Trng Trung Cp Y k Lk

LI NI U
c mt hnh trang bc vo ngh tt, khng ch cn kin thc trong
hc tp m cn phi hc hi, tch ly nhiu kinh nghim t nhiu yu t bn
ngoi. Bi vy, phi hc i vi hnh.
K thc tp l thi gian sinh vin bt u lm quen vi tc phong lm
vic tiu c s y t. i vi dc s trung hc tng lai, y l c hi tt em
c th vn dng nhng kin thc c hc trn gh nh trng v kinh
nghim trong thc t hon thnh bo co thc tp.
Bi bo co thc tp ca em l cun ti liu thu nh, ghi chp li tt c
nhng vn em c hc, thc hin v nhng gt tip thu c trong qu
trnh i thc t ti c s.
hon thnh tht tt cc mc tiu nh trng giao, t chuyn i thc
t, em hc hi c nhiu kinh nghim t cc y bc s ti bnh vin. l
nhng kin thc b ch, l hnh trang vng bc sau ny bc vo ngh sau
ny trong cng tc chuyn mn.
Qua y em cng gi li xin chn thnh cm n n cc thy c gio
trong trng v cc y bc s ti bnh vin to mi iu kin gip em hc
hi nng cao v chuyn mn, kin thc thc t
Bun Ma Thut, ngy 27 thng 1 nm 2014
Sinh vin

ng Th Thu Tho

SVTH: ng Th Thu Tho

Trang 1

Trng Trung Cp Y k Lk

LI CM N
Qua mt nm hc tp ti trng Trung cp y t k Lk, y l khong
thi gian khng di nhng em c cc thy c tn tnh dy d, truyn t
cho em nhng kin thc qu bu v b ch trong ngnh y dc.
Sau t thc tp thc t 5 tun ti bnh vin a Khoa Tnh k Lk va
qua em cng hiu hn cng sc ca cc thy c, nhng k nng kint hc m
cc thy c trao i cho chng em l rt ln m chng em khng bao gi
qun.
Bi thu hoch ny ch l mt phn kin thc nh b, n cha nh gi ht
nhng g m thy c ch dy cho chng em.
Em xin chn thnh cm n.
* Ban gim hiu, phng o to vi qu thy c trong trng du dt
chng em t nhng bc i u tin, xy dng cho chng em mt nn kin
thc qu bu v b ch trong ngnh y dc.
* Ban gim c bnh vin a Khoa Tnh k Lk, cng ton th cc cn
b y, bc s ca bnh vin to iu kin thun li cho em thu nhp s liu ti
bnh vin.
Em xin chn thnh cm n!
Bun Ma Thut, ngy 27 thng 1 nm 2014
Hc sinh

ng Th Thu Tho

SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

I. Gii thiu i nt v c s thc tp

* Lch s hnh thnh v pht trin
Bnh vin a Khoa Tnh k Lk thuc thnh ph Bun Ma Thut, tnh
k Lk, c xy dng gn trung tm tnh k Lk. Bnh vin c din tch
ln, nm trn trc ng giao thng thun li nn rt thun tin cho vic khm
cha bnh cho nhn dn, vi s dn gn 100.000 ngn dn, l mt thnh ph
ng dn c v dn tc thiu s nn lng ngoi ti khm cha bnh rt ng.
Chnh v vy m bo thc hin tt ni dung khm cha bnh ti c s l
chm sc sc khe cho ngi dn trn a bn, nn bnh vin a Khoa Tnh
k Lk xy dng c c s vt cht, khang trang, sch s, y . Gm c
cc khoa, phng bnh, khun vin, sn th thao thong mt, rng ri v c i
ng y, bc s c tay ngh p ng nhu cu chm sc sc khe ca nhn dn
trong thnh ph v mt s ni ln cn.
II. V tr ca khoa dc
- Khoa dc ca bnh vin l mt khoa chuyn mn gip gim c bnh
vin qun l ton b cng tc dc v cung cp nhu cu cho cng tc iu tr v
nghin cu dc trong bnh vin.
- L t chc cao nht m bo mi cng tc chuyn mn v dc, do
khoa dc khng ch mang tnh cht ca mt khoa qun l, tham mu v ton
b cng tc dc trong ton bnh vin nhm gp phn nng cao hiu qu v
m bo an ton trong cng tc khm v cha bnh nht l trong vic s dng
thuc.
Khoa dc chu s lnh o ca ban gim c bnh vin.
1. Chc nng ca khoa dc
- Qun l thuc men, ha cht, dng c v cc ch chuyn mn v
dc trong bnh vin.
- Trong bnh vin khoa dc c b tr a im thun li trn, c
iu kin lm vic, h thng kho, kho iu ch thuc y hc c truyn phng cp
pht m bo ch v sinh, sch s, cao ro, thong mt.

