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MINISTERUL EDUCAIEI NATIONALE

COALA POSTLICEAL SANITAR CAROL DAVILA

BUCURESTI

PROIECT DE ABSOLVIRE

DOMENIU: SANATATE SI ASISTENTA PEDAGOGICA

CALIFICARE PROFESIONALA: SANATATE SI ASISTENTA

PEDAGOGICA

COORDONATOR:

PROF. ALBU LUIZA

ABSOLVENT:

Defta Ma!a" A#!a"

CLASA III$F

BUCURESTI

%&'(

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INGRI)IREA PACIENTULUI CU AFECTIUNI ALE

GLANDEI TIROIDE

2

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CUPRINS

MOTTO

INTRODUCERE

CAPITOLUL 11.1 NOIUNI DE ANATOMIE SI FIZIOLOGIE

1.2HORMONII TIROIDIENI

1.3HORMONII HIPOTALAMICI SI HIPOFIZARI

1.4HIPERTIROIDISMUL I HIPOTIROIDISMUL

CAPITOLUL 2

2.1 GLANDA TIROIDA

2.2 DEFINITIE2.3 SIMPTOMATOLOGIE

2.4 DIAGNOSTIC

2.5 EVOLOUTIE,COMPLICATII SI PRONOSTIC

2.6 TRATAMENT

2.7 PROFILAIE

CAPITOLUL 3!

3.1 INGRI"IRI SPECIFICE ACORDATE PACIENTULUI CU AFECTIUNI ALE GLANDEITIROIDE

3.2STUDIU

CONCLUZII

#I#LOGRAFIE

ANEE

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= G0% ' '-+&+$ )% &'()0) *%0)0'= S(&'(&0) ( '-+&+$ %0 0)%$( )% &'()0) *%0)0',$(9(&% *0(' %0 +-(% $%*0'% + ' (&()( 0&(' '$+'( %$'(, '&%)&'% %' %)( '& -%90)'($'$+''0)0'.

= M+''-%$' %)( %$0)0' ' '()''= P%$0) ' '()(% + 0($' -'8%$' '& -%90) -+&''')+$ '$+''(&(. I&+ (-'%) '($($(% %$0)0' (( $(-(& %+-'%% -0 *)%&% '$+'%. I& -%90) '+'$+''0)0' %$0)('&( $%*'), %$0, 0-% ' ( % $0( -0 00$'&%, '%$ '()(% % ((&' %$%, '&*$+%% ' +)9+%%.

13

http://www.sfatulmedicului.ro/Tulburari-de-tranzit--diareea-si-constipatia-/constipatia_530http://www.sfatulmedicului.ro/Avortul/avortul-spontan-pierderea-spontana-a-sarcinii_1051http://www.sfatulmedicului.ro/Sanatatea-mentala/cauzele-medicale-ale-starii-de-nervozitate-iritabilitate_9234http://www.sfatulmedicului.ro/Insomniahttp://www.sfatulmedicului.ro/Afectiuni-ale-nervilor-periferici/sindromul-de-tunel-carpian_5632http://www.sfatulmedicului.ro/Afectiunile-gleznei-si-piciorului/fasceita-plantara-inflamatia-fasciei-plantare_1620http://www.sfatulmedicului.ro/Tulburari-de-tranzit--diareea-si-constipatia-/constipatia_530http://www.sfatulmedicului.ro/Avortul/avortul-spontan-pierderea-spontana-a-sarcinii_1051http://www.sfatulmedicului.ro/Sanatatea-mentala/cauzele-medicale-ale-starii-de-nervozitate-iritabilitate_9234http://www.sfatulmedicului.ro/Insomniahttp://www.sfatulmedicului.ro/Afectiuni-ale-nervilor-periferici/sindromul-de-tunel-carpian_5632http://www.sfatulmedicului.ro/Afectiunile-gleznei-si-piciorului/fasceita-plantara-inflamatia-fasciei-plantare_1620

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P+%( %(% )+- ' + '($($( %--(&0%% % %$0)0', $(-0 ' -%($(% %$*'&'' (:($'+%$( % $%&-(&()+$.P($+%&()( -%$( 0($% ( '($'$+'' +$ %(% '()(% $%*')% ' 08'$( ' +$ -+&%% + -%($( (($%% %$0)0'.

= P$+8)(( '&('&%)(= C+&'%'% (($% %0 ( )0&*% 0$%% (( $(-(& %+-'%% -0 '+'$+''0),'& ' -( '%$((% %0 '&$+0) ( '&('& '$'%8') 0& -+$()%( -0 '($'$+''0).

