Professional Documents
Culture Documents
cLISME
' -
intoducerca unor incdi.dtricdrci obliD.rca nrurci iidirirc pcmru cdce&rca brcituh'i KoclL
lubrilicrckqtr, gcl):
minLsid.rni.rink,!iili
epruh.r. pun,{r colccroare p.nh .otecbrca cdnljndulLi elininari alinrnrc. mcdicamentcin tun.rie de sc.p tl indi.x!icl tahdrnd. Lclcoplas. lrosoaDe. serclctc dc hedie: prosop. drmp pcnh ndecl ia lcnjci cj.
- sc cxnLici sco0ulsinccc$r.a. modul dc derutatc a proccduni. dnrar:: . r f (J trtuJ.'tdccntd r dc. .cnh"n, . tr ,nL r; rt, 5c indcpin.azi ndeTa d tari Si se punc ifu-un pabf mt .u qril sondd sc p.ate inlrcduc. pe d1e nazala sdtr bucaE: - pdcimrulesefls.r saurjubt si sicmrc nasulr
se alcgc nafu in
vfitici
sc sc sc
ininlcazi Fc
scnisdand:
dc utuci lilosinldi prcrejeu.i lenjeria enruLui .u un ptus'p sru un ciD]p pLas sub b.rbic: sc misoori dislanFdintu lobnl ulcchii ri vedirl trlsului Dini la.pcndicclc xilbid: sc rrchcdzi loc0lcclor2 nisuritorlsru sc rolcaza di$ilolc dri sonda c{e gradrd: sc di pacicnrului si rint rrlih.mti $rb brrbic: se unczcstc larfirl sordei pen(ru a asiguD inai'rllrll sonft scinrodncccnErij.prinnaEsclectaGnnpiugand-osprcsnarcin jos: inghi!iEa sc fd.c lcil, dind p.cicrtolui la ncvoic canliriti hlci dc ap.'il pacicrtuI ilshitclrini la pri'nu semnl sc o[scni sl.rca pocicrtuluidco!rccc pot atlrc tusea. ozri hlb0riri rospirdbrii. cccx co rftii cr sondaa.juns in Lmhccal p1 agr iinlhniid*'p:r:,,dldoird-.'r'
imbnci ninnsi
ci
:.
'
od.
'tr
d.
inr uJ re J ",. J. i' un u , pcn!ru dinrcnratic sru ifiloduccrcounor mcdicamcnlc 't vcrincdrd tcbuic
'
-Jhr
liou$pri'l
c.trrol ridiolocici cAnd sonda d ajuns in idohc la diviznrca 45 sau 55. in lunclie dc .alcn p. clre I a inrodus. sc lixcazi cu lclcoplasl pc ms adf.l inctl sn nu nnpicdicc voderea si \a fu
screali/eazaobuclidinp! eallbeli!sordqpc.n!apcmirenri\.aNaLibqidcrptrh'iri sc tncc a dona nr.rc: r..isntul ene 4e2t in porric conodii se conrinuilubajul conibn scopnlui ti indicrlici:
M i !u
se
sc lcritici sc asigtrlr
lcnr..bilild'q
sondcii
ri p entru conbatrer incid entelor 'dacaO.cicntulnucol.boto./:l.lrrcconundrcamcdiculuiscpoar.lblosispnyanc$cz1ci - sond. a piiruns jn ciile Espnrrorii (plcicrtulturcstc, sc cidnoaazi) se 'ragc.nacicmu| eslc lis sdsc Liri$.sct, scinccarcidir notri scnalir dc !om{ si arcali sc combd[ pnn rcspiradi p.olunde.
e
I n
dicllii Drivind schi mb rrcn sond ei: - sordclc dc.Nciuctot li lisxrc pc 1..2-:1,
irr ce
din
nlrcrialplaiic,l ?2ilcl
cind cxistl indicailr dc schimb.m I sondci inrE indqinaru si reDu.crc rebuic si un ftprus in timpol nophi dd 6 3 !re: Rn,da sc rcpunc tblosirdcealalli nanni.