SVTH: ng Th Thu Tho

Trang 3

Trng Trung Cp Y k Lk

- Lp k hoch cung ng v m bo s lng, cht lng thuc khng

thng, thuc chuyn khoa, dng c y t ha cht cho iu tr ni tr. Ngoi tr
p ng nhu cu hp l.
- Tham gia qun l kinh ph thuc, thc hin tt hiu qu cao, l c s
thc hnh ca cc trng trung hc y dc.
- Tham gia nghin cu khoa hc, thng tin v thuc.
2. Nhim v ca khoa hc
- Lp k hoch pht trin cng tc dc v k hoch lp d tr v nhu cu
thuc, nghin cu khoa hc v l c s o to cn b cho cc trng.
- Thng xuyn thc hin kim tra, kim sot thuc cht ch, nhm
khng ngng nng cao trch nhim, m bo an ton cho ngi dng.
- Bo qun thuc, dng c khoa phng mnh qun l ng thi hng dn
phng khc trong bnh vin v bo qun thuc, y dng c.
- Chp hnh cc ch chuyn mn v dc trong khoa phng mnh
hng dn v thc hin cc ch chuyn mn cho ngnh.
- Hng dn s dng thuc, thc hin cc ch ca bnh vin, tham d
v tham gia kin v dc trong cc bui hp chuyn mn.
- Ch o k thut v nghip v v dc i vi tuyn trc.
- Nghin cu khoa hc v dc theo phng hng ca ngnh v yu cu
iu tr.
- Tng hp bo co trnh hot ng thng k, quyt on thuc v mt
hm lng dng ng quy nh, ng thi hn v ng quyn hn chuyn mn.
- Lp k hoch v cung ng m bo s lng, cht lng thuc thng
thng v thuc chuyn khoa, ha cht vt dng y t tiu hao: Bng, bng, cn,
gc cho iu tr ni tr, p ng nhu cu iu tr hp l.
- Kim tra theo di, vic x l, s dng thuc an ton, hp l trong ton
bnh vin.
- Tham gia qun l kinh ph thuc, thc hin tit kim t hiu qu cao
trong phc v ngi bnh.
- L c s thc hnh cc trng cao ng, trung cp y dc.
SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

- Tham gia nghin cu khoa hc thng tin v thuc.

- Khoa dc c b tr thun tin, c iu kin lm vic, cung cp
thuc cho cc khoa v bnh nhn.
- Qun l quy ch, ch chuyn lp k hoch hng thng thuc. VTTH
st vi thc t cho iu tr ni ngoi tr ca bnh vin.
- Cung ng thuc, vt t tiu hao cho ton bnh vin v 22 n v x,
phng.
- Cp pht thuc ni, ngoi tr hng ngy cho bnh nhn, hng thng cho
x, phng.
- Cp pht, thuc chng trnh cho bnh nhn ngoi tr.
- Giao thuc iu tr ni tr ti tn khoa lm sng.
- Kim k hng thng vo ngy cui thng.
- i chiu xut, nhp, tn bo co, vi phng k ton bnh vin.
- Bo co thuc gy nghin, hng tm thn hng ngy, 6 thng, c nm.
- Qun l thuc hng thn, gy nghin.
- Qu trnh cp pht.
* Nhim v khoa dc vi hi ng v iu tr ca bnh vin.
- Xy dng danh mc thuc ph hp vi c th bnh tt v chi ph v
thuc, vt t tiu hao ca bnh vin.
- T vn cho gim c v cung ng, s dng thuc an ton, hp l v hiu
qu.
- Xy dng danh mc thuc ph hp vi c th bnh tt v hp l vi
chi ph.
- Theo di phn ng c hi ca thuc v bo co kp thi ln cp trn.
- Gim st vic thc hin quy ch s dng thuc v quy ch cng tc kho
dc.
- T chc gim st vic thc hin quy ch, chun on, qun l h s
bnh nhn, bnh n v k n iu tr ca bc s.
- Bo co giao ban rt kinh nghim trong cng tc qun l v sai st trong
dng thuc an ton, hp l, hiu qu v tit kim.
SVTH: ng Th Thu Tho

