.
Conform clasificrii, prin obezitate se subnelege surplusul ponderal de
________% i mai mult.
8. Descrii gradul obezitii apreciat prin adaos la masa corporal n %.
Gr.I_________
_

Gr.II________
__

Gr.III________
__

Gr.IV_______
___

Gradul obezitii se determin conform formulei Broca


M = H - 100
unde M - masa necesar (kg)
H - nlimea (cm))
7. Descrii cmplicaiile sarcinii i naterii la gravidele obeze.
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________

36

8. Completai gravidograma.
DINAMICA TENSIUNII ARTERIALE I BTILOR CORDULUI FETAL
Data, luna. Anul
8 sptmni

16 sptmni

22 sptmni

30 sptmni

36sptmni

38 sptmni

180

Btile cordului
fetal

Terminul sarcinii

160
140
120
100
80
200
180
160
140

120
100
80
60
40
EVOLUIA SARCINII I NATERII N CONFORMITATE CU NLIMEA FUNDULUI UTERIN(cm)
45

40

35

30

25

20

15
17

18

19

20 21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

Greutatea iniial (Kg) Adaus la greutate (Kg)

DINAMICA GREUTII PE PARCURSUL SARCINII


20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
-1
-2
-3
4

12

16

20

24

28

32

36

40

Evaluarea cantitativ a deprinderilor preactice realizate


Nr.
d/o
1.
2.
3.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului ____________________
37

Tema 10
Subiectul: ngrijirea gravidelor cu insuficien feto-placentar i incompatibilitate
sanguin feto-matern n sarcin.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire a
gravidelor cu insuficien feto-placentar i incompatibilitate sanguin fetomatern.
ABILITI :
1. Aprecierea strii generale a gravidei.
2. Identificarea factorilor de risc n dezvoltarea insuficienei fetoplacentare.
3. Auscultaia btilor cordului fetal.
4. Aprecierea probelor funcionale de efort.
5. Supravegherea i ngrijirea gravidelor cu insuficien fetoplacentar.
6. Identificarea cazurilor de imunizare a femeii i aprecierea gradului de imunizare.
7. Supravegherea i ngrijirea gravidelor cu incompatibilitate sanguin fetomatern.
8. Proiectarea i realizarea convorbirii Profilaxia bolii hemolitice a nounscutului.
Desfurarea leciei practice:
1. Completai definiia cu cuvinte omise.
Hipoxia fetal este o ______________________________________________,
determinat de __________________________________ sau de o lips de
utilizare a ____________________la nivelul esuturilor.
2. Denumii cele 5 tipuri de hipoxie.
1.________________________________________
2.________________________________________
3.________________________________________
4.________________________________________
5.________________________________________

3. Enumerai factorii de risc major ce duc la insuficiena placentar.


________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________

38

4. Descrii diagnosticul clinic al hipoxiei acute.


A.______________________________________________________________
________________________________________________________________
________________________________________________________________
B.______________________________________________________________
________________________________________________________________
________________________________________________________________
C.______________________________________________________________
________________________________________________________________
________________________________________________________________
5. Descrii probele funcionale pentrul diagnosticul hipoxiei cornice.
PROBA
FUNCIONAL
DE EFORT

PROBA CU
OXITOCIN

PROBA DE
REINERE A
RESPIRAIEI

NUMRAREA
MICRILOR
INTRAUTERINE ALE
FTULUI N
DINAMIC.
PROBA

TERMIC

__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
______________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
______________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
______________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
______________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
______________
39

5. Descriei conduit gravidei cuhipoxie fetal.


__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
6. Completai definiia cu cuvinte omise.
Hipotrofia fetal reprezint o _______________________________intrauterin
a produsului de concepie care are o ______________________________celei
normale pentru _____________________________la care s-a nscut.
7. Descrii etiologia hipotrofiei fetale.
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
__________________________________________________________
______________

8. Caracterizai cele 2 tipuri de hipotrofie fetal.


Asimetric
Simetric
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
___________________________
Incompatibilitatea sanguin
fetomatern.
__
1. Completai__definiia cu cuvinte omise.
Allo-imunizarea i izoimunizarea este _______________________________a
unui individ de anumit specie ca rspuns la aciunea ___________________ce
aparine _____________________________de aceeai specie.
Incompatibilitatea sanguin feto-matern este cauzat de conflictul imunologic
declanat de antigenul, care este fixat pe hematiile fetale.
2. Descriei cazurile imunizrii femeilor.
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________
____________________________________________________________

40

3. Denumii factorii care influeneaz gradul de izoimunizare a


organismului matern i afectarea ftului.
1.____________________________________________________________
_____________________________________________________________
2.____________________________________________________________
_____________________________________________________________
3.____________________________________________________________
_____________________________________________________________
4.____________________________________________________________
_____________________________________________________________
5.____________________________________________________________
_____________________________________________________________
6.____________________________________________________________
_____________________________________________________________
4. Descrii evoluia sarcinii.
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
_______________________________________________________
5. Denumii
metodele de stabilire diagnosticului sarcinii.
_______________________________________________________
__________________________________________________
_______________________________________________________
__________________________________________________
_______________________________________________________
__________________________________________________
_______________________________________________________
_______________________________________________________
__________________________________________________
_______________________________________________________
__________________________________________________
6. Care_______________________________________________________
este conduita sarcinii?
____________________

_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
Completai gravidograma.

