bc thỰc tẬp tyt .p8
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MC LCPHN 1 GI THIU CHUNG V N V THC TP 1.1./Tn n v v a ch n thc tp ..........................................................................8 1.2/.Nhim v quy m t chc .......................................................................................8 1.3/.Ch tiu , k koch v thnh tch hot ng ..............................................................9 1. 3.1./Cng tc dc .....................................................................................................9 1. 3.2/.Cc ch tiu : * V sinh an ton thc phm...............................................................................9 * Tim chng m rng........................................................................................9 * Chng trnh v sinh ngoi cnh......................................................................9 * Chng trnh k hoch ha gia nh................................................................9 * Chng trnh phng chng suy dinh dng.....................................................9 * Cng tc khm cha bnh v kt hp iu tr ng ty y...............................10 * Chng trnh phng chng Vitamin A ..........................................................10 * Cng tc phng chng Lao, Phong.................................................................10 *Chng trnh phng chng bu c................................................................10 *Cng tc phng chng HIV/AIDS...................................................................10 *Cng tc phng chng st xut huyt..............................................................11 1.3.3./ K hoch...........................................................................................................12 1. 3.4/. Thnh tch.........................................................................................................12 1.4./ Chc nng v nhim v ca dc s trung cp ti c s .........................................12 PHN 2 KT QU THC TP ....................................................................................13 2. 1/ K hoch cung ng thuc v kinh ph mua thuc ...................................................13 2. 1.1/.D tr , xut nhp , nhp v tn thuc ...............................................................13 2. 1.2./Cc loi s sch .................................................................................................16 2.2/.Sp xp , trnh by quy trnh cp thuc ....................................................................17 2.2.1/ cc loi thuc cp cu ..................................................................................17 2.2.2/ Thuc cc chng trnh y t khc (chng trnh v tn thuc ) ....................22 2. 2.3./Sp xp v trnh by thuc ..........................................................................24 2.2.4/Sp xp thuc................................................................................................. 24 2.2.5/Trnh by thuc .............................................................................................241
2.2.6/.Quy trnh cp pht thuc.............................................................................. 26 2.3.Tham gia hng dn s dng thuc an ton .............................................................26 2.4.Theo di thng k hin tng phn ng c hi ca thuc .........................................27 3.1.n thuc ti trm y t...............................................................................................27 4.1.Vn thuc nam .......................................................................................................34 PHN 3. KT LUN- KIN NGH ..............................................................................44 3.1.Kt lun ..........................................................................................................44 3.2.Kin ngh .......................................................................................................44
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CNG HA X HI CH NGHA VIT NAM c lp- T do- Hnh Phc
BNG CHM IM THC TP TT NGHIPH v tn sinh vin: NGUYN TH THANH THU Lp M s sinh vin : 09TDS56 : 3109001579
Cn B trc tip hng dn ti c s: YS DNG TH NH NGUYT Giao Vin B mn PT nhm thc tp: HUNH TN Thi gian thc tp:T ngy: 14 thng 02 nm 2011 n ngy: 08 thng 03 nm 2011 STT A 1 2 3 B 1 2 3 NI DUNG THI HC TP CA SINH VIN o c Tc phong Chuyn cn NI DUNG BI BO CO Hnh thc Ni dung TNG CNG IM TI A 4 2 1 1 6 2 4 10 ( Sinh vin t> 60% s im mi t t thc tp) XC NHN CA C S THC TP (K tn- ng du) IM THC
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.......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... .......................................................................................................................................... Tp H Ch Minh Ngy thng .nm.
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Tp H Ch Minh Ngy thng .nm.
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Nn kinh t nc ta ang chuyn sang hot ng theo c ch th trng c s qun l ca nh nc. Trong s nghip i mi kinh t i hi nhng ngi tham gia k inh doanh phi nhanh chng tip cn vi nhng thay i v cnh tranh khc lit ca th trng, Mi bin ng ca th trng u c nh hng trc tip hoc gin tip n cc nghnh kinh doanh ni chung v kinh doanh thuc ni ring, Bi thuc cng ch l mt loi hng ho nh tt c cc loi hng ho khc c by bn trn th trng nn hot ng kinh doanh thuc cng phi tun theo quy lut cnh tranh ca th trng tn ti v pht trin. Hn bao gi ht thuc l mt trong nhng yu cu quan trng trong s nghip bo v chm sc sc kho cho nhn dn nn vic cung cp y v s lng l trch nhim ca nghnh y t ni chung, trong cc bnh vin, trung tm y t, trm y t, nh thuc, hiu thuc ng vai tr quan trng, Cng t i hi mi bnh vin, trung tm y t, trm y t, nh thuc, hiu thuc phi c kin thc, c trnh chuyn mn cung ng v t vn, p ng cc yu cu ca nhn dn. Nhn bit c tm quan trng sau mt thi gian thc tp b ch ti Trm Y T Phng 8 Qun Ph Nhun di s bo ban nhit tnh ca cc c, v cc ch cng vi s du dt ca thy c trng Cao ng Nguyn Tt Thnh, gip em vng tin em hon thnh bi bo co thc tp em xin chn thnh cm n s gip qu bu gip em hon thnh tt bi bo co ny!