Trang 5

Trng Trung Cp Y k Lk

- Theo di ADR thng tin v thuc mi.

- Xy dng mi quan h hp tc cht ch, gia dc s, bc s, y t, trong
dc s l ngi am hiu v thuc v tham gia t vn cho bc s iu tr, bc
s ch nh y bnh, y t hng dn s dng thuc an ton, hp l, ng y bnh
trong qu trnh chm sc bnh nhn.
- Dc s trng khoa v hi ng thuc iu tr hp nh k hng thng
mt ln.
3. Nguyn tc iu tr v hot ng ca hi ng thuc
- Bnh vin phi c hi ng thuc v iu tr.
- Hi ng thuc v iu tr l t chc t vn cho gim c bnh vin v
cc vn lin quan n thuc v iu tr bng thuc ca bnh vin, m bo s
dng thuc an ton, hp l v hiu qu, c th ha cc phc iu tr ph hp
vi iu kin bnh vin.
4. Cng tc cung ng, tip nhn, tn tr, bo qun cp ht thuc, ha
cht, trang thit b y t.
- Lp k hoch thuc, ha cht, vt dng y t tiu hao ng thi gian quy
nh.
- Khi nhu cu thuc tng t xut th phi lm d tr b sung.
- Bnh vin ch yu mua thuc doanh nghip nh nc, i vi thuc
gy nghin, thuc chuyn khoa do cc cng ty dc phm trung ng hoc a
phng cung ng theo ng k hoch.
- Mi ngun thuc trong bnh vin mua, vin tr u phi kim nhp.
- Vic mua bn thuc phi thc hin qua th thc u thu, chn thu, ch
nh thu cng khai theo quy nh ca Nh nc.
- Kho c thit k theo ng quy nh ca nh nc.
- Vic sp xp trong kho ngn np c gi k, xp theo chng loi d
thy, d ly.
- Thuc, ha cht bo qun iu kin thng thng.
+ Phi bo qun theo ng tnh cht, yu cu ring tng loi

SVTH: ng Th Thu Tho

Trang 6

Trng Trung Cp Y k Lk

+ Trnh m mc cho thuc vin, trnh chy nc cho vin nang, vin bao
ng.
+ Thng xuyn theo di cc hin tng bin cht, i mu, vn c,
hunh quang i vi thuc tim.
- Dc liu phi c ng gi v c bin php bo qun thch hp vi
tng loi
+ ni kh ro thong mt
+ m bo tiu chun cht lng quy nh, c nh k kim tra, c
bin php phi sy.
+ Chng h hng, su mt, mc.
+ nh k chuyn, o kho.
- Thuc, ha cht c yu cu bo qun c bit
* Ch cp pht thuc khoa dc
- Phiu lnh thuc nu ghi sai hoc phi thay th thuc phi c bc s
iu tr sa li v xc nhn vo phiu sau khi c kin ca dc s khoa dc.
- Thuc gy nghin, thuc c, thuc hng thn phi thc hin cp pht
thuc theo quy nh hin hnh.
- Thuc bt, thuc nc phi ng gi liu nh cho tng loi, tng ngi
bnh
- khoa dc bnh vin c cc phng cp pht thuc: kho cp pht thuc
bo him y t, y dng c v kho cp pht thuc vin ph, ngun thuc cho tr em
di 6 tui, hai kho ny c nhim v qun l, d tr, cp pht thuc v cp y c
cho ni tr, ngoi tr.
+ Khoa ni nhi nhim
+ Khoa ngoi sn
+ Khoa cp cu
+ Ngun bo him
+ Ngun tr em di 6 tui, vin ph, cp thuc chng trnh
+ thc hin tt cng tc cp pht thuc ngi dc s trc khi pht
thuc phi thc hin tt 3 kim tra, 3 i chiu.
SVTH: ng Th Thu Tho