= T0)80$%$' %)( (&$0%'(' ' $+8)(( ( ($')'%(= M(&$0%'')( 0$($+%( ' %80&(&( 0&$(-(& %+-'%( -0 '+'$+''0). A0&-' -%& 0$%% (&$0%'(' (( %' -0$% ' %-(%% (( %'0'& '+$%&% -%&'%', +%( ' ')'-% '($'$+''0). I&($')'%(% +%( ' %+-'%% -0 0)')(-+&''' '$+''(&( &('%*&+'-%( ' &($%%(.

= I+$'-0) %')'%)= D%-% '& '+$'-0) 0&(%+%$% %')'%) (:'% ($+%&( -%$( %0 $+8)(( -0'$+'%, %(' 0& $'- %/+$ ( % (9+)% 8+)' '$+''(&(. E( +'8') % &0 '' '&+(%0&% -+&'(&' ('0&-'')( '$+''(&( '& %')'% 0&(%+%$%, '&$0-% 0)' (8$'' %' %')'(' +'8') % &0-0&+%-% %0) -% 0($% ( %&0'( -+&''' %)( '$+'(' %0 % ( $%+$(9( )% %-((% -% $+8)(( %)(*)%&(' %0 *0('. E( '+$%& % %-+$%' %(&'( -$(($'' (:-('( '& *$(0%(%)( (8$')+$%')'(', '&$0-% %-((% + ' (-)%&%( ( %(-'0&' '$+''(&(.

= P$+8)(( -0 -+)(($+)0)= C+)(($+)0) $''-%, %' %)( -() %)( -%$0' %)+$' &0 -% '& 0$%$%%(&()+$ ('-%(&+%(, '((' ' (:($-''')+$ '9'-(, +%( ' 0& (& ( '+'$+''&('%*&+'-%. N'()0$')( &(+8'&0' ( -%90( ( -+)(($+) + ' (&( %)( $(9(&(''($'$+''0)0'.

= D($('( ' %&:'(%(= A+-'%( %0 &0 -0 %%$''% 8$0-% % 0)80$%$')+$ ( %&'-%, ($('% '%&:'(%(% + ' (&( %)( 8+)')+$ '$+''(&(. H'+'$+''0) (( -() %' ( %+-'% -0 ($('%, '&' -( '($'$+''0) (( -+$()% (0) ( $(-(& -0 %%-0$')( ( %&:'(%( %0 ( %&'-%. D($('%-%$( &0 ( %()'+$(%9% '& 0$% $%%(&0)0' -0 %&'($('( +%( ' 0& (& %) 0&(' %(-'0&'&('%*&+'-%( % *)%&(' '$+'(.

= M+''-%$' %)( *$(0%''= C'%$ %-% 0$%' + '(% %$%-% '& *$%'', -0 0'&( -%)+$'', %(' 0&$+*$% $'*0$+ ( (:($-''' '9'-( ' &0 $(0'' % '($(' '& *$(0%(, 8% '& -+&$%, -%'*%' K')+*$%(,%$ 0(% ' ')'-%% + $+8)(% % *)%&(' '$+'(. D''-0)%')( ( '($($( % *$(0%'' + ' 0& (& ('+'$+''.

= O8+(%)%= C'%$ %-% +$'' =1 +$( ( &+%(, % ''' (0'9%' ' % %)%' '& '+'8')'%(% ( %0&-'+&% %$% % +$'' ( %$-0$0) 9')(', %0&-' %-( )0-$0 %$ 0(% (&%)% + '0&-'( % *)%&(''$+'(, %' (:%- '+'$+''. I& -%90) '($'$+''0)0', (( +'8') % 0($'' ( '&+&'(, '&0$% -%$('% % (' '' +8+'' ( %$-0$0) '&$(*'' 9')(.