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Trong thi gian hc tp trng Cao ng Nguyn Tt Thnh em nhn c s dy d tn tnh ca cc thy c em c hnh trang bc vo ngh. Sau thi gian em c i thc tp ti trm y t phng 8 Qun Ph Nhun tip xc v hc hi t thc t vn dng nhng g hc trng vo cng vic thc t, vn dng nhng g hc trng vo cng vic thc t. Vi s ch dn nhit tnh ca ch v cc c t rm y t gip em thm vng nhng kin thc hc v c kinh nghim trong thc t , vi nhng kin thc hc hi nh bit th no l cung ng thuc, t chc cp pht thuc, tim chng hng thng.. Tuy thi gian ch c hai tun ti trm y t nhng i vi em tht c ngha, v gip em cng c thm c nhiu kin thc b ch trong thc t v nay cng l nhng kin thc gip em vng tin hn khi bc vo ngh. Mt khc em cn bit c tm quan trng ca nghnh dc cng nh vai tr ca ngi dc s. Qua bi bo co ny cn nhiu thiu st em rt mong c c ch trm y t phng 8 Qun Ph Nhun cng cc thy c khoa dc trng Cao ng Nguyn Tt Thnh ch bo v ng gp kin cho em bi bo co tt hn. Em xin chn thnh cm n!
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PHN 1 : GII THIU CHUNG V N V THC TP1.1/Tn v a ch n v thc tp1.1 1.2
Tn n v : Trm y t phng 8 a ch n v thc tp : 223 Nguyn Trng Tuyn , phng 8 , Qun
Ph Nhun 1.2/. Nhim v v quy m t chc :
BNG PHN CNG NHIM V -
BS L Ngc nh
H tr cng tc khm cha bnh ti trm , hng tun vo ngy th 2 , th 3 , th 5 H tr cng tc truyn thng gio dc sc khe YS Dng Th nh Nguyt Chi trch nhim v cc hot ng 10 tiu chun quc gia v y t trc ng y , y ban nhn dn v Ban Gim c TTYTDP Ph Nhun Xy dng k hoch qu , thng , nm , bo co tng hp Ph trch chng trnh tim chng , chng trnh phng chng suy dinh dng Ph trch cng tc v sinh an ton thc phm , v sinh ngoi cnh , v sinh mi Qun l chng trnh qun l bnh lao , tm thm , HIV /AIDS, st rt. Ph trch cng tc phng chng dch bnh ti a phng Ph trch cng tc truyn thng GDSK Thc hin nhim v chuyn mn NHS Trn Th Uyn Nga Ph trch chng trnh chm sc sc khe sinh sn , KHHGD Chng trnh phng ly nhim HIV t m sang con H tr cng tc tim chng , truyn thng GDSK , sc khe tr em H tr cng tc phng chng dch Thc hin cng tc chuyn mn DT Phm Thanh Xun Ph trch qun l cng tc dc chnh Qun l trang thit b vt t y t , ti sn c nh . H tr cng tc phng dch , tim chng ti trm Qun l mng li y t t nhn8
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-
trng .-
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Ph trch cng tc th qu , bo co cng vic ti chnh ca trm. YS. ng nh Tun: Ph trch ng y 1.3. /Ch tiu , k hoch thnh tch hot ng 1. 3.1/. Cng tc dc
Thc hin theo quy ch dc chnh : 3 tra , 3 i , 5 chng -
Cng tc qun l thuc bo him y t , thuc hng tm thn , thuc st rt, thuc Ch d tr , bo co thuc , lp th kho, Kim tra k n thuc ph hp vi tng loi bnh chn on n thuc phi nghi y phn hnh chnh Tn thuc phi ghi r rng hm lng , s lng thuc , ch hn s dng
nga thai (thuc k hoch ha gia nh ).
thuc , khng nn thuc ht hn nu gn ht hn phi bo co v lp bin bn x l (nu thuc ht hn phi hy , gn ht hn phi i thuc mi ti khoa dc bnh vin ) Thc hin ch kim k thuc hng thng 1.3.2. Cng tc truyn thng gio dc sc khe -
V sinh an ton thc phm
Tng s qun n c qun l l 30 qun , tng s qun c cp giy iu kin Ch tiu kim tra qun n t > 80%
l 10 qun , khng c trng hp ng c thc phm xy ra Tim chng m rng Chng trnh v sinh ngoi cnh
Ch tiu tr < 1 tui tim chng phng 8 bnh tr em t > 95% - T l h s dng nc sch phi t 100% - Nh v sinh t hoi : t 100%, cc h dn phi thu ngi rc 100%
Ch tiu v k hoch ha gia nh Chng trnh phng chng suy dinh dng
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T l pht trin dn s t 0.28%
Tr SDD hin c 7/456 t l 1,53% T l qun l tr di 2 tui t 98% (tr c cn o hng thng , tim chng y
8 bnh : lao , bch hu , ho g , un vn , vim gan siu vi B vim mng no m , si, bi lit)
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Hot ng kt hp iu tr ng ty y
t t l 20 % theo quy nh ca B Y t , khm cha bnh y hc c truyn kt hp T l khm cha bnh ti trm so vi tng s dn 0.5 % vt ch tiu do b y t quy Chng trnh phng chng Vitamin A
vi y hc hin i (ng Ty y kt hp)-
nh 0.2 ln / 1 nm /1 ngi - Thc hin 2 t/ nm ( thng 6, thng 12) - T l phi t trn 90% cho tr t 6 thng n 36 thng - Tr SDD, Khng b m trong nhng thng u, tr b kh gic mc. Chng trnh phng chng lao, phong - Pht hin v chuyn ngay ngi c triu chng nghi lao dn phng khm lao Qun - Thc hin lnh iu tr ca T chng lao Qun v gim st vic dng thuc chng lao ca ngi bnh bng cch nh du vo phiu iu tr c kim sot - Tuyn truyn GDSK v bnh lao trong cng ng 4 ln /nm - Theo di kim tra vic tim phng lao bng BCG cho tr s sinh - Trng trm y t phng ch chu trch nhim qun l, vng gia bnh nhn lao 1thng/ 1 ln c th hin trn phiu gim st bnh nhn (yu cu BN ung thuc iu tr lao ng liu ) thuc lao c cp min ph. * Tuyn truyn vn ng ngi dn bit cch phng chng bnh phong * Bit cch pht hin, bit cn phn ng v bit cch chm sc - iu tr l o * BN c khm v iu tr ti c s y t chuyn mn, thuc iu tr c cp pht min ph
Chng trnh phng chng bu c
-T l ngi dn s dng mui iot t 90% -S ca hng bn l s mui c 6 ca hng -
Cng tc phng chng HIV/AIDS Tng cng cng tc thng tin gio dc Chng trnh gim thiu tc hi d phng ly nhim HIV t m sang Ph bin cc vn bn php lut ca ng Nh nc v chng trnh
con-
phng chng HIV/AIDS.