DINAMICA TENSIUNII ARTERIALE I BTILOR CORDULUI FETAL


Data, luna. Anul
8 sptmni

Btile cordului
fetal

Terminul sarcinii

16 sptmni

22 sptmni

30 sptmni

36sptmni

38 sptmni

180
160
140
120
100
80
200
180
160
140

120
100
80
60
40

41

EVOLUIA SARCINII I NATERII N CONFORMITATE CU NLIMEA FUNDULUI UTERIN(cm)


45

40

35

30

25

20

15
17

18

19

20 21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

Greutatea iniial (Kg) Adaus la greutate (Kg)

DINAMICA GREUTII PE PARCURSUL SARCINII


20
19
18
17
16
15
14
13
12
11
10
9
8
7
6
5
4
3
2
1
-1
-2
-3

Evaluarea cantitativ a deprinderilor preactice realizate


4

Nr.
d/o
1.
2.
3.
4.
5.

12

DENUMIREA DEPRINDERII
PRACTICE

16

20

24

28

CANTITATEA

32

36

40

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Obiecii____________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului ___________________
42

Tema 11
Subiectul: ngrijirea gravidelor cu infecia HIV/SIDA n sarcin.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire a
gravidelor cu infecia HIV/SIDA n sarcin.
ABILITI :
1. Aprecierea strii generale a gravidei.
2. Expunerea influienei infeciei HIV asupra sarcinii, influienei sarcinii asupra
infeciei HIV.
3. Conduita sarcinii la gravidele cu infecia HIV.
4. Profilaxia transmiterii infeciei HIV de la mam la ft.
5. Descrierea principiilor tratamentului antiretroviral.
6. Respectarea precauiilor standard la locul de munc.
7. Supravegherea i ngrijirea gravidelor cu infecia HIV/SIDA.
Desfurarea leciei practice:
1. Completai definiia.
SIDA este o maladie__________________________________________________
__________________________________________________________________
__________________________________________________________________
2. Care din afirmaiile de mai jos este adevrat:
a. n Republica Moldova majoritatea consumatorilor de droguri intravenoase
sunt HIV infectai
b. n Republica Moldova se constat tendina c principala cale de rspndire a
infeciei va fi schimbul de seringi printre consumatorii de droguri
intravenoase
c. n Republica Moldova nu exist riscul de epidemie HIV/SIDA deoarece
prevalena maladiei este net inferioar comparativ cu Ukraina
d. n Republica Moldova ultimii ani a crescit rata pacienilor HIV infectai pe
cale sexual
3. n Republica Moldova cea mai mare rat de pacieni HIV infectai se
constat la:
a. Chiinu
b. Bi
c. Cahul
d. Briceni
4. Agentul etiologic al infeciei HIV este :
a. adenovirus
b. retrovirus
43

c. compilavirus
5. Virusul HIV afecteaz:
a. macrofagii
b. limfocitele
c. leucocitele
d. eritrocitele
e. nici una din variantele enumerate
6. n Republica Moldova, domin infecia cu subtipul virusului HIV:
a. C
b. B
c. A
7. Virusul HIV se caracterizeaz prin:
a. variabilitate antigenic nalt
b. variabilitate antigenic joas
c. lipsa variabilitii antigenice
8. Este oare adevrat afirmaia Testul la HIV negativ indic lipsa
infectrii:
a. Da
b. Nu
9. Virusul HIV:
a. pierde viabilitatea i virulena n materialul biologic pstrat la temperaturi
joase
b. manifest o sensibilitate major la temperaturi ridicate
c. fierberea nu inactiveaz virusul
10.Transmiterea pe vertical a infeciei HIV nseamn:
a. transmiterea virusului de la adult la copil
b. transmiterea virusului de la mam la ft
c. transmiterea virusului de la copil la copil
11.Perioada cea mai susceptibil pentru transmiterea infeciei HIV de la
mam la ft, este:
a. primul trimestru
b. al doilea trimestru
c. sfritul sarcinii
d. travaliul
12.Care factori influieneaz riscul de transmitere a infeciei HIV de la
mam la ft:
e. stadiul maladiei
f. nivelul viremiei plasmatice
g. durata perioadei alichidiene
h. durata travaliului
i. subtipul virusului
j. terapia antiretroviral
k. modul de natere
l. toi cei enumerai
44

13.Care din urmtorele complicaii ale sarcinii sunt asociate cu imfecia HIV:
a. preeclampsia
b. diabetul gestaional
c. materea prematur
d. infertilitatea
e. Masa mic la natere (<2500 g)
14.Care sunt scopurile supravegherii obstetricale antepartum:
a. Consilierea gravidei n necesitatea ntreruperii sarcinii.
b. Detectarea i prevenirea naterii premature.
c. Efectuarea amniocentezei sau a biopsiei corionului pentru depistarea la timp
a anomaliilor
d. Detectarea i tratamentul infeciilor sexual transmisibile
e. Profilaxia antiretroviral a transmiterii infeciei HIV de la mam la ft
Planificarea modului de natere
15.Care din strategiile de mai jos sunt mai cost-eficiente n redicerea riscului
de transmitere a infeciei HIV de la mam la ft:
a. Prevenirea infectrii brbatului prin promovarea sexului protejat (condom)
b. Prevenirea infectrii femeii i brbatului prin promovarea sexului cu
parteneri cu statutul HIV cunoscut
c. Prevenirea sarcinii la femeile HIV infectate
d. Profilaxia antiretroviral n sarcin i natere
e. Alptarea artificial
f. Alptarea exclusiv la sn
16.Dac mama nu-i cunoate statutul HIV, ea trebuie ncurajat s:
a. alpteze la sn
b. alimenteze copilul cu amestecuri pn la stabilirea statutului HIV
17.Trecerea de la alimentaia la sn la cea artificial la femeia HIV infectat
trebuie s fie:
a. rapid, imediat
b. lent, pas cu pas
Evaluarea cantitativ a deprinderilor preactice realizate
Nr.
d/o
1.
2.
3.
4.
5.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului ____________________
45