DIAGNOSTIC

D'%*&+'-0) = %$( 0$>+%$()( (%(!1. D'%*&+'-0) +9'' %&%&(9%, (:%(&0) -)'&'- ' (:%'&>$')( %$%-)'&'-(2. D'%*&+'-0) '($(&?'%).1 D'%*&+'-0) +9'': ( %8')(( ( 8%9% %&%&(9(' ;(80 8$0- ( ' '&(-?'+

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A&%&(9% ! '+$'-0) 8+)''E:%(&0) -)'&'- ! S'+()( )+-%)(-+&%0 '& ($%% -)%'-> % +$'->$(' '&)%%?'' != 0+$! '($$+'( '$+''%&% %((% %$-%>, -0 '&($(%$( *)+8%)> %0 )+8%$>, -0 -+&'(&?%10&'+$> ' $(&'(&> '& -()( &(00$%'(, %0 -0 9+&( ( )0-0(&?>, -0 (&'&?% )% %8-(%$('& -()( 00$%'(= +)+$! '$+'% (( 0$($+%> +&%& %0 )% %)%$(, 0$($( '$(- $++$'+&%)> -0 '(9% -0

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

P%)%$( = '$+'% ( -+&'(&?> -$(-0>, 0$($+%>F)0-0(&% %8-(

E:%(&()( %$%-)'&'-(1. L(0-+-'+9> -0 &(0$+')'(2. V%)+$' -$(-0( VSH ;VSH 1 .5. E-+*$%'( = '&'?'%) '+(-+*(&, $%&+&'- )% -+&'0'$(% %8-(0)0'.6. H(+-0)0$% +%( '9+)% 0&(+$' %*(&0) %+*(&.7. R%'+'++-%%$(% '& )''( &+$%)(.. P0&-'( . P$()(%$( 0$+' ' '9+)%$( %*(& ('+)+*'-

D'%*&+'-0) '($(&?'%)( %-( -0!= %)( '$+''( %-0(, 08%-0( ;%)( 08'0$'=-' ($+'=-' '$(+*)+

='&)%%?'' (-''-( '$+''(&(=)'+=)'+=-' '%'-

=%)( %(-?'0&' %)( +$*%&()+$ '& $(*'0&(% -($'-%)>

INVESTIGATII

1. P%)%$(%.P$'& '&(-'% '90%)% % 9+&(' '$+''(&( ' %)%$(% %-(('%, ('-0) %$(-'%9%

'(&'0&')( ' -+&'(&% *)%&(', $(-0 ' $(9(&% ((&0%)')+$ &+0)'.

N+%! '$+'% )% ;%0+

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-(%)%)% % )%$'&*()0'. S'0)(%9% '-%$(% ( '&*''$(, (&$0 -% '$+'% ( $''-% ' + +' ((-% 0+$.

P%)(%9% 8)%& ( + %$( ' ( %)% % )%$'&*()0' ' (9' %-% ( '( $(9(&% 0&0' &+0).

2. E-+*$%'% '$+''%&%. S$0-0$% '$+'(' (( (%)0%% '& (%)'0 -0 %/0+$0) (-+*$%'(', '%$

'(&'0&')( *)%&(' 0& %8')'( -0 %-0$%((. N+0)'' &(('%' $'& %)%$( + ' ((-%' -0

%/0+$0) %-(0' ' ( '&('*%'(.

3. I&('*%'' -0 %/0+$0) T++*$%0)0' ' RMN ;$(9+&%&% %*&('-% &0-)(%$% &(-('>?')( ( +$+&' '$+''(&' 0& -+$(- %-+($'( 0> -0 % %' $(-'9%, >0$%$(%TSH=0)0' &0 (( -+&-)0(&> )% %-'(&?'' -%$( %0 )(9'0&' ;0+$', -'$0$*'(, (-< ( 9+&%

'+%)%00)0' '%0 % '+'9(', )% %-('% 0$>$'&0=( %)+$')( T3 ' T4

=T3, T4! &'()0) @& &*( %) -()+$ +' +$+&' '$+''(&' ((&?'%)' -+&-(&$%?'% %-(+$% (( '&($

$++$?'+&%)> -0 % TSH @& '($'$+''(! &'()0) -$(-0 %) T3 ' T4 % '&'8% (-$(?'% ( TSH '&

'+'9> '%$ %8)+0) % '! T3, T4 -$(-0(, TSH $(0 ;+%( -'%$ &(((-%8') %-(%% +''-%$( ' @&-(%$-> > + -+8%> $'&

(-$(?'% 0&(' -%&'>?' %$' ( TSH -%$( > '0)(9( '$+'% > $+0-> +$+&' %8)+0) % '! T3 ' T4

-%90(, TSH -$(-0

16

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=F$((T3, F$((T4! $%-?'')( )'8($( %)( -()+$ +' +$+&' 0& %' 0')( (- -+&-(&$%?'')( +%)((+%$(-( >+%$%, 0% -0 % %' $(-'9%, +%$ %$(% %-'> (%8+)'- % +$+&')+$ (:'(&?' @&&*( )% 0& +(& %