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Tip cn gio dc cc i tng nhm gip h thay i hnh vi , cung Chng trnh chm sc h tr cho ngi b ly nhim
ng cc dch v k hoch ha gia nh , kim tim min ph Chng trnh gim st HIV - Mc tiu : Gim t l mc, t vong do st rt, khng c dch xy ra, kim sot c s ngi i n vng c st rt lu hnh - Ni dung : * D tr y c s thuc iu tr * Qun l v xc minh cc trng hp st rt c k sinh trng (+) * Thc hin TTGD v phng chng st rt : 4 cuc/ nm. Hng dn ngi dn bit cch phng chng mui t, bit cch pht hin sm bnh , s dng thuc st rt liu t iu tr khi i vo vng c st rt lu hnh * 100% BN c st v c lin quan n yu t dch t st rt u phi n TYT th mu , phn u thc hin 7 lam/ thng * Khuyn co BN st rt nn th mu li ln 2 sau khi iu tr y 1 liu thuc st rt, nhng ngi thng xuyn vo vng st rt lu hnh nn n TYT khm v xt nghim mu khi ln cn st * Lp s theo di, bo qun, bo co y vo ngy 25 hng thng * BN b nhim P.Vivax phi c iu tr chng ti pht xa bng Primaquine sau khi ct cn st
Cng tc phng chng st trt
Phng chng St xut huyt a bn , tng cng cng tc gim st, pht hin v kim sot dch bnh
y mnh cng tc TTGDSK cho nhn dn khng dch ln xy ra trong Phi hp tt vi TTYTDP Qun, Bnh vin, Phng Y t trong cng tc phng chng dch, m bo thc hin y v kp thi ch thng k bo co v cng tc phng chng dch theo qui nh Gim t l mc, cht st xut huyt, hn ch pht sinh dch T chc tt 3 t chin dch dit lng qung
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1.3.3 K hoch : - Tham mu cho ng y, UBND, Mt trn T Quc xy dng k hoch hot ng y t 2011 da trn nn 10 chun quc gia v Trm y t 1.3.4 Thnh tch : - Cui nm 2010 : Trm Y t Phng 8 c S Y t TP. HCM v phc tra v cng nhn Trm t 10 chun quc gia v Trm y t. 1.4. Chc nng v nhim v ca dc s ti c s - Tip n bnh nhn - Ghi cc n thuc - Cp pht thuc cho bnh nhn - Hng dn BN cch dng thuc theo n ca bc s - Sp xp, bo qun thuc, kim tra s sch - Dn dp v sinh quy thuc ti Trm
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PHN 2 KT QU THC TP1. K hoch cung ng thuc v kinh ph mua thuc
1.1. D tr , xut , nhp v tn thuc Vic lp d tr bit c lng thuc xut nhp tn nhm m bo lng thuc cp pht D tr - Lp d tr tt c cc thuc ca cc chng trnh - Da vo s thuc dng trong thng m ph trch dc ca trm thng k - Sau khi thng k s c bo co ln khoa dc ca bnh vin
BIN BN KIM NHP THUC BHYT THNG 05/2011Ngy 04 thng 05 nm 2011 HI NG KIM NHP GM : 1. Trng trm : YS. Dng Th nh Nguyt 2. Qun l dc : DT. Phm Th Thanh Xun Nhp ca khoa dc TTYTDP Qun Chng t s : 27,43 ngy 22 thng 04 nm 2011S T T 1 2 4 5 N V vin vin vin vin N GI 95 55 405 500 S LNG 1200 1000 300 200 THNH TIN 114,000 55.000 121,500 10,000 Hn dng 02/08/13 05/10/12 31/05/14 10/05/13
TN THUC Phenobarbital 100mg Aminazine 25mg Carbatol 200mg Haloperidol 2mg
Qun l dc
Trng trm
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TH KHO Tn thuc/ Ha cht/ Vt dng y t tiu hao : CHLORPROMAZINE Hm lng/ Nng / Quy cch : 25mg M vch : n v : Vin Ngy Thng (1) 20/04/11 S Chng T Nhp (2) Xut (3) (4) Tn thng trc 04/05/11 9/05/11 20/05/11 43 4 n Nhp trong thng Xut trong thng Tn cui thng 1000 330 796 S Lng Din Gii Nhp (5) Xut (6) Cn (7) 126 1126
M s:
S l Hn dng (8) L:061109 05/10/12
Bo co thuc tm thn :S T T 1 2 3 4 5 6 7 Tn thuc v hm lng ( mg ) Chlorpromazine 25mg Levomepromazine 25mg Haloperidol 2mg Risperidone 2mg Phenobarbital 100mg Carbamazepine 200mg Olanzapin 10mg n V Vin Vin Vin Vin vin 40 28 179 1200 300 200 60 28 420 120 15 180 0 959 245 30 200 400 100 50 Tn Thng Trc 126 Nhp Trong Thng 1000 Dng Trong Thng 330 Tn Cui Thng 796 D Tr Thng Ti 500 200 Ghi Ch
Vin 65 Vin 45