crrjc
tava
sx
rnisuii
pcr
n! n'rt$idlci
rninu$
dcrn
blosinli;
lici re.oDuf d aro mcd ictr llli pn vlnd indcninxrer/sc I i'nbro soDdcj i ici P.occdum: tdclentll.nc dc4r i. pdziric renri$czi.dJ \ru .szArd i. tun.riedcsar Bcrcrdlr:
sc vci sc cxp sc 0D icn n'b blirb ir pacicmulu i un prosopi sc spalii ftlinilc \e nnbraci ninusi dc uni.i fblosinLi:
vurinci daci sondi cncpcisari: s. indcDi'rcaza lcrdplastulcu blandclo dcpc nas Jifali: pacicnrul c$Dtugar si i'rttir. sisa riinind in apncci sr pritc sondr nrtrc dceclc sj r! prcselza binc. apoi sc rcrage nrd ni oprodpc dr tamge. rpoi or o m i!.dr. dpidii se tudcpinezi: in tihnulcxtmaciisonJa poarr fi ghidari cu cctrotri,niDi folosind lcNctclc sau proson de hifri. p inzird crpirtrLttbcr: FllcitLl .r. tugI si r.sptr! n.nmL: s. nrf.r u pahrr cu api tlnrnL r \i. l!fa.
sc
n.no7i piloicii pcntunrdepaf.rca 5ra7.i: iruinrc. mor opeotii pcnoinri ir ai [., ea$oscopici.
sonda
rruchcrslu
sotrdo
gdricd
nrai
ni.
cnnidcsticlasru .rdldc5lr
cirbmc aninal. solurii htiddldupicvi eprubele penm rccottarc. itr caz de intoxic.liii
2 soitun inpennddbi le:
cvcmaal
ddkhtitor
dc
gri, ctnriLd
dc i,aubalie
lspiralic.
idhrinct prcientul: ci rccomrndarcr mcdicali: sc intomuzi lacicrlul asutm ncccsilatil procod0iii sc cxilici paoicnrul0i mo{tr1 dc dcruldrc { ptuccdriij .-ntur'd7it' r1'l i {c pulib I q i \c entu . Je o 'J: .d obtife colaboErea ti oonsin,limantul: se 3faz, pasicntul pc scau cu laF sprc luninr: ' se pmtcjcui lcnlcria cu un prosop nrins jn j urul gtrului !i cu ur so{ dc nidrdid DLArlc: - sc ii dcpinevi roreTa i - se oled pacicniului rivilr rcndi si cstc rugar si o lini sub birbie or atub.te ortrnL (imobiLizcozi N6lnilc si caf tcazd sali!.)i cnc in(flrn sii rcspin prolibd pcnh d coDbatc evcnruala scnzarin de \ona
se se verifi
D
sc aduce
se
sc
'
jnbnca n,nusi
lolosinri:
proccdulii
ioi
in tonca ,lrcopti a prcicnlulri si fixcd7i ddpll accstui. inre toracc $i anrcbmr: soliciti ptuicnlul0isid!s..[idi gud !i stEspirc prohrd] sc in{rodkc cdp ul dl sondei pAn, l. psdcte Dostcior {t teingctut aprcapc dc 'olmjil rrd icina limbi i, pacientul fihd inlitar s, ingh i(i: rc supravegltc.zi pcmanmr narea pacicrtului pcnrru d ovira pirudccx n,ndej nr cijtc Espn rii (rlentie h rrcies. rcspi!4ic, anaritia tusci): sondajnainreazillcctnr csotig sisprc somd. pini la diviziunca45-501a arcadd dcnraii: se adaprcat nelnia la odpfurl lib0r al sondcil sc cobor, pilnia subnivclulloacclui fi scumptc.u tichid ta tcnrpcr.{ura de 25-26c,300se se
rFazi
sc
ndloi ulor pahia dca$rpn capulLi Dacientului pcotru a pcrtunc pirrundcrc. bttndi
. -
iminr. de reminarca cololnci dc lic[id din pllnic. iccasra sc coboad suh rivc trt stomaalui (cfi8anrulri) pcnru I pcnnnc !idhidului din {omac si sc inroar.i in
conlormirdrc.u pnncipiul silonajuluil sc golcac con{inurul pil.iei in vrsul oolcctori
AI
RO(A\,
POPI-A
tt.a:a.i) o\ ari pti llnhi.l.lhnitus...t|(t:i\rutrtp." r ( t. f"hr fut l?tulltit.il \. rcn.rx opcririLnea dc 4.5.ri prlni cittrd tichidut etimr.r e*c ctrid. 6ri reJruri
rlihcnrrr.
sru alic
5 Lnr
hloricrliii
I iu pcnnir. conrinlrulu din urncnut , t{'..,. l.ir.: ',, ' o niscarc scr.i 1csondrlcnrntnilr|lcl|lfxringeLLriiDoi ruprdi:e nrd+irlcrzli:
se pciscr/:i binc
.ap,o liticr xl
. .