Trang 7

Trng Trung Cp Y k Lk

+ Hng dn bnh nhn cch s dng thuc an ton hp l, ng liu quy

nh.
+ Khoa dc chu trch nhim ton b v cht lng thuc do khoa dc
cp pht.
III. Danh sch thuc ca khoa dc:
A. Thuc d tr bo him:
STT
1
2
3
4
5
6
7
8
9
10
11
12

Tn Thuc

Nystatin
Clrithromycin 500mg
Erythromycin 250mg
Hoxithromycin 250mg
Spyramycin 1,5tr VI
Spiramycin 3tr VI
Spiramycin 750.000VI
Spiramycin +

13
14
15

Nalidixicacide 500mg

16

Oflexcin 200mg
Sunfamethoxa +

18
19
20
21
22

Hng SX

VT

Qung Bnh

vin

Bidiphar

Danaphar

S. Pharm

vin

Th Nh K

vin

Ampharco
Khapharco
Tipharco
Domesco
Domesco
Domesco

vin
vin
vin
vin
vin
vin

Ung Naphacogyl

Nam H

vin

Ung Scanex 500

Nh mt Evrocin 5ml
Ung Nergamdicin

Stada
VN

vin
l

Khapharco

vin

India

vin

Ung: Biseptol 480

Ba Lan

vin

Ung
Ung
M tra mt
Ung
Ung: Pharmox

Stada
Mekopha
Qung Bnh
Domesco
TW7

vin
vin
tube
vin
vin

I. Nhm thuc khng khun

Chloramphenicol 250mg ung Chlosamphenico
Nh mt
Chloramphenicol 0,4%
Chlosamphenicol
Chloram +
nh mt: ticolder
dexamethoson
Metronida zole 250mg
ung
Metro + Neomycin +
t m o: Neo

Metronidazole
Gprofloxacin 500mg
Gprofloxacide 0,3%

17

Bit Dc

trimethoprin
Doxycylin 100mg
Tetracylin 500mg
Tetracylin 1%
Tinidazol 500mg
Amoxycillin 500mg

SVTH: ng Th Thu Tho

penotran
ung: Amfarex 500
ung: Erythromycin
Ung
Ung Dorepcin
Ung Dorepcin
Ung Dorepcin

500
Ung: Mediflox 200

Trang 8

D
Tr

Trng Trung Cp Y k Lk

23
24
25
26

Amoxycillin 250mg
Amoxycillin 250mg
Amoxyallin +

ung
Ung eumocin
Ung ofmantin 250 +

Clavulalamic
Amoxycillin +

3125
Ung Claminat 500 +

Clvlalamic

125
Ung Unasyn 250 +

27

Ampicillin + Sulbactim

28
29
30
31
32
33
34
35
36
37
38
39
40

Cefalexin 500mg
Cfalexin 250mg
Cefalexin 250mg
Cefixime 100mg
Cefixime 200mg
Cefaclor 250mg
Cefaclor 500mg
Cefuroxin 250mg
Cefuroxim 500mg
Cefadroxyl 500mg
Cefdinir 300mg
Cefdinir 125mg
Cfradin 500mg