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BO CO XUT NHP TN THUC BHYT T5/2011T Tn T n g Tng n D u nhp xut cui TR 14 241 8 151 300 50 144 5 4 5 1 90 3 145 200 118 60 3 95 91 960 700 200 15 6 125 4 150 78 90 5 82 593 56 223 10 900 7 116 4 1 222 50 54 122 5 1, 108 34 3 122 108 60 3 1, 155 000 500 000 100 8 200 12 300
STT Bit dc 4 1 Diclefenac Stada 50mg 2 Pacific Ketoprofen 30mg 24 Meloxicam Stada 7.5mg 26 Yeltu 7.5mg 33 Mexcold 150mg Tydol Sachet Powder 34 150mg 35 Hapacol Infants F 150mg 41 Acemol A 325mg 42 Tydol 325mg 43 Mexcold 500mg 48 Hapacol codein si 53 Pyme Ditavic 55 Piantawic 61 Allopurinol 300mg 63 Dochicin 1mg 69 Asist 500mg 70 Lubrijoint 500mg 74 Medo 21
VTNN 7 vin ming vin vin gi gi gi vin vin vin vin vin vin vin vin vin vin vin15
n gi 12 243. 00 7,000. 00 595. 00 800. 00 1,050. 00 1,250. 00 1,208. 00 85. 00 270. 00 231. 00 1,700. 00 1,021. 00 300. 00 525. 00 960. 00 2,500. 00 2,450. 00 1,199.
75 Opetrysin Serratiopeptidase Stada 77 10mg 78 Doren 10mg 79 Clorpheniramin 4mg 80 Allerfar 4mg 82 Cetirizin Stada 10mg 83 Cinarizin 25mg 89 Lonlor 10mg 90 Loratadin 10mg 105 Mebendazol 500mg
vin vin vin vin vin vin vin vin vin vin
00 1,000. 00 400. 00 378. 00 39. 90 48. 00 238. 00 200. 00 800. 00 500. 00 709. 00
34 0 1 57 147 80 1 33 8 480 100 570 300 500 400 476 259 284 30 635 383 2
91 58 141 1 73 147 70 15 1 130 6 500 10 300 800 500
1.2. Cc loi s sch (ni dung v mc ch s dng ) Trong chng trnh KHHG Thuc nga thai : - Ideal - Exluton (m cho con b) Vng trnh thai : - Vng ML 375 - Tcu 380 Thuc ung sau khi t vng - Doxycyclin 100mg - Nospa 40mg B m mang thai c cp vin st trong sut thi k mang thai (c s qun l) S qun l bo thuc BHYT S qun l thuc st rt S xut nhp thuc hng tm thn - Ni dung : thng k lng thuc dng trong ngy , tng hp bo co thng - Mc ch : bit c s lng thuc c nhp xut hng ngy - S thng k - Ni dung : thng k thuc pht ra trong tng thng , tng nm cp pht thuc cho bnh nhn - Mc ch : nhm bit c lng thuc tn c k hoch lp d tr
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2. Sp xp , trnh by , quy trnh cp thuc 2.1. K tn cc loi thuc cp cu , thuc chng shock , thuc thit yu , thuc
bo him y t (mi loi 20 thuc) 2.1.1. Tn cc loi thuc cp cu
- Atropin 0.25 mg
- Ventoline 5 mg
- Glucose 5 % 500ml
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- Lactac ringer 500ml
- Nifedipin 20mg
- Captoril 25mg
18
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Atenolon 50mg
- Isosorbide dinitrate 100mg
- Diazepam 5mg
19
- Seduxen 10mg/2ml
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Efferalgan 500mg ( Paracetamol)
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Paracetamol codein
20
- Acemol E 100mg
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Chlorpheramin 4mg
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Dofopam 40mg (Alverin citrat )
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2.1.2. C S THUC DNG C HP CHNG SHOCK
1. Adrenaline 1mg 1ml 2. Nc ct 10ml 3. Hydrocortisone 100mg 4. Bm kim tim v khun
02 ng : 02 ng : 02 ng
10 ml : 02 ci 1 ml : 02 ci 5. Phng tin kh trng ( Bng , bng , cn gc ) 6. Dy ga-r 7. Pht cp cu shock phn v .2.2. Thuc cc chng trnh y t khc (tn chng trnh v tn thuc ) :
DANH MC THUC THUC CC CHNG TRNH Y T KHC STT 1 2 3 4 5 1 2 TN THUC HM LNGTHUC ST RT
N V vin vin vin ci ci vin vin vin vin vin vin vin vin vin
S LNG 30 80 16 30 30
XUT X VN VN VN VN VN
HN DNG 12/2011 6/2012 10/2013
Chloroquine 250mg Primaquin phosphat 13.2mg CV Artecan Lam knh Blood lancetTHUC KHHG
Microgynon ED St sulfat acid folicTHUC TM THN- HNG THN