=ATPO, TRA8, %&''$+*)+80)'&%! %&'-+$' @+$'% 0&+$ $0-0$' %)( '$+'(' %/0% )% '%*&+'-%$(%8+)')+$ '$+''(&( $'& (-%&' %0+'0& ;'$+''(, 8+%)% #%(+W=G$%( @& -%&'%( %$( @& '$+'> >0$%$(% (' ( %-( )% %-'(&?' +($%?';'$+'% (:-)0> @& +%)'%(< ( -%&-($ '$+''%& 0& &'() %&+$%) -$(-0 )% %-('% $''-> 0'-'0&(%-> %' (:'> ?(0 '$+''%& @& +$*%&' -%$( +%( ' +''-% %)'*&

EVOLUIE. COMPLICAII. PROGNOSTIC

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

T'$+''% H%'++ (( + %(-'0&( %0+'0&%. A-( )0-$0 '&(%&% -% '(0) '0& %%-% (00$')(%&%+%( %)( -+$0)0' '& )+- % )0( -0 8%-($'')( %0 '$00$')( -%$( '&%(%9% +$*%&'0). I& %-(-%9, '(0) '0& $+0-( %&'-+$' -%$( %%-% *)%&% '$+'% -% ' -0 %-(%% %$ ' + 08%&% $%'&%-( $(80'( '$0%. L(9'0&')( $(90)%( + 0-( )% -%($(% $+0-'(' ( +$+& '$+''%&.

G0% ')%!G0% ')% ( ('&(( -% + -$(($( % +)00)0' '$+'(', (-0&%$ 0&(' -$(($' % &0%$0)0' -()0)()+$'$+''(&( %$% '($'$+''( ' &()(*%% ( 0& $+-( '&)%%+$ %0 &(+)%9'-.G0% ')% (( + %(-'0&( +%$( $(-(&%. G0% ')%, %%$( $(($(&'%) )% (('. F%-+$'' *(&('-'

/+%-% 0& $+) '+$%&, -((% -( (:)'-% $(-(&% %&(-((&()+$ %')'%)( )% %-(' 8+)&%'.T$%&'($(% *0(' ')( ( ((-0(%9% '& + %0++%) $(-('.

P$'& ('&''(, ( +$8(( ( *0% ')% +$%'-% %0&-' -%& %-(%% %(-'0&( '&($((%9% %' 0'&( 1B '& +0)%'% 0&(' $(*'0&'. P(( %-( $+-(&%/, ( '-0% ( *0% ')% (&('-%.

N+0)0' '$+''%& +)'%$

D('&' -)'&'- -% + 0(%-'( )+-%)'9%% % *)%&(' '$+'(, &+0)0' '$+''%& +)'%$ +%( ' (:$('% 0&('%$' $'(%' %+)+*'-( )(9'+&%)(.C)%''-%$(% &+0)')+$ '$+''(&' '& 0&-'( ( %(-0) )+$ -'&'*$%'- ''&*(!= (:'% N+0) -%) ;A(&+ +:'-

= (:'% N+0)X-%)0Y ':(%9% '+0)Y %' 0'& (- $(0) %$(&-'.

= (:'> &+0) $(-(Y &0 ':(%9% I 131 0(- -%&-($ '$+''%&17

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

$+*&+'- +%$( 80& (&$0 +$()( (:$'%( $'&$=0& &+0) '$+''%& '9+)% ' -0 + $%% (0$%'(0'$( )% 25 ( %&' ( B, '&*)+8%& +%( '0$')( '+)+*'-(.

H'($'$+''% $($(9'&% '($0&-'% *)%&(' '$+'(. #+%)% G$%( -0&+-0% -% ' 8+%)% P%$$J %0#%(+W (( + %(-'0&( -%$( ( -%$%-($'9(%9% $'& 3 %&'(%$' %/+$(! '($'$+''( -0 *0% '09%,($+%'( (( + ' +%)+%'(. A-(( %&'(%$' %/+$( &0 %%$ '&+(%0&% '$(0&%.

#+%)% #%(+W (( + %(-'0&( $()%' $(-(&% -%$( +%( % %%$% )% +$'-( %$% '&% (( %'$(-(&% '& (-%()( 3 ' 4 ( '%%, $(-(&% (' ''& %' -$(-0% )% (('. I& 9+&()( *(+*$%'-( 0&(

*0% &0 (( (&('-% $%+$0) ((' 8%$8%' (( ( 7!1 %% ( $(*'0&')( *(+*$%'-( -0 *0% (&('-%0&( $%+$0) (( 0) %' '-.