Tema 12
Subiectul: Infecia HIV/SIDA i sarcina. Stigma i discriminarea gravidelor care
triesc cu HIV.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor de conduit a sarcinii la
gravidlele HIV infectate i reducerii stigmii i discriminrii persoanelor care
triesc cu HIV.
ABILITI :
1. Aprecierea strii generale a gravidei.
2. Identificarea barierelor n dezvoltarea unei asistene calitative persoanelor care
triesc cu HIV.
3. Definirea noiunei de steriotip i caracteristicile principale ale stereotipurilor.
4. Relatarea noiunei de stigm i discriminare.
5. Expunerea factorilor, care contribuie la dezvoltarea fenomenului stigmatizrii la
nivel social a persoanelor cu HIV i consecinelor ale stigmatizrii i
discriminrii persoanelor care triesc cu HIV/SIDA.
6. Expunerea drepturile persoanelor care triesc (sau sunt suspectate) cu HIV sunt
nclcate prin diverse moduri.
7. Reducerea stigmei i discriminrii fa de persoanele seropozitive.
8. Aplicarea instrumentelor i strategiilor de comunicare n reducerea stigmei i
discriminrii pesoanelor care triesc cu HIV.
Desfurarea leciei practice:
1. Definii noiunea de stigm.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
2. Descriei modaliti de manifestare a stigmei.
1.________________________________________
2.________________________________________
3.________________________________________
4.________________________________________
5.________________________________________

3. Enumerai factorii, care contribuie la dezvoltarea fenomenului


stigmatizrii la nivel social a persoanelor care triesc cu HIV.
46

1.________________________________________
2.________________________________________
3.________________________________________
4.________________________________________
5.________________________________________

4. Definii noiunea de descriminare.


__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
5. Descriei forme de discriminare.
1.________________________________________
2.________________________________________
3.________________________________________
4.________________________________________
5.________________________________________

6. Enumerai consecine ale stigmatizrii i discriminrii persoanelor care


triesc cu HIV/SIDA.
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
7. Relatai abordari contemporane pentru reducerea stigmei i discriminrii
fa de persoanele seropozitive.
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
_______________________________________________________________
Evaluarea cantitativ a deprinderilor preactice realizate
Nr.
d/o
1.
2.
3.
4.
5.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului ___________________
47

Tema 13
Subiectul: ngrijirea gravidelor cu infeciile cu transmitere sexual n sarcn
(sifilisul, gonoreea, herpesul genital, citomegalovirusul).
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire a
gravidelor cu sifilisul, gonoreea, herpesul genital, citomegalovirusul n sarcn.
ABILITI :
1. Aprecierea strii generale a gravidei.
2. Definirea noiunei de ITS, principalele caracteristici ITS, cele mai
frecvente simptome ITS
3. Expunerea etiologiei, tabloului clinic al gonoreei, riscul pentru
sarcin, riscul pentru nou-nscut.
4. Relatarea etiologiei, tabloului clinic sifilisului, riscul pentru sarcin,
riscul pentru nou-nscut.
5. Expunerea etiologiei, tabloului clinic citomegalovirulsului, riscul
pentru sarcin, riscul pentru nou-nscut
6. Relatarea etiologiei, tabloului clinic herpesului genital, riscul pentru
sarcin, riscul pentru nou-nscut.
7. Efectuarea:
inspeciei organelor genitale externe;
examenului n valve;
examenului bacterioscopic;
examenului bacteriologic.
8. Supravegherea i ngrijirea gravidelor cu infecii cu transmitere
sexual.
9. Proiectarea i realizarea convorbirii Profilaxia infeciilor cu
transmitere sexual n sarcin.
Desfurarea leciei practice:
1. Definii noiunea de infeciile cu transmitere sexual.
Infeciile cu transmitere sexual-______________________________________
_____________________________________________________________________________
_____________________________________________________________________________
_____________________________________________________________________________

2. Enumerai principalele caracteristici ale ITS.


_______________________________________
_______________________________________
_______________________________________
_______________________________________
48

3. Denumii cele mai grave ITS care afecteaz sntatea.


__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
4. Caracterizai cele mai frecvente simptome ITS
____________________________________
________________________________________
________________________________________
________________________________________
________________________________________
5. Descriei infecia la alegerea profesorului.(Gonoreia, sifilisul,
citomegalovirusul, herpesul genital).
Infecia Agentul
Cile de
patogen contaminare a
ftului