sondsl
kJo,.,ll I
.si
pcfru
.]it.issa e!ft:
cieposihiLsi&uTc0soriiJi\figiecircd*rurctilinakmcnl
veriligi rnrcl: c rlmduce capanr I ihera sondcijr(hnprharcLaFsiscobscj{dxcialurbutcdcaer: \! i rodnccnerp.if soMli rr \c.\ctrlri cL arutool unrijctoscopi \e supnrcgherziFcicfrul: dira sc cimoTeazi. alx. rcitcxtrtdc rac e$c s.mn.a sord.. ajrns in ciih rcst mlorii! sc rchge.
s
Poz(lx sondci
' r{rrLr:tr
Qr.iutrLLur Jo.d.irlii \rdrca LroL rcnc de d rSno!r.; Ltr.nrr.tr.aitf brhr'.: rLlD' n-hrrJLnorlich lchiJ rrnL! 5i Duririve. a unor njcdicrmenrc: 6ptrric c.nri'n'i la |acicmi chirurg oall
$ndi rrirtiom
ftrilii
gnyoDl
pcmi.iLindicas.u rd suldlnb
o paturri solLLric
|crtu
hidrrtan si
thrn
rLi'ncrraru. nrdicrmcnrc)i
se
cxplici scopul
si
necesil]rcr:
sc.brineconsimlimint'l:
sc indc|)artcozd prorca dcnlaE doci
c x
in rr un
p3hd cn atr:
sau
se
rau.
difu-d pirtrt
tulr prcienruLui o nrusdmr acopritacu!lezai se insruictt pacicntoi sainghihincd,Icnt.I-2cin laI5 minurc: csE.rcnliond ci inghitirc. i.pida hvorizM/i incdlicnea sondci nr slomac: severifici poTiria sondei Drin: intoducclca capaiu lu i libc. !l sondc i irtr'o cprubcL - nomd sc scu' se bilar sc insulla 60 mL Nr h sond! tl sc r_nccdrii rocupc.rft, dupi I Dir.da., sc dbrin nrai ptrtin dc 20nl sond{ csc in drcdcnl sc inroduc l0mllaprccdnnu'miDorfi recuperali soida esre un duodcni contolradiologioi La diviznnc. T5 la arc.da dcntari. soida e{c in duodcn ti so cdminui rlbartrl if conlbmira rc cu scopul um iri r.
ingrijirm prcicnturui duDi prcccdurn: $]da poatc st dmana pc loc pcntnr indcplirrM s.oprlui sotrdr sc po.{o rohlo in 3 pdsl: - inrii pini la nivclul {onrullij rpoi Pini la nivelulfaringeLuii cuo mi$crre rdpldi se exnagc i. caln.ra bucdli:
prcpus:
ofed pacic.tulul.prl
si-iicll.xsci guo
3..1
Sondajul
teriul h tmcic
sDontaD.
cdphd unnii
in
cv
de incontinentr:
.onJ u' .
r'
1lc(thlcr.
clab-lL.Jf' d tr
LloslnF:
iunr,
dc unidi
sol ii dc/inf ranre, tupodc si cofrpr.se sreile. scrinei. so li2iotogto solulii sterilc pcnh lubn ficrca son de il
nratcrjalc Fntru toalck olganclor gcnnrb:
sau
.ti
neriLr.
2 eprubctc cnr.rc
ti
trscrte.
in tormcaTi prcicnb privind dcru larea proc sc obl inc r olrbomftr si con {im rimanlulr sc asdiTi pacienra ln poziic girccologicil
sc
cdnii i
se rs
igul. intimnatcr.
idcntificd prcicnla si sc vcrili!, sconandrea med icala i sc Drctrjaz, pdul c0 rLa si cu dNamlj sc dczbr.tct prncd inf.nori a corpuluii
5e
rDi si snpuni schimbi rinusllccucele sterile: sc cvidcnlinf rneatd urhar: sc de/infcdcazd oriliciul{rclmld. $rs in.i.s loldsind ?,3lxnpornel se prindcsondo nrft dcgcrclc mcdir si inclar!le mainii doninantel sc Lubrili.rl $ndr cL ulci lcnL sc linc sonda.rp pcLncrctun in rin,pul scrisului ii is inlroducc in rrcti h o adincinc de
sc continunsondajrl in
. -
$1. rjuhii \i s imbm- si 5c rlczc intr s. \eriticr daca acuza dis(nion: da.i rcuzi durcri sdu stn!.rcdzi s
poritie comodi:
3.5 Sondnjur
\.zic,rh bnrbrt
mri pmduco rponran.
sau
uinci
nr caz dc
ircoi'incnrri
'u
.nlurrd.