41

Phenoxy Methypenicillin

42
43
44
45
46
47
II
48
49
50
III

Gentamycin 0,3%

Bnh nh
Eoviphar

vin
vin

Domesco

vin

Imexopham

vin

vin

Cyprus
Bnh nh
Euviphar
TW7
Torren
VN
Medo
Indian
Indian
Torren
Uphace
Uphace
Bidiphar

vin
vin
gi
vin
vin
vin
vin
vin
vin
vin
vin
gi
vin

Mekopha

vin

Bidiphar

Nh mt: Maxitron

Euviphar

Nh mt: Fyraan

Nh mt: Eytobra D

Korea

Thy S

Php

Domesco
Medipharco
Domesco

vin
tube
vin

125
Ung Cefalexin 500
Ung Cefalexin 250
Ung Eulexcin
Ung Mexim 100
Ung forfexim 200
Ung
Ung: Medoclo
Ung: Penturox 250
Ung: Lexibase 500
Ung: Torodroxyl
Ung Uphacefdi 300
Ung Uphacefdi 125
Ung Bfrandin
Ung: penicillin
400000 VI
Nh mt: Gentamycin
10g

Neomycin + polymicinB
+Dexa
Thramycin
Thramycin +
Dexamethas
Chloramphenicol +
Dexamerh
Providon + Acidbo +

Nh mt Sperradex
5ml
Nh mt: Oculotect

Nacl + KG
10ml
Thuc nhm Virus
Acyclovir 200mg
Ung Acylovir
Acyclovir 5%
Dng ngoi
Lamivudin 100mg
Ung
Thuc khng nm vng ngoi

SVTH: ng Th Thu Tho

Trang 9

Trng Trung Cp Y k Lk

51

Clotrimazol +

52
53

Betamothsol
Fluconazol 150mg
Ketoconazole 200mg

54

Ketoconazole 2%

55
56

Nystatin 100.000VI
Nystatin 500.000VI
Nystatin + Metro +

57
58
59
60
IV
61
62
63
V
64
65
VI
66
67

Cloram + Dexa
Nystatin + Neomyein +
Ploy
Saliaflic aad +

Dng ngoi Gentrison VN

tube

Ung: Flucoted
Ung
Dng ngoi: Comzel

t V Ph
Stada

vin
vin

VN

tube

Medipharco
ng Nai

vin
vin

DP 3/2

vin

t: Fungract

Indian

vin

Ampharco

tube

OPV
TW7
Indian

l
vin
vin
vin
vin

Danaphar
Danaphar

vin
vin

Apla

Apla

Vidiphar

Pymephare
c

vin
ng

VN

ng

ng

Organon
Organon
B

vin
vin
vin

5g
t
Ung

Dng ngoi:

Betamethason
Keradesim 15g
Du m u
Dng ngoi
Thuc tr giun, sn
Albendazol 200mg
Ung zentel
Mebendazole
Ung: Benca 500mg
Pysantel 125mg
Ung: pantel
Thuc chng ri lon tm thn
Sulepercl 200mg
Ung
Amitriptylin 25mg
Ung
Thuc hc mn, thng thn, ni tit t:
Dng ht: Budenase
Budesomicl
AQ
Beclometason
Dng xt: Beclate
(Dicloproncit)
Dexamethason +

0,1%
Nh mt, mi:

69
70

Neomycin
Methyl prednisolo 4mg
Hydrocortisone 100mg

71

Hydrocotisone 1%

polydexon 5ml
Ung: Medison
tim
Dng ngoi: Enoti

72

Ergometrin

73
74
75

Estriol 1mg
Lynestrenol
Progestersone

68

SVTH: ng Th Thu Tho

10g
Tim: Egrometrin
0,2mg/1ml
Ung: ovestin
Ung: orgametri 5mg
Ung: Utrogestan

Trang 10

Trng Trung Cp Y k Lk

VII
76
77
78
79
80
81
82
VIII
83
84
85
86
87
IX
88
89
90
91
92
93
94
95
96
97
X
98
99
100

100mg
Thuc h ng huyt, huyt thanh v gluco min dch
Gliclazide 80mg
Ung: Gliclazic 80
Domesco
Gliclazid 30mg
Ung Dcron 30MR
Domesco
Gliclazid 80 +
Ung: Dianm M
Indian
Metformin 500
Tim Wosulin
Insulin (30/70)
Wockhardt
4000L/10ml
Metfomin 500mg
Ung Finascar
Banglades
Proglitazon 15mg
Ung: Dobidi
Domesco
Huyt thanh khng un
Tim: Sat 5000l/mlIvae
vn
3ml
Thuc gin c v tng trng lc c
Epesison 0,05g
Ung Macininr
Indian
Pipercusium bronmicle
Tim arduan 4mg/2ml Hung
Suxamethonium
Tim
c
100mg/2ml
Thiccolehicosid 4mg
Ung Coltramyl
Russel
Neostigmine bromicle
Tim Notigmine 0,55 c
Thuc iu tr mt, tai, mi, hng
Nh mt: Tetracin
Dicein
DP 3/2
0,5%
Acetazolemide 250mg
Ung
Pharmedic
Nh mt: Isopto
Piloceurpin 2%
Alcol
carpin
Nh mt: Airopin
Atropin 0,1%
Vin mt
0,1%
Nh mt, mi Natrol
Natri chloride 0,9%
Euviphar
10ml
Triopicamid 0,5% 5ml
Nh mt: Mydrin P
Nht
Nh mi:
Xylometazolin 0,05%
Danaphar
Xylometazolin
Naphazolin 0,05%
Dng ngoi: Euvinex Euviphar
Argyrol 3%
Nh mt
Danaphar
Betahistin
Ung: Sese 8mg
H Lan
Thuc cm mu, thc , gy t, m
Oxytexcin 50L
Tim: Vinphatoxin
Vinpharco
Mysoprostol
Ung: Alsoben 200mg Korea
Halothan
ng h hp: 250ml Anh

SVTH: ng Th Thu Tho

vin
vin
vin
ng
vin
vin
ng
vin
ng
ng
vin
ng
l
vin
l
l
l
l
l
l
l
vin
ng
vin
l
Trang 11

Trng Trung Cp Y k Lk

101

Bupsvaceine

102
103

Lidocein _ Adrelnalin
Lidocein 10%

104

Lidocein 2%

105

Lidocein 2%

106

Isoflusane

107

Propofol

108
109

Tim Marcain 0,5%

4ml
Tim: Medicein 2%
Kh dung: 10% spay
Thuc m: Xylocein
2% 30g
Tim
ng h hp Foran
100ml
Tim Propofol

Ioxitalmetmeglumin +

20ml/200mg
Tim telebrix 35

Sodium
Thiopental 1g

mg/50ml
Tim

Thy S

ng

Korea
Hungari

ng
l

Thy S

tube

Vnh Phc

ng

Anh

Brdun

ng

Php

l
l

D tr
Kho BHYT

Kho vin ph

Khoa lm
sng

Khoa cn lm
sng

Mua

Vn chuyn

* QUY TRNH CUNG NG V CP PHT THUC CA KHOA DC

Kim nhp

Khoa ngoi
sn
Qun l ti
khoa

Khoa cp cu
lin chuyn
khoa

Khoa ni
nhi nhim
ng y

Kim k

Lp s sch
SVTH: ng Th Thu Tho
Thng k
Cp pht

Trang 12
Kim tra

Trng Trung Cp Y k Lk

B. Mt s bn lu khi dng thuc cho bnh nhn

* NHNG THC NN GIM, TRNH HOC THN TRNG
KHI DNG NGI BNH SUY GIM CHC NNG THN
TN THUC

MC SUY
THN

Acetazolamid

Nh

Aud Acetyl Salicylic

Nng

Gentamycin

Nh

Insulin
Ironiazid

NHN XT
trnh dng, nhim c aud, chuyn ha
Tranh dng vi nc v natri gin tit sau khi
TM nhanh
Dng liu hiu qu thp nht gy tch nc v
natri, yhair chc nng thn c th dn n suy

chcx nng thn

T va n nng Trnh Dng
Liu ti a 200mg/Ngy, bnh thn kinh
Nng
ngoi vi

SVTH: ng Th Thu Tho

Trang 13

Trng Trung Cp Y k Lk

Magnesi sulfat

Va

Morphin

T va n nng

Ofloxacin

Nh

Pethilin

T va n nng

Kaliclorid

Va

Propranolol

Nng

trnh dng hoc gim liu

Gim liu hoc trnh dng c tc dng tng
hoc ko di, nhy cm ca no tng
Dng liu u tien nh bnh thng sau
dng liu gim = 1/2
Gim liu hoc trnh dng, tc dng cao hoc
ko di, tng nhy cm ca no
Trnh dng hng ngy c nguy c kali huyt
cn
Bt u vi liu nh c th lm gim lu
lng mu trong thn nh hng xu n
chc nng thn ngi bnh suy chc nng