Riscul
pentru
sarcin

Riscul
Diagnosticul Tratamentul
pentru ft
i profilaxia
i n/n

49

INTEROGAREA GRAVIDEI
Nume ______________Prenume____________________________________________
Data naterii____________________________________________________________
Domiciliul______________________________________________________________
Profesia ________________________________________________________________
Condiiile de munc______________________________________________________
Starea civil__________________Anul prezentei cstorii______________________
Condiii de trai__________________________________________________________
Sntatea tatlui
Vrsta ________________
Relaii de rudenie ntre soi ________________________________________________
Antecedente familiale_____________________________________________________
Antecedente personale ____________________________________________________
Grupa sanguin _____________________Factorul Rh__________________________
Examen radiologic_______________________________________________________
Antecedente n familie i personale la mam _________________________________
_______________________________________________________________________
Funcia Menstrual
vrsta, cnd a aprut prima menstruaie i caracterul ei (cu dureri sau nu, durata menstrei
i cantitatea de snge pierdut
_______________________________________________________________________
felul ciclului menstrual (regulat, neregulat) dup ce perioad de timp sa stabilit ciclul
menstrual regulat
_______________________________________________________________________
modificrile ciclului menstrual dup nceputul vieii conjugale, dup avorturi,
natere_________________________________________________________________
data ultimei menstruaii normale________________________________________
Funcia de reproducere
_____________________________________________________________________________
_________________________________________________________________
Luat n eviden la ______________________________________________________
Prima micare a ftului___________________________________________________
Vizite efctuate la medicul de familie_________________________________________
Examen obiectiv
starea general____________________________________
TA (S)__________ (D)____________ puls _____________
Greutatea _______________________
Talia___________________________
Diametrul bispinos________________
Diametrul bicrest_________________
Diametrul bitrohanterian___________
Conjugata externa________________
nlimea fundului uterin__________
Cicumferina abdomenului_________
Btile cordului fetal_________________________________________
Vrsta sarcinii la ziua de azi: ___________________Saptmni de sarcin:
Prima zi a ultimei menstruaii__________
Prima vizit la medic ____________________

_____________________
_____________________
50

Prima micare a ftului___________________


USG______________________________
Examen obiectiv_____________________

____________________
_____________________
_____________________

Concediu prenatal__________________________________________________
Data naterii_______________________________________________________
Masa aproximativ a ftului
1/20 parte din greutatea gravidei______________________________________
FU x CA _________________________________________________________
(FU + CA + Talia + Greutatea) x 10___________________________________
(FU + CA) x 100___________________________________________________
4
Diagnosticul n ziua examinrii_____________________________________________
_______________________________________________________________________

Evaluarea cantitativ a deprinderilor preactice realizate


Nr.
d/o
1.
2.
3.
4.
5.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Obiecii____________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului ____________________

51

Tema 14
Subiectul: ngrijirea gravidelor cu infeciile cu transmitere sexual n sarcn
(candidomicoza, tricomoniaza, vaginoza bacterian).
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire a
gravidelor cu candidomicoza, tricomoniaza, vaginoza bacterian n sarcn.
ABILITI :
Aprecierea strii generale a gravidei.
Expunerea etiologiei, tabloului clinic al candidomicozei, riscul pentru sarcin,
riscul pentru nou-nscut.
3. Relatarea etiologiei, tabloului clinic tricomoniazei, riscul pentru sarcin,
riscul pentru nou-nscut.
4. Expunerea etiologiei, tabloului clinic citomegalovirulsului, riscul pentru
sarcin, riscul pentru nou-nscut.
5. Relatarea vaginozei bacteriene, tabloului clinic herpesului genital, riscul
pentru sarcin, riscul pentru nou-nscut.
6. Efectuarea:
inspeciei organelor genitale externe;
examenului n valve;
examenului bacterioscopic;
examenului bacteriologic.
10.Supravegherea i ngrijirea gravidelor cu infecii cu transmitere
sexual.
11.Proiectarea i realizarea convorbirii Profilaxia infeciilor cu
transmitere sexual n sarcin.
1.
2.

Desfurarea leciei practice:


Descriei infecia la alegerea profesorului (Candidomicoza, tricomoniaza,
vaginoza bacterian).
Infecia Agentul
Cile de
Riscul
Riscul
Diagnosticul Tratamentul
patogen contaminare a
pentru
pentru ft
i profilaxia
ftului
sarcin
i n/n
52

INTEROGAREA GRAVIDEI
Nume ______________Prenume____________________________________________
Data naterii____________________________________________________________
Domiciliul______________________________________________________________
Profesia ________________________________________________________________
Condiiile de munc______________________________________________________
Starea civil__________________Anul prezentei cstorii______________________
Condiii de trai__________________________________________________________
Sntatea tatlui
Vrsta ________________
Relaii de rudenie ntre soi ________________________________________________
Antecedente familiale_____________________________________________________
Antecedente personale ____________________________________________________
Grupa sanguin _____________________Factorul Rh__________________________
Examen radiologic_______________________________________________________
Antecedente n familie i personale la mam _________________________________
_______________________________________________________________________
Funcia Menstrual
vrsta, cnd a aprut prima menstruaie i caracterul ei (cu dureri sau nu, durata menstrei
i cantitatea de snge pierdut
_______________________________________________________________________
53

felul ciclului menstrual (regulat, neregulat) dup ce perioad de timp sa stabilit ciclul
menstrual regulat
_______________________________________________________________________
modificrile ciclului menstrual dup nceputul vieii conjugale, dup avorturi,
natere_________________________________________________________________
data ultimei menstruaii normale________________________________________
Funcia de reproducere
_____________________________________________________________________________
_________________________________________________________________
Luat n eviden la ______________________________________________________
Prima micare a ftului___________________________________________________
Vizite efctuate la medicul de familie_________________________________________
Examen obiectiv
starea general____________________________________
TA (S)__________ (D)____________ puls _____________
Greutatea _______________________
Talia___________________________
Diametrul bispinos________________
Diametrul bicrest_________________
Diametrul bitrohanterian___________
Conjugata externa________________
nlimea fundului uterin__________
Cicumferina abdomenului_________
Btile cordului fetal_________________________________________
Vrsta sarcinii la ziua de azi: ___________________Saptmni de sarcin:
Prima zi a ultimei menstruaii__________
_____________________
Prima vizit la medic ____________________
_____________________
Prima micare a ftului___________________
____________________
USG______________________________
_____________________
Examen obiectiv_____________________
_____________________
Concediu prenatal__________________________________________________
Data naterii_______________________________________________________
Diagnosticul n ziua examinrii_____________________________________________
______________________________________________________________________