T!..i"r' rrt 'nt i.oup'.r.at" !.r ig,. , fi.,irEr..r,f,)rri.3 (ftni ubnticrcr \onJe i
sj
rrnusi
dc unici folosnn.l
tius.
intbnnca/i pmieDtul dclprc dcrularea proccduriir obli'ie colabordea $i oonsnnlimentuli sc .iazi ta.icnlul jn d.ctrbn d.s.l ctr DicioareLc intinsc uior dcpandrd cu o pcmi
sc sc
rare
\Lb
Ptin'ri yndti rcitdl td lnrbat v tnr tlc c,lt'? ptncattn rcde "'edit, arislentuI ht..li.al pc ho:d un i p'nto.ol:Lthiln ti:onnut d. netli - selcifi.e rcc.mrM,rc, 'ncdicrlel - sc aei Dacientul jn pozlt ftc.nMdrtii se proteic@i paiul cu rlcTj :i mulanra: scspllamdiDil!riscnnbracin[trusidcunici,Uosinli:
I |il.rtu a! .drt
sc sc
clcotuoa, tdalcrallxndulLd ctr apii si sioun: dczintc.rcui nicatol uri.ar lblosind I rampornc. scr fi7iologic $l solurie anriscplicii
\d schimbi mlnu5lle cu cele stenle: \e prinde sonda cu mtua donilanlai sc lLrbnfiazt in inlr.ginc a c{trnirarea
liberi
se intoducc
nrd
la o adrncinre de
l0-t5
se rcspccrt rniecru
ingrjji.d prcirnrurui
sonda polre
- pdcicntul c$c.icar int{ pdilie co'nodii - scvcnidld l ictr/i disconfon. daci arc sctr^ric dc d6uri.
Ddla !,nlu
fi
tit1. ni
t.id
pe"u
ctitse
ni n,Lc .ile s( lhh^ete n,t.la taler 1. aft twd tnllii haknnr-ni catu!\ed:t:and iu itt. ont
o pungA
u.larkdzd ta
indcpi aE! exudatclorDatolo8iccn^lhre in um! iniamotici nuco4ei lcziolc: cud!tua calititii in r.dcrca rcdi/.irli uno!qtlolnri (.isoscopic). pielogmfic
Medidn - )vontuntt[t
L,h
btt,.lctlneazd prh,nllonddi
mnnu
de
micn foiosi4n.
nAnuii
de
lnict fdlosinl5i
unmd (dacd nu $!e nonhra)i pcise homost ticc; scringr euyln, la ncvoic bcdii de culturr:
sonda
doud
solutic de sptlnnin la lenpmlura coDutui rcconandati de mcdici solutic d rivanol 0,1,2%i nilrar dc argint l4qri vasc[na sltrili stu ulci dc paEfinl pcnrru hbnfieE.
se se
- sc efectucaz, roalch enema: - * atu d in poziric ginecolagicri - se protcj@i parul cu alczt !i cu musana. identificr pacicntul: se verinct indicatia ncdiculuir
sc
arumi $ cxp licA ncccsibrea efecnriri i prdcn uii; 6igui rcspcddd inrinit5liir
consinlihantuli rMlch orgarctoi genitatc; sc continui cu $ldajul vaical cvocurtori sc odrpt@n b sondi *ringa Cuyon; scinrDduc30-l00ni solulic: se detaieri $ringa ti sc hsa se se etinine lichidul inr un sc reper5 opclati, pena cand chiduteEcuar stc rin1]redc;
sc oblinc
se inccpc cu
baziner sau in
raviF rmali:
ingrij irc, pdci$tulu i d u p i proccdu rn sondi raninc pe loc. nind inchhi cu o punsii sr0 racordari, dupr cx/. ta o Durgd
obscFa aspcctul
mdn'lll 0rln{r.