10/2012 19/05/2012 02/08/2013 VN VN VN VN n n 05/10/2012 13/01/2013 10/05/2013 26/05/2013 08/09/2012 31/05/2014
1 Phenobarital 100mg THUC THNG 1 Aminazin 25mg 2 Levomepromazin 25mg 3 Haloperidol 2mg 4 Sperifar 2mg 5 Ozapine 10mg 6 Carbatol 200mg
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Danh mc thuc thit yu :CHLORPPHENIRAMINE PARACETAMOL VITAMIN B6 ( Pyridoxine Hydrocloride ) VITAMIN B1 (Thiamin nitrat ) THEMAXTENE ( Alimemazin tartrat ) VIFAREN ( Diclofenac natri ) METRONIDAZOL MAGNESI B6 ( Magnesi lactate dihydrat + Pyridoxin ) CIMETIDIN SMECTA ( Diosmectite ) ACETYLCYSTEIN TYDOL ( Paracetamol) TYDOL (Paracetamol) SALBUTAMOL MEKOZETEL ( Albendazol ) EFFERAGAN ( Paracetamol ) PREDNISOLON Efticol PARACETAMOL THUC M D.E.P ( Diethyl phtalat 95% ) SUPERTON ( Vitamin, khoang cht ) VASELINE 300mg 3g 200mg 150mg 80mg 2mg 400mg 80mg 5mg 0.9% 500mg 4mg 500mg 250mg 250mg 5mg 50mg 250mg
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2.2 Sp xp v trnh by thuc 2.2.1. Sp xp thuc -
Theo tc dng dc l Theo vn A-B-C Theo nguyn tc : d thy , d ly , d kim tra Ti Trm y t khng c thuc c bng A-B, ch dng cc loi thuc gim c nh : thuc hng tm thn .thuc k hoch ha gia nh , thuc st rt nhng c ring tng t v c sp sp gn gng. 2.2.2. Trnh by thuc
Thuc khng sinh :
Cephalexin 500mg Glonacin 3 M.I.U (spiramycin) - Metronidazol 250mg (Metronidazol 250mg) - Travinat (cefuroxime 500mg) - Ayclovir (acyclovir 800mg) Thuc gim au, h st:-
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Alphachymotrypsine choay (Chymotrypsine) - Panadol (paracetamol 250mg) - Hapacol codein (paracetamol 500mg, codein phosphat 8mg) - Efferalgan (paracetamol 500mg) Khng vim: Predni solon 5mg Seratidaz (serratiopeptidase 10mg) Norflux 90mg Solupred 4mg, 16mg, 20mg
Thuc d ng-
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Clorpheniramin 4mg (Chlorpheniramine) Clanoz (loratadin 10mg) Cedesfarmin (Betamethasone 0.25mg, Dexchlorpheniramine maleate 2mg) Dopola (Dexchlorpheniramine 2mg) Vacopola (Dexchlorpheniramin 6mg)
Thuc mt , mi, tai-
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Cloraxin 0.4% (Chloramphenicol 0.04g) Efticol (nacl 0.09g) Neodex (Dexamethasone 25mg, Neomycin 5.5mg) Povidine ( Povidone Iodine 2g ) Natri clorid (natri clorid 90mg)24
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Osla ( natri clorid 0.033mg)
Thuc b , vitamin-
-
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Zoscal (Calci hydrophosphat , Calci carbonat , Vitamin A,D ) Myvita (vitamin nhm B , E, C, km, ng) Vitamin C 1000 (acid ascorbic 1000mg) C- calci (acid ascorbic , calci carbonat) Luxy cal- D (calcium carbonate , vitamin D3) Calcium- D (calcium gluconat , vitamin D3)
Tiu ng-
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Diamicron MR (Gliclazide) 30mg Gliclazic 80mg Glucofast ( Met formin) 500mg, 850mg, 1g
+ Cao huyt p-
-
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Nifedipin (nifedipin) 10mg Taratril 5 mg Czartan 50 Nifehexal 20mg Amlodipin 5mg
Tr giun sn:
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Zentel (albendazol) Fugacar (mebendazol)
Thuc ho long m: -
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Eugica (tinh du trm , menthol , tinh du tn , tinh u gng ) Acemuc 100mg Mucomyst (acetylcystein) 200mg E xomuc (acetylcystein) 200mg Codatux syrup
+ Thuc gin ph qun:-
Salbumol 2mg Theostat LP 100mg, 300mg
Thuc d dy tiu ha:
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Forgast Maalox (Aluminium hydroxyde 400mg)25