Evaluarea cantitativ a deprinderilor preactice realizate


Nr.
d/o
1.
2.
3.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului ____________________

54

Tema 15
Subiectul: ngrijirea gravidelor cu prezentaie pelvian.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire a
gravidelor cu prezentaie pelvian.
ABILITI :
1. Culegerea anamnezei la gravide.
2. Aprecierea strii generale a gravidei.
3. Determinarea vrstei sarcinii, datei naterii, datei concediului prenatal.
4. Palparea abdomenului dup Leopold.
5. Auscultaia btilor cordului fetal.
6. Asistena n natere n prezentaia pelvian.
7. Supravegherea i ngrijirea gravidelor cu prezentaie pelvian.
Desfurarea leciei practice:
1. Descriei cauzele prezentaiei pelviene.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
2. Clasificai prezentaiile peelviene.

3. Descrii evoluia sarcinii n prezentaiile pelviene.

n prima perioad a sarcinii


____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________
____________________________

n a doua jumtate a sarcinii


_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________
_____________________________

55

4. Descriei problema.
n maternitate a fost internat multipara C., 25 ani cu travaliu regulat
ce a ncepu 8 ore n urm.
Sarcini II. I sarcin a avut loc trei ani n urm, sarcina i naterea au evoluat
normal.
Examenul obiectiv:
Starea parturientei este satisfctoare. TA 120/70 mmHg, ps 78 b/min, culoarea
tegumentelor i mucoaselor vizibile roz-pal. Circumferina abdomenului 94cm,
nlimea fundului uterin 36cm.
Dimensiunile bazinului 25 29 31 21cm
Prezentaie longutidinal. La fundul uterin se palpeaz o parte dur, voluminoas,
cu contur precis, baloteaz. Partea prezentat este moale, cu contur neprecis, fixat
la intrarea n bazinul mic.
Btile cordului fetal se determin n stnga, mai jos de ombilic, clare, ritmice 140
b/min.
S-au scurs apele fetale conin meconiu.
Masa aproximativ a ftului 3200gr.
Tactul vaginal :
Vaginul liber, colul uterin ters, dilatarea 6 cm,punga apelor lipsete, n vagin se
determin ambele picioare, fesele nu se disting. Promontoriul nu se distinge.
Care este conduit naterii?
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
INTEROGAREA GRAVIDEI
Nume ______________Prenume____________________________________________
Data naterii____________________________________________________________
Domiciliul______________________________________________________________
Profesia ________________________________________________________________
Condiiile de munc______________________________________________________
Starea civil__________________Anul prezentei cstorii______________________
Condiii de trai__________________________________________________________
Sntatea tatlui
Vrsta ________________
Relaii de rudenie ntre soi ________________________________________________
Antecedente familiale_____________________________________________________
Antecedente personale ____________________________________________________
Grupa sanguin _____________________Factorul Rh__________________________
Examen radiologic_______________________________________________________
Antecedente n familie i personale la mam _________________________________
_______________________________________________________________________
Funcia Menstrual
vrsta, cnd a aprut prima menstruaie i caracterul ei (cu dureri sau nu, durata menstrei
i cantitatea de snge pierdut
_______________________________________________________________________
56

felul ciclului menstrual (regulat, neregulat) dup ce perioad de timp sa stabilit ciclul
menstrual regulat
_______________________________________________________________________
modificrile ciclului menstrual dup nceputul vieii conjugale, dup avorturi,
natere_________________________________________________________________
data ultimei menstruaii normale________________________________________
Funcia de reproducere
_____________________________________________________________________________
_________________________________________________________________
Luat n eviden la ______________________________________________________
Prima micare a ftului___________________________________________________
Vizite efctuate la medicul de familie_________________________________________
Examen obiectiv
starea general____________________________________
TA (S)__________ (D)____________ puls _____________
Greutatea _______________________
Talia___________________________
Diametrul bispinos________________
Diametrul bicrest_________________
Diametrul bitrohanterian___________
Conjugata externa________________
nlimea fundului uterin__________
Cicumferina abdomenului_________
Btile cordului fetal_________________________________________
Vrsta sarcinii la ziua de azi: ___________________Saptmni de sarcin:
Prima zi a ultimei menstruaii__________
_____________________
Prima vizit la medic ____________________
_____________________
Prima micare a ftului___________________
____________________
USG______________________________
_____________________
Examen obiectiv_____________________
_____________________
Concediu prenatal__________________________________________________
Data naterii_______________________________________________________
Masa aproximativ a ftului
1/20 parte din greutatea gravidei______________________________________
FU x CA _________________________________________________________
(FU + CA + Talia + Greutatea) x 10___________________________________
(FU + CA) x 100___________________________________________________
4

Evaluarea cantitativ a deprinderilor preactice realizate


Nr.
d/o
1.
2.
3.
4.
5.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului ___________________
57

Tema 16
Subiectul: ngrijirea gravidelor cu bazin strmtat.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire a
gravidelor cu bazin strmtat.
ABILITI :
1.
2.
3.
4.
5.
6.
7.
8.

Culegerea anamnezei la gravide.


Aprecierea strii generale a gravidei.
Determinarea vrstei sarcinii, datei naterii, datei concediului prenatal.
Msurarea dimensiunilor bazinului.
Aprecierea indicelui Soloviov.
Determinarea masei aproximative a ftului.
Aprecierea rombului Mihaelis.
Supravegherea i ngrijirea gravidelor i parturientelor cu bazin strmtat.