. -
prcgftnea Drcientolui pcntru cxaminiri cndos.!pi.c si c.rdntogice: pEgunea l)cnta inlcrcntii chinr3icilci clacuaro.otr!irNtrluj rcdsl nr cv dc cdn{ipriie
iigator, !ubdccdtrcir. hng dc .aiuli ro.hlii icnEj pdr.i dc cru ci uc pdn ru sugari
apa caldi (35,:17') 500 1000
1,5 2 mi
'nt
narivDeno! irilllol Drahialc pcnld dcycd crdcruui puisxriv: sdrc (r tiuuiri ta r I dc.pii). uteidc ricir (4 Lingrj la l lapi), gliceina(409r. r500mtapi).srpun(l lingrili rusi Lr I
dcrularu prdrcdGi: sc asiatrli pa.i.nlul de respectarc. pLlddriii sc rlcgc polili! nr tuncac dc shtoa gencnlal dNtrbn do6al cu mcmbrclc inlcnoan L!o, ncchr. $i colljsctc dcpi,hrej dccubit lorcmlstins cu nchbrul inlirior inrins )i cc I d Npr tccraij gcnrpdcbaLi sc izolca/i pdtul cn nn pxm van:
se explica
sd
pNtjcaz.
cu
xl., )im$rml
d..rlinr:
r) Clismn cucu,.orje snnplii \efi\ca7i c rln h ribtrliigrrnulLL !j s.in.hid.i0hirctut([.cv.icse]pljciope'sii): s. \ crirlcr rcnrpciirlr r|t i
'
obinctuls sc.linintlrcn'ld!na oxtu sc inchide drn nor: lubritirzi.inuh cu vrscliDli tir.\i'rl comnrcsc dc ritnnl 5e lixci2i ,ngrbnL l). shrir: scs|]xln nr,ifilcs { nnbtucl nli'n'\i: r nidc0irrc.^ lcsctr prcicnru tri sise:itoducc cxruti Di anus in ,c.r.u !i.tuLo,ictral \0.cfor!irdl.rioari,noitDrptlnutsr.nltri(p.rrn'rtuspcclxcurbwaftctuhi)l sc irtuodtrc.crnula l0 l?cminl n.nulrccnrlui: sr dc\chidc oli n.tul srn rnsx si sc illie nigdonLt ta.prorimrti! 50 dn rrnbtr i
sc d.schide
\e
sa
pxcicnrulrcrTi du'9c $ cobofii ir lltont lcfuu 3 s.ad.a pRsiuD..li.hnlu uil s. inchnb rob,icr'lnRinLc d! rcmiDi'.a ti.hxlu uiifdnL r m Fmrdcrer):
daca
Fr!
decubrr
dorxlpctrhL
rpoi si
sau sc
clrnini labrleri
Folnnzim.dc 10-40 cnr: nigat.n \c ridrci [ 1.5 n pcnr i crc*. prsjun.: rpci; icD,Nrrrra ltci esrc m.isci/rli (t5 t6.L) pcnru aacnr cte.hrtpuga{n
scefecnrcazipentruridqjii'rd$.cxldletor.nuroruuid.D.s,rrafa$tuucoActor: aiula e(c irrloc0ira o \onJu de 15.40 crn uBinic cu dnmeN dc t.j .jn p,cviizurii cu
cct n
't
' 'I
MONTORULOF]CALAL ROMANIE
sc foloscsc oprorihrd,200
sc mcminc
sc cx.c
uleiulin rcd 6-12 ore: ut, scar., clim inrca sc tlcc dininca ra: sc lo loscsrc in constipalii cro n icc. lcc, krnj sc pror.je,i lcrjcri. dc pdr. cxnrtndposibitirdrea
elirinirii rcconrrol.tc
sclutrutuj
8.3
lDtrodn&r$ tubuhri
lntotiuccreunuirlbsemi !iddcl0-35cinlunEin.ri3 12'mrdirmeh.u cu sc.Nldc r climina eazclc din colon ir caz dc bcrc.rism abdonrinat.
Mcdicul - @on.ndi nroDrarcr tubului. ,\sisrcnrulncdi.it toalc c tccnD poccduE po e cvacua guclc in mod sponlrn
tb
runc i
asctr p!cicntol jn
pozirjc
scimbncinUnulidchicifolosinlii
urgc tnbu cu lascliDa lcrilti sc deD!frcazi lcsclc pdcieDrului.u mino $ings iar cu prin anus in ftcr, prin mi!.in de .otalic, h pa.icmll esio a.otorir cu. iirvclirorftj
sc
mim drcopti
sc inlrodrce tubu
semntine mrxin
2 oru:
mi$dri dcrurallci
I'
ROMAIIE
das sG ndoie
$ e'abilqG
cirturatio la n,lelul
duole
sc
dupe
ihdcpitura tubului
de
goz.