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Cimetidin 300mg Trimafort suspension (Gel Nhm hydroxide, magnesi hydroxide, Simethicone) Smecta (Dioctahedral smectite.) Varogel suspension (Aluminium hydroxide gel) Helinzole (Omeprazol 20mg) Nexium 40mg (Esomeprazole)
An thn kinh tho dc:
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Mimosa ( bnh vi , sen l , lc tin , vng nem l, trinh n) Night queen (bnh vi, sen l, lc tin , l vng nem , trinh n ) Good night (melatonin , cao tm sen )
Thuc li tiu:
2.3.-
Furosemid 40mg Hypothiazid 25mg Quy trnh cp pht thuc
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BS khm v k n Dc s qun l toa , pht thuc Thc hin kim tra (3 tra , 3 i) Giao thuc cho bnh nhn v hng dn cch s dng thuc Dn d nu thy c tc dng ph ca thuc , ngng thuc ngay , n bnh vin hay c s y t gn nht
2.3/Tham gia hng dn s dng thuc hp l an ton 2.4. Tham gia hng dn s dng thuc an ton v hp l
S dng thuc hp l , an ton theo quy ch - Bc s hocY s ph trch chng trnh tm thn k n theo tn bit dc lnh ca chng trnh - Nhn vin dc pht thuc theo ng tn thuc c k n , n thuc phi c ch k nhn ca bnh nhn - So snh thuc iu tr vi chun on : s lng , liu dng ph hp vi tng loi bnh Ging nhau : mc ch iu tr cha bnh Khc nhau : Thuc iu tr : xc nh r nguyn nhn gy bnh nn vic dng thuc thng t hiu qu cao , chnh xc , an ton cho ngi bnh Thuc chun on : do cha xc nh r nguyn nhn gy bnh m ch nghi ng nn vic dng thuc t t kt qu iu tr
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2.4/Theo di thng k hin tng phn ng c hi ca thuc
D ng vi thuc : Laroscorbine Nng , hm lng 500mg x 6 ng , ngy dng 1 ng tim tnh mch chm Din bin : bnh nhn ht hong , da nim xanh , huyt p thp. Cch khc phc v bin php hn ch : - Cch khc phc : ngng lp tc loi thuc ang tim , cho bnh nhn, nm ngh u thp chn cao. - Thuc chng shock phn v: Adrenalin 1% tim tnh mch - Bin php hn ch : thng bo cho bnh nhn bit loi thuc ang dng c phn ng ph , ghi vo s khm bnh ca bnh nhn bng bt , bnh nhn d ng vi Laroscorbine ng tim 3.1 n thuc ti trm y t phng
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n thuc s 1-
H tn ngi bnh : L Mnh Hng M s th: GD7790600904270
Nm sinh : 1955 (Nam)
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a ch:125/26 Nguyn trng tuyn. Qun ph nhun. Chn on : RL m mu Thiu mu c tim Si thn
Tc dng ca thuc : 1/ Trimetazidin 20mg 30 vin Ngy ung 2 ln , mi ln 1 vin 2/Atorlip 20mg Ngy ung 1 ln , mi ln 1 vin 3/ Kim Tin Tho 60 vin Ngy ung 2 ln , mi ln 2 vin 1/ Trimetazidin 20mg : Phng cn au tht ngc. 2/Atorlip 20mg: Ri lon m mu v lm gim t vong cc bnh tim mch. 3/ Kim Tin Tho: si mt, li tiu. Nhn xt: n thuc ca bc s ng vi bnh RL m mu Thiu mu c tim Si thn.
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n thuc s 2-
H tn ngi bnh : Trng Th Ngc Nga M s th : TQ 7972130004709 a ch: Nguyn trng tuyn, Q PN Chn on : Vim xoang mi
Nm sinh : 1963 (N)
Ch nh thuc : 1/ Doroxil 500mg TV (Cephadroxil) Ngy ung 2 ln , mi ln 1 vin 2/ Serratiopeptidase 10mg Ngy ung 3 ln , mi ln 1 vin 3/ Dopalgan 500mg Ngy ung 2 ln , mi ln 1 vin 4/ Loratadin 10mg Ngy ung 2 ln, mi ln 1 vin Tc dng ca thuc : 1/ Doroxil 500mg TV (Cephadroxil): Nhim trng ng h hp trn: nhim trng tai mi hng nh vim tai gia, vim xoang, vim amidan v vim hng hu. 2/ Serratiopeptidase 10mg: Vim xoang, polyb mi, vim tai gia, vim hng. 3/ Dopalgan 500mg: Gim au nhanh cc triu chng au nhc v kh chu. 4/ Loratadin 10mg: Gim cc triu chng nh ht hi s mi v nga. Nhn xt: n thuc ca bc s ng vi bnh Vim xoang mi. 20 vin 15 vin 10 vin 10 vin
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n thuc s 3-