Desfurarea leciei practice


1. Definii bazinul strmtat.

Bazinul anatomic srmtat esteBazinul clinic srmtat este_____________________________


_________________________________
_____________________________
_________________________________
_____________________________
_________________________________
_____________________________
_________________________________
_____________________________
_________________________________
_____________________________
_________________________________
2.
Descriei
etiologia
bazinului
strmtat.
_____________________________
_________________________________
__________________________________________________________________
_____________________________
_________________________________
__________________________________________________________________
_____________________________
_________________________________
__________________________________________________________________
_____________________________
____________________________
__________________________________________________________________
_____________________________
3. Clasificai bazinul dup forma de strmtare.
______
1__________________________________
2__________________________________
Forme des ntlnite
3__________________________________
4__________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
___________________________________
Forme rar ntlnite
___________________________________
_________________
___________________________________
___________________________________
___________________________________

58

4. Gradul de strmtare al bazinului este determinat dup dimensiunea


________________________.
5. Clasificai bazinul strmtat dup gradul de strmtare.
Gradul II
Gradul III
Gradul I
____________________
_____________________
____________________
____________________
_____________________
____________________
____________________
_____________________
____________________
____________________
_____________________
____________________
____________________
_____________________
____________________
6. Descrii evoluia sarcinii
n bazin strmtat.
____________________
_____________________
____________________
________________________________________________________________
____________________
_____________________
____________________
________________________________________________________________
____________________
_____________________
____________________
________________________________________________________________
____________________
_____________________
____________________
________________________________________________________________
____________________
_____________________
____________________
7. Descrii evoluia naterii
n bazin strmtat.
____________________
_____________________
____________________
________________________________________________________________
____________________
_____________________
____________________
________________________________________________________________
____________________
_____________________
____________________
________________________________________________________________
____________________
_____________________
____________________
________________________________________________________________
____________________
_____________________
____________________
8.
Rezolvai
problema.
____________________
__________
____________________
n
maternitate
a
fost
internat
gravida
C.,
22ani.
Vrsta
sarcinii 39-40 sptmni.
_____
_____
Acuze nu prezint.
Abdomenul este mrit conform vrstei sarcinii. nlimea fundului uterin 32 cm.
Circumferina abdomenului 105 cm. Greutatea gravidei 68 kg. Dimensiunile
bazinului 24-26-28- 19cm.
1. Determinai masa aproximativ a ftului.
2. Denumili forma bazinului lund n consideralie dimensiunile.
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
INTEROGAREA GRAVIDEI
Nume ______________Prenume____________________________________________
Data naterii____________________________________________________________
Domiciliul______________________________________________________________
Profesia ________________________________________________________________
Condiiile de munc______________________________________________________
Starea civil__________________Anul prezentei cstorii______________________
Condiii de trai__________________________________________________________
Sntatea tatlui
Vrsta ________________
Relaii de rudenie ntre soi ________________________________________________
Antecedente familiale_____________________________________________________
Antecedente personale ____________________________________________________
Examen radiologic_______________________________________________________
59

Funcia Menstrual
vrsta, cnd a aprut prima menstruaie i caracterul ei (cu dureri sau nu, durata menstrei
i cantitatea de snge pierdut
_______________________________________________________________________
felul ciclului menstrual (regulat, neregulat) dup ce perioad de timp sa stabilit ciclul
menstrual regulat
_______________________________________________________________________
modificrile ciclului menstrual dup nceputul vieii conjugale, dup avorturi,
natere_________________________________________________________________
data ultimei menstruaii normale________________________________________
Funcia de reproducere
_____________________________________________________________________________
_________________________________________________________________
Luat n eviden la ______________________________________________________
Prima micare a ftului___________________________________________________
Vizite efctuate la medicul de familie_________________________________________
Examen obiectiv
starea general____________________________________
TA (S)__________ (D)____________ puls _____________
Greutatea _______________________
Talia___________________________
Diametrul bispinos________________
Diametrul bicrest_________________
Diametrul bitrohanterian___________
Conjugata externa________________
nlimea fundului uterin__________
Cicumferina abdomenului_________
Btile cordului fetal_________________________________________
Vrsta sarcinii la ziua de azi: ___________________Saptmni de sarcin:
Prima zi a ultimei menstruaii__________
_____________________
Prima vizit la medic ____________________
_____________________
Prima micare a ftului___________________
____________________
USG______________________________
_____________________
Concediu prenatal__________________________________________________
Data naterii_______________________________________________________
Masa aproximativ a ftului
1/20 parte din greutatea gravidei______________________________________
FU x CA _________________________________________________________
(FU + CA + Talia + Greutatea) x 10___________________________________
(FU + CA) x 100___________________________________________________
4

Evaluarea cantitativ a deprinderilor preactice realizate


Nr.
d/o
1.
2.
3.
4.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
_______________________________________________________________
Semntura profesorului ____________________
60

Tema 17
Subiectul: ngrijirea gravidelor cu prezentaiile transverse i oblice, sarcina
multipl.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire a
gravidelor cu prezentaiile transverse i oblice, sarcina multipl.
ABILITI :
1. Culegerea anamnezei la gravide.
2. Aprecierea strii generale a gravidei.
3. Determinarea vrstei sarcinii, datei naterii, datei concediului prenatal.
4. Palparea abdomenului dup Leopold.
5. Msurarea circumferinei abdomenului i nlimii fundului uterin.
6. Auscultaia btilor cordului fetal.
7. Supravegherea i ngrijirea gravidelor cu prezentaii transverse i oblice.
8. Supravegherea i ngrijirea gravidelor i parturientelor cu sarcin multipl.