M(-%&' '9'+%+)+*'-!

I& 8+%)% #%(+W *)%&% '$+'% %$( 0& +)0 -$(-0 '09, (( ( -+&'(&% -$(-0% ' 8+*%%-0)%$'9%%. M+''-%$')( %+)+*'-( ( )% &'()0) %0 0& '($$+'% ;-$(($(% +)00)0'< ''($)%9'% ;-$(($(% &0%$0)0' ( -()0)(< %$(&-'0)0'.O%)+%'% '& 8+%)% #%(+W ( -%$%-($'9(%9% $'&$=0& '&')$% '&)%%+$ )% &'()0) -+&'&00)0'+$8'(' ;-%$( $((-% *)+80) +-0)%$< -0 )'+-'(, )%+-'( ' %+-'(.D($+%'% '& 8+)% #%(+W (( -%$%-($'9%% ( '&*$+%$(% ($0)0', %-(% ''& '&')$% -0)'+-'( ' 0-++)'9%%$'( '$+')(, (%-$+%'-(.

S'+(

M%&'(%$')( -)'&'-( ( -)%''-% '& %&'(%$' -%$( $()(-% '$(++:'-+9% %+-'%% ' -()( (-''-( 8+)''#%(+W.C()( %' $(-(&( %&'(%$' -)'&'-( %)( '$(++:'-+9(' 0&! )%8')'%( (+'+&%)%, &($+9'%(,$(+$,'&+&'(,$%&'$%'( (:-('% ' '&+)($%&% )% -%)0$% $(-0 ' -$(($(% ($'%)'0)0' '&('&%).D( %((&(% -%($(% +&($%)% (( +8'&0'% '& +'% (&'&($'' %0 -$(($'' %('0)0'.E(

$(9(&% ' )%8'-'0&(% 0-0)%0$'' $+:'%)( -0 ''&0%$(% +$(', %&'(%% %((% $'& ''-0)%()% 0$-%$(% -%$')+$. L% ((')( %)%( '& ($'+(&+%09% (:'% (&'&% ( %%$''( % +)'*+ ' %(&+$(('.I& *(&($%) '+%+)+*'% +'&%% ( &($+9'%( (( $(9(&% )% '&($' '& ' -( )% %$&'-'

$(+'&% '+%+)+*'% -%$'+%-0)%$% ' +%)+)+*'-%.1

http://www.sfatulmedicului.ro/dictionar-medical/gusa_1037http://www.sfatulmedicului.ro/dictionar-medical/gusa-endemica_6900http://www.sfatulmedicului.ro/dictionar-medical/tremor_6501http://www.sfatulmedicului.ro/dictionar-medical/insomnie_1249http://www.sfatulmedicului.ro/Diete-de-mentinere/controlul-apetitului_1557http://www.sfatulmedicului.ro/dictionar-medical/amenoree_227http://www.sfatulmedicului.ro/dictionar-medical/gusa_1037http://www.sfatulmedicului.ro/dictionar-medical/gusa-endemica_6900http://www.sfatulmedicului.ro/dictionar-medical/tremor_6501http://www.sfatulmedicului.ro/dictionar-medical/insomnie_1249http://www.sfatulmedicului.ro/Diete-de-mentinere/controlul-apetitului_1557http://www.sfatulmedicului.ro/dictionar-medical/amenoree_227

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M%&'(%$')( (-''-( %)( 8+)'' #%(+W 0&!= *0% '09% '($0&-'+&%)%= ($+%'%= +%)+%'%.A-(( %&'(%$' %%$ '& '($( -+8'&%'' ' -0 + $(-(&% +%$( %$'%8')%, -(% %' $(-(&% ''&*0%.

G0% '09% '($0&-'+&%)% +%( ' %'($'-% ' )+80)%$%. D('%$(% 0&0' $(%% )% &'()0) *)%&(''$+'( '&'-% ( +8'-(' $(9(&% '$(++:'-+9(', '&% %-( (& (( 0&(+$' $(9(& ' '& %)( +$( ('($)%9'( '$+''%&%. D'%*&+'-0) '($(&'%) ( %-( -0 0$0$0) (&+ ' 0)0) -%$+''%&. L%

%)%$(% '$+''%&% +%( ' ('% 0& )+8 '$%'%) %$'.

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#I#LOGRAFIE

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ANEE

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