H tn ngi bnh : Nguyn Ha Thun M s th HC 7790904400031 a ch: TT YTDP Chun on : Hi chng c vai
Nm sinh : 1979 (Nam)
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Ch nh thuc : 1/ Meloxicam 7.5mg Ngy ung 2 ln , mi ln 1 vin(sau n) 2/ Dorotyl 250mg (Mephenesin) Ngy ung 3 ln , mi ln 1 vin ( sau n) 3/ Scanneuron (B1, B6, B12) Ngy ung 3 ln , mi ln 1 vin 4/ Omeprazole 20mg Ngy ung 2 ln, mi ln 1 vin Tc dng ca thuc: 1/ Meloxicam 7.5mg: iu tr hi chng vim au xng khp. 2/ Dorotyl 250mg (Mephenesin): Bnh l thoi ho ct sng v cc ri lon t th ct sng: vo c, au tht lng, au lng, cc tnh trng co tht c km theo. 3/ Scanneuron: CAc hi chng thiu VITAMIN B v suy nhc. 4/ Omeprazole 20mg: Tro ngc dch d dy - thc qun, lot d dy t trng, hi chng zollinger Ellison. Nhn xt: n thuc ca bc s ng vi bnh Hi chng c vai. 20 vin 20 vin 20 vin 20 vin
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n thuc s 4-
H tn ngi bnh : Phm Vn Minh M s th : GD 7790900901904 a ch: 9/2 Nguyn Trng Tuyn Q PN Chn on : cao huyt p , RL lipid mu
Nm sinh: 1932 (Nam)
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Ch nh thuc : 1/ Amlodipin 5mg Ngy ung 1 ln , mi ln vin 2/ Bisocar 5mg ( Bisoprolol) Ngy ung 2 ln, mi ln vin 3/ Nitrotad 2.5mg Ngy ung 2 ln mi ln 1 vin 4/ Atorlip 10mg Ngy un 1 ln,mi ln 1 vin 5/ hot huyt dng no Ngy ung 2 ln, mi ln 1 vin 15 vin 15 vin 30 vin 15 vin 30 vin
Tc dng ca thuc : 1/ Amlodipin 5mg: Tr cao huyt p, phng nga cn au tht ngc. 2/ Bisocar 5mg: Tng huyt p, au tht ngc, suy tim. 3/ Nitrotad 2.5mg: iu tr cao huyt p, cn au tht ngc. 4/ Atorlip 10mg: Ri lon lipit mu. 5/ Hot huyt dng no: Hi chng tin nh ; au u, hoa mt chng mt, suy mch vnh, suy gim tr nh. Nhn xt: n thuc ca bc s ng vi bnh cao huyt p, RL lipit m mu.
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n thuc s 5-
H tn ngi bnh : ng nh Tun M s th : HC 779090440134 a ch: TTYTDP Chun on : Ri lon tiu ha
Nm sinh : 1962 (Nam)
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Ch nh thuc : 1/ Cotrim 960mg Ngy ung 2 ln , mi ln 1 vin 2/ Carbogast Ngy ung 2 ln , mi ln 1 vin 3/ Subtyl Ngy ung 2 ln, mi ln 2 vin 4/ Orerol 1 gi pha mt lt nc ung. Tc dng ca thuc: 1/ Cotrim 960mg: L trc khun, nhim trng ng tiu ha. 2/ Carbogast: Tr cc chng bnh v d dy v ng rut: snh hi, chua d acid, vim d dy. 3/ Subtyl: Phng v tr tiu chy, ri lon tiu ha sau khi s dng khng sinh. 4/ Orerol: Phng v iu tr mt in gii v nc trong a chy cp t nh n va. Nhn xt: n thuc ca bc s ng vi bnh Ri lon tiu ha. 10 vin 10 vin 20 vin 06 gi
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n thuc s 5 H tn ngi bnh : Nguyn Th Kim Phng M s th : HC 7790901400021 a ch: THCS Ng my Chun on : Vim hng, au c tay tri(t) Nm sinh : 1967 (N)
Ch nh thuc : 1/ Amoxicillin 500mg Ngy ung 2 ln , mi ln 1 vin 2/ Prednisolon 5mg Ngy ung 2 ln , mi ln 1 vin 3/ Dopalgan 500mg ( Paracetamol) Ngy ung 2 ln, mi ln 2 vin 4/ Bromhexin 8mg Ngy ung 2 ln , mi ln 1 vin Tc dng ca thuc: 1/Amoxicillin 500mg: Nhim trng h hp tai mi hng, rng ming, tiu ha, sinh dc v gan mt. 2/ Prednisolone 5mg: iu tr vim xng khp 3/ Dopalgan 500mg ( Paracetamol): gim au, h st do cm cm. 4/ Bromhexin 8mg: Ch nh ng h hp nh vim hng, tng tit m v kh long m. Nhn xt: n thuc ca bc s ng vi bnh Vim hng, au c tay tri(t) 10 vin 10 vin 10 vin 10 gi
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4.1 / Vn thuc nam Do din tch trm y t khng m bo trng cc loi thuc nam. Tuy nhin trm c trng by cc hnh nh ca cc loi cy thuc nam m bo c 40 cy thuc nam c t gc gio dc truyn thng gio dc sc khe , m bo khi ngi dn n tm hiu v cng dng cch dng ca cy thuc nam s y .