Desfurarea leciei practice:


1. Definii prezentaia transvers i oblic.

Prezentaia transvers este - _______________________________________


________________________________________________________________
________________________________________________________________
Prezentaia oblic este - ___________________________________________
________________________________________________________________
________________________________________________________________
5. Denumii metode de diagnosticaree a prezentaiei transverse i oblice.
________________________________________________________________
________________________________________________________________
________________________________________________________________
________________________________________________________________
6. Descrii conduita obstetrical n prezentaiile transverse i oblice.
________________________________________________________________
________________________________________________________________
________________________________________________________________
61

Sarcina multipl
1. Definii sarcina multipl.
Sarcina multipl este - ___________________________________________
________________________________________________________________
_____________________________________________________________
Copiii ce se nasc din sarcin multipl se numesc-__________________.
2. Caracterizai sarcina gemelar
Bivitelin (biovular, bizigot) Univitelin (monoovular,
monozigot)

3. Descrii diagnosticul sarcinii multiple.


________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

4. Caracterizai evoluia sarcinii i naterii n sarcina multipl.


________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________

62

INTEROGAREA GRAVIDEI
Nume ______________Prenume____________________________________________
Data naterii____________________________________________________________
Domiciliul______________________________________________________________
Profesia ________________________________________________________________
Condiiile de munc______________________________________________________
Starea civil__________________Anul prezentei cstorii______________________
Condiii de trai__________________________________________________________
Sntatea tatlui
Vrsta ________________
Relaii de rudenie ntre soi ________________________________________________
Antecedente familiale_____________________________________________________
Antecedente personale ____________________________________________________
Grupa sanguin _____________________Factorul Rh__________________________
Examen radiologic_______________________________________________________
Antecedente n familie i personale la mam _________________________________
_______________________________________________________________________
Funcia Menstrual
vrsta, cnd a aprut prima menstruaie i caracterul ei (cu dureri sau nu, durata menstrei
i cantitatea de snge pierdut
_______________________________________________________________________
felul ciclului menstrual (regulat, neregulat) dup ce perioad de timp sa stabilit ciclul
menstrual regulat
_______________________________________________________________________
modificrile ciclului menstrual dup nceputul vieii conjugale, dup avorturi,
natere_________________________________________________________________
data ultimei menstruaii normale________________________________________
Funcia de reproducere
_____________________________________________________________________________
_________________________________________________________________
Luat n eviden la ______________________________________________________
Prima micare a ftului___________________________________________________
Vizite efctuate la medicul de familie_________________________________________
Examen obiectiv
starea general____________________________________
TA (S)__________ (D)____________ puls _____________
Greutatea _______________________
Talia___________________________
Diametrul bispinos________________
Diametrul bicrest_________________
Diametrul bitrohanterian___________
Conjugata externa________________
nlimea fundului uterin__________
Cicumferina abdomenului_________
Btile cordului fetal_________________________________________
Vrsta sarcinii la ziua de azi: ___________________Saptmni de sarcin:
Prima zi a ultimei menstruaii__________
Prima vizit la medic ____________________

_____________________
_____________________
63

Prima micare a ftului___________________


USG______________________________
Examen obiectiv_____________________

____________________
_____________________
_____________________

Concediu prenatal__________________________________________________
Data naterii_______________________________________________________
Masa aproximativ a ftului
1/20 parte din greutatea gravidei______________________________________
FU x CA _________________________________________________________
(FU + CA + Talia + Greutatea) x 10___________________________________
(FU + CA) x 100___________________________________________________
4
Diagnosticul n ziua examinrii_____________________________________________
_______________________________________________________________________

Evaluarea cantitativ a deprinderilor preactice realizate


Nr.
d/o
1.
2.
3.
4.
5.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Obiecii____________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului ____________________

64

Tema18
Subiectul: ngrijirea gravidelor n naterea prematur, sarcina supramaturat,
naterea ntrziat.
Data: _____________
COMPETENA SPECIFIC:
Dobndirea cunotinelor i formarea deprinderilor practice de ngrijire a
gravidelor n naterea prematur, n sarcina supramaturat, naterea ntrziat.
ABILITI :
1. Culegerea anamnezei la gravide.
2. Aprecierea strii generale a gravidei.
3. Palparea abdomenului dup Leopold.
4. Auscultaia btilor cordului fetal.
5. Expunerea cauzelor declanrii naterii premature.
6. Identificarea semnelor prematuritii ftului.
7. Supravegherea i ngrijirea parturientelor cu natere prematur.
8. Sfaturi gravidelor la ruperea prematur a pungii apelor.
9. Determinarea vrstei sarcinii, datei naterii.
10. Msurarea circumferinei abdomenului.
11. Expunerea particularitilor copilului supramaturat.
Desfurarea leciei practice:
1. Rezolvai testele.
1.Naterea prematur se declaneaz la vrsta sarcinii
a)38-40 sptmni
b)22-37 sptmni
c)16-22 sptmni
2.Ftul prematur are masa de
a)1000-2500 gr
b)2600-3000 gr
c)mai puin de 1000 gr
3.Lungimea ftului prematur este de
a)47-50 cm
b)35-47 cm
c)mai mic de 35 cm
4.La ftul prematur mrimea capului constituie din lungimea corpului
a)1/3parte
b)1/4parte
5.La ftul prematur
a)pielea este de culoarea roie uscat
b)pielea este de culoarea verzuie uscat cu pete de descuamaie, cu maceraie pe palme i
tlpi
d)pielea este de culoarea roz- pal, elastic, acoperit cu resturi de sebum
6.La ftul prematur
65

a)cartilagele urechilor sunt rezistente i elastice


b)pavilioanele urechilor sunt moi
7.La ftul prematur
a)oasele craniului sunt masive i dure, suturile sunt nguste, fontanelele micorate
c)oasele craniului sunt moi, mobile, de multe ori se suprapun unul peste altul
8.La ftul prematur
a)unghiile sunt slab dezvoltate i nu ajung pn la vrful degetelor
b)unghiile sunt lungi, fragile, se rup uor
c)unghiile depesc pulpele degetelor
9.La ftul prematur
a)stratul subcutanat este slab dezvoltat
b)pielea este uscat, cu riduri
10.La ftul prematur
a) testiculele sunt coborte n scrot la biei, la fetie labiile genitale mari acoper labiile
genitale mici
b)testicule nu sunt coborte n scrot la biei, la fetie labiile genitale mari nu le acoper
labiile genitale mici

2. Citii afirmaiile i indicai A dac ele sunt adevrate i F dac sunt


false.

Nr.

Afirmaia

1.

Naterea prematur se declan la vrsta sarcinii de 16-22


s.o
Naterea la termen este naterea la 38-42 s.o.
Sarcina peste 41-42 s.o., la care ftul nu se deosibete prin
nimic de cel matur se numete sarcina prelungit.
Frecvena naterii premature este de 5.8%
Ftul prematur are masa de 1000- 2500 gr.
Lungimea ftului prematur este de 47-50 cm.
La ftul prematur lungimea capului constitue din
lungimea corpului.
La nou-nscutul prematur pielea este de culoare verzue cu
pete de descuamare, cu maceraii pe palme i pe tlpi.
La ftul prematur cartilagele urechelor sunt moi.
La ftul prematur oasele craniulu sunt moi i mobile.
La ftul matur unghiile sunt lungi i fragile.
n sarcina supramaturat se gsesc schimbri patologice n
placent, cum ar fi: semne de regresie, calcificri, regiuni
necrozate.
Copii prezint semne de supramaturizare n toate naterile
ntrziate.
n dinamic dup 42 s.o. se micoreaz vdit dimensiunele

2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.

13.
14.

Adevrat/
Fals

66

15.
16.
17.
18.
19.
20.

abdomenului.
n sarcina supramatur folumul capului copilului este
micorat, oasele sunt moi.
La scurgerea precoce a lichidului amniotic este indicat
spitalizarea de urgen n maternitate.
n sarcina supramaturat are loc schimbarea micrilor
fetale.
La termenul sarcinii de 42 s. o. esre recomandat
spitalizarea gravidei.
Sarcina supramaturat este asociat cu polihidroamnios.
n sarcina supramaturat esti indicat declanarea naterii
pe calea chirurgical, medicamentoas s-au combinat.
INTEROGAREA GRAVIDEI
Nume ______________Prenume____________________________________________
Data naterii____________________________________________________________
Domiciliul______________________________________________________________
Profesia ________________________________________________________________
Condiiile de munc______________________________________________________
Starea civil__________________Anul prezentei cstorii______________________
Condiii de trai__________________________________________________________
Sntatea tatlui
Vrsta ________________
Relaii de rudenie ntre soi ________________________________________________
Antecedente familiale_____________________________________________________
Antecedente personale ____________________________________________________
Grupa sanguin _____________________Factorul Rh__________________________
Examen radiologic_______________________________________________________
Antecedente n familie i personale la mam _________________________________
_______________________________________________________________________
Funcia Menstrual
vrsta, cnd a aprut prima menstruaie i caracterul ei (cu dureri sau nu, durata menstrei
i cantitatea de snge pierdut
_______________________________________________________________________
felul ciclului menstrual (regulat, neregulat) dup ce perioad de timp sa stabilit ciclul
menstrual regulat
_______________________________________________________________________
modificrile ciclului menstrual dup nceputul vieii conjugale, dup avorturi,
natere_________________________________________________________________
data ultimei menstruaii normale________________________________________
Funcia de reproducere
_____________________________________________________________________________
_________________________________________________________________
Luat n eviden la ______________________________________________________
Prima micare a ftului___________________________________________________
Vizite efctuate la medicul de familie_________________________________________
67

Examen obiectiv
starea general____________________________________
TA (S)__________ (D)____________ puls _____________
Greutatea _______________________
Talia___________________________
Diametrul bispinos________________
Diametrul bicrest_________________
Diametrul bitrohanterian___________
Conjugata externa________________
nlimea fundului uterin__________
Cicumferina abdomenului_________
Btile cordului fetal_________________________________________
Vrsta sarcinii la ziua de azi: ___________________Saptmni de sarcin:
Prima zi a ultimei menstruaii__________
Prima vizit la medic ____________________
Prima micare a ftului___________________
USG______________________________
Examen obiectiv_____________________

_____________________
_____________________
____________________
_____________________
_____________________

Concediu prenatal__________________________________________________
Data naterii_______________________________________________________
Masa aproximativ a ftului
1/20 parte din greutatea gravidei______________________________________
FU x CA _________________________________________________________
(FU + CA + Talia + Greutatea) x 10___________________________________
(FU + CA) x 100___________________________________________________
4
Diagnosticul n ziua examinrii_____________________________________________
_______________________________________________________________________

Evaluarea cantitativ a deprinderilor preactice realizate


Nr.
d/o
1.
2.
3.
4.
5.

DENUMIREA DEPRINDERII
PRACTICE

CANTITATEA

SEMNTURA

Concluzii:__________________________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
Semntura profesorului ____________________
68