Cc loi cy thuc nam
Thin ng mn (Asparagus cochinchinensis ) B phn dng : r c Cng dng:cha ho m,vim ph qun
Lc tin (Passiflora foetida) B phn dng : dy , l , hoa Cng dng : thanh nhit gii c
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Da cn (Catharanthus roseus) B phn dng : r, l Cng dng : cha huyt p , i tho ng
Cy gip c (Houttuynia cordata) B phn dng: ton cy Cng dng : thanh nhit, gii cm
Ct toi b (Drynaria fortunei) B phn dng : thn r Cng dng : cha bong gn, au lng, thp khp
L du tm (Morus alba) B phn dng: l Cng dung : tr cao huyt p ,mt ng
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Ngh vng (Turmeric) B phn dng : c Cng dng cha vim lot d dy vim gan
M lng (Paederia foetida L) B phn dng : l Cng dng: cha au d dy, tiu chy
Cy trinh n (Mimosa pudica L) B phn dng : thn r , dy l Cng dng : cha au nhc xng , thp khp
Thy xng b (Acorus calamus L) B phn dng : thn r Cng dng : kch thch tiu ha v li tiu
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Cc tn (Pluchea) B phn dng : ton cy , tr r Cng dng : th huyt , cm ho dai dng do vim kh qun
S qun t (Quisqualis indica L) B phn dng: ht Cng dng : tr giun , cam tch
Qu (Cinnamomum) B phn dng : v thn , v cnh Cng dung : cha tay lnh , au bng37
Hoa he (Sophora Japonica L) B phn dng : n hoa Cng dng : phng s va ng mch
Dip h chu (Phyllanthus urinaria L) B phn dng : ton cy Cng dng: tiu c, st trng , tan , iu kinh
H th (Fallopia multiflora) B phn dng : thn r Cng dng : thp khp , au nhc gn ct
M (Plantago asiatica) B phn dng : ton cy tr gc r Cng dng : cha li tiu , thanh nhit , si niu38
Kim ngn (Lonicera japonica) B phn dng : hoa cnh v l Cng dng : thanh nhit , li thp , gii c, li tiu
Trc b dip (Biota orientalis) B phn dng : l cnh Cng dng : tr ho g , chy mu cam , quai b , rng tc
Cc hoa (Chrysanthemum indicum L) B phn dng : cm hoa n Cng dng : cha cm lnh , nhc u , m mt
Cy c mc (Eclipta alba Hassk) B phn dng : ton cy Cng dng : cm mu , dit khun , tiu vim, dng da39
Gng (Zingiber officinale) B phn dng : thn r Cng dng : cha cm cm bng lnh , n ung khng tiu
Mung tru (Zingiber officinale) B phn dng : l Cng dng cha hc lo , bnh herpet vng
Ngi cu (Artemisia vulgaris) B phn dng : ton cy Cng dng : cha chy mu cam, l ra mu ,nn , au bng, au dy thn kinh
a bp (Ficus elastica) B phn dng : moraceae Cng dng: phi hp vi du kh qua lm h dng trong mu
Ru mo (Orthosiphon aristatus) B phn dng : ton cy Cng dng: tr si thn, si mt , st ban
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Kim tin tho (Desmodiumstyracifolium) B phn dng : thn , cnh v l Cng dng: li mt , thng tiu tin , cha si thn , si mt
Hng nhu ta (Ocimum tenuiflorum) B phn dng : ton cy tr r Cng dng : cha au bng , au u , gim st
Tn dy l (Plectranthus amboinicus) B phn dng : c cy Cng dng : cha au bng , au u , gim st
Mch mn (Ophiopogon japonicus) B phn dng : r c Cng dng : cha ho, long m, vim ph qun , to bn
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Si t (Wedelia calendulacea) B phn dng : c cy b r Cng dng : tr l lot , tr rm sy , st rt
Tho quyt minh (Cassia tora L) B phn dng : ht Cng dng : li tiu v i tin , ho nhun trng , cao huyt p , nhc u
Bn h (Typhonium trilobatum ) B phn dng : c Cng dng : ho nhiu , tc ngc
Cam tha t (Scoparia dulcis L.) B phn dng : r hoc thn r Cng dng : thanh nhit , gim nga , cm tiu chy , cm st ho
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X can (Belamcanda chinensis Lem) B phn dng : thn r Cng dng : ho m vim hng
C tranh (Imperata cylindrica ) B phn dng : thn r Cng dng : cha tiu but , tiu dt , tiu ra mu , st nng
Chi t (Gardenia jasminoides Ellis) B phn dng : qu phi kh Cng dng : gii nhit , li mt , cm mu
Nhn (Dimocarpus longan Lour) B phn dng : cm qu Cng dng : cha mt ng , hay qun , m hi trm43
Phn 3 KT LUN - KIN NGH 3.1. Kt lun Trong sut qu trnh thc tp c s y t phng 8 cc nhn vin trm to mi iu kin tt nht em tip xc vi cc loi thuc , xem qua cc bo co lu tn tr trm xem quy trnh cp pht thuc em c th tm hiu v lm tt nhim v ca mnh Nhng k nng thc hnh c hc hi Cch hng dn s dng thuc Cch sp xp , bo qun thuc , cp pht thuc cho bnh nhn Cch kim tra s sch Nhng kinh nghim c tch ly Cch lm vic ti tram y t Kh nng t vn , cp pht hng dn s dng thuc cho bnh nhn Bit c phong cch lm vic ti trm y t 3.2. Kin ngh Do thi gian thc tp ngn nn em cha nm c nhiu v quy trnh lm vic y . Em mong nh trng s to iu kin cho em c thc tp nhiu hn chng em hiu r hn v quy trnh v gip em c kin thc hn trong chuyn ngnh.
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