Nng
Nh

thn nng
Trnh Dng
Gim Liu
Dng vi1/2 liu thng thng nu thanh

Nh

thi creatinin l 15 30ml/pht trnh dng

Wasfarin
Calcionin

Nng
Va

Cefoaxim

Nng

nu thanh thi nh hn 15ml/pht

Gim liu
Gim liu
Dng vi liu chc nng thn tng nguy c

Amoxicylin
Amoxicylin +

Nng

Quinin
Streptomycin
Sulfa methoxazolt
trimethoprum

Acidclauvulanic
Ampicillin,penzathin
, pennicillin
Carbamazepin
Cloramphenicol
Cloroguine
Cimeiclin
Ciprofloxacin

xut huyt ng tiu ha

Gim liu hay pht ban

T va n nng Gim Liu

Ng c thn kinh, liu cao, c th gy co

Nng

git
Hng sn xut khuyn co nn thn trng
Trnh dng nu c thuc thay th gim d to

Nng
Nng

huyt theo liu

T va n nng Gim liu
Hn ch liu xung 600/800mg/ngy i khi
T nh n va
c nguy c ri lon
Dng liu thng thng, thi gian na i

Clindamycin
SVTH: ng Th Thu Tho

va

trong huyt tng thng ko di c th cn

gim liu
Trang 14

Trng Trung Cp Y k Lk

Codein

T va n nng

Diazepam

Nng

Digoxin

Nh

Gim hoc trnh dng tng liu v ko di tc

dng ca thuc, tng nhy cm ca no
Bt u vi liu nh, tng nhy cm ca
no
Gim liu, tng nhim c do nhiu lon cht

Ephedrin
Erythromycin
Fusoseinid
Ceflexin
Clopromazin
Closythromycin

in phn.
Nng
Trnh dng, ng c h thn kinh trung ng.
Nng
Dng liu ti a 1,5g/ngy, ng c thnh gic
Va
C th cn dng liu cao
Nng
Liu ti a 500mg/ngy
Nng
Bt u thp nht
T va n nng Dng vi liu
Dng vi liu tc dng thp, theo di chc

Biclofencie

T va n nng nng thn gi nc v Natri gy hi chc

Fentanyl

T va n nng

Indomethacin

Nh

nng thn c th dn n suy thn

Gim liu hoc trnh dng, tng nhy cm
ca no
Dng liu thp nht, theo di chc nng thn
gi nc v Natri gy hi chc nng thn c
th gy n suy thn
Dng vi liu c tc dng thp nht, theo di

Pisoixcam

T va n nng

Tetracylin

Nh

ur trong huyt tng tng tc hi ti chc

Nh

nng thn
Gim liu
Bt u vi liu thp hn

Tobramycin
Diltiazem

chc nng thn.

Trnh dng tc dng chng ng ha, tng

* Nhng loi thuc nn trnh hoc thn trng khi dng cho:
TN THUC
Acid Acetylsalicylic
Amynophylin
Carbamzpin
Theophylin
Eteme
Levonrgestrel

NHN XT
Trnh dng nguy c chy mu, ng tiu ha.
Gim liu
Suy gim chuyn ha bnh gan ang tin trin
Gim liu
Trnh dng
Trnh dng ngi bnh gan tin trin nu c lch s bnh
nga hoc vim mt trong thi k mang thai.

SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

Silfamethoxzel + Trime

Hng sn xut khuyn co nn trnh dng ngi b bnh

Testostesson

gan nng
Trnh dng th tt hn c kh nng gy c theo liu v gy
tch nc

* Cc thuc bi tit qua sa m

TN THUC
Ru
Cc loi thuc chng
ng mu

Thuc khng Histamin

NHN XT
S lng ln c th nh hng n tr v gim tiu th
sa
Tng nguy c xut huyt do thiu vitamin, warafin an ton
nn trnh dng phenidone, hng sn xut dicuomasol gi
d phng vitamin K cho tr.
Mt s thuc Histamin vo sa m vi mt s lng ln
mc d cha r tc hi nhng cc hng sn xut khuyn
co khng nn dng, c thng bo tr b hoa mt, chng

Cephalospin

mt vi thuc Clemastine
C bi xut trong sa m vi nng thp.
Nn dng loi khng sinh khc v c th gy ng c ty

Closmaphenicols

xng tr em, nng thuc trong sa m thng khng

Gprofloaxcin

gy hi chng xanh, xm, Greysyndrome.

Trnh dng, nng thuc trong sa m s cao
Trnh ung thuc trnh thai trong 6 thng hoc cho n

Thuc trnh thai ung

Erythrromycin
Thyprofen

Isonizid

khi cai sa m.
Ch c lng nh trong sa m
Lng thuc qu nh khng gy hi nhng mt s nh
sn xut khuyn co nn trnh dng.
Theo di tr phng c ng c thuc nguy c trn l
thuyt v co git v bnh thn kinh khuyn dng
Pysidoxin d phng cho c m v con
Liu iu tr khng c nh hng n tr, vi nhng b m

Morphin

Nicolin
Norflexain

ph thuc xy ra triu chng cai thuc ph n cho con

b khng phi l bin php tt nht iu tr ph thuc
con nn ngng li.
Trnh dng, c trong sa m
Cha c thng tin, khuyn co nn trnh dng.

SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

Paracetunol
Penicillin

Lng thuc vo sa m qu nh, khng gy hi

Theo di lng thuc trong sa
Thng bo c gy kch thch cho tr, dng ch phm

Theophylin

phng thch gy c kim sot, c th an ton.

Thuc Steriod chuyn

ha (Anabohic Steroid

Gy nam ha cho thai nhi n

1.2.3)
Vi liu lng c ch h hp s sinh, gim trng lng
Thuc gy m ti ch

v nhp tim chm sau khi nghn c, hoc ngoi mng

cung, Methacmoglebin huyt s sinh vi thuc prilocin v
procain

Thuc ng mu
Heparin (1.2.3)

C thng bo v chng long xng sau khi dng ko di.

C th gy c ch pht trin ca thai nhi trong t cung,

Thuc Chen beta

gy gim glucose huyt v nhp tim chm, nguy c cai hn

th hin tng huyt p trm.

Tetracylin
Trnh dng v gy vng men rng tr
Thuc gy m chung
Gy c ch h hp s sinh
* Cc thuc nn trnh s dng hoc thn trng khi s dng trong
thi k mang thai:
+ Giai on: 1:3 thng u
+ Giai on: 2:3 thng tip theo
+ Giai on: 3:3 thng cui
Thuc
Cc thuc c ch

Nhn xt
Trnh s dng nh hng ti thai nhi, huyt p v chc

men chuyn ng

nng thn ca tr s sinh, cng c th gy khuyt tt s v

Angiotesin

gy chong t dch i, c ng c thng qua nghin cu

Albandazol
Ru (1,2)

trn ng vt
Cc nh sn xut c gy qui thai trn ng vt
Nu dng hng ngfy c th gy qui thai (hi chng ru
trong thai nhi) v c th gy chm pht trin nu thnh
thong ung v ung t c th an ton, c th xut hin hi

Thuc nhm

chng cai thuc nhng tr c m nghin ru.

Gy tn hi thn kinh thnh gic hoc thn kinh tin nh,

SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

Aminoglycosid

nguy c cao nht vi thuc Streptomycin c nguy c rt

(2,3)

nh vi thuc gentamyan v tobramyin, nhng nn trnh

dng ngoi tr trng hp cn thit (nu dng phi theo

Nicotin (1,2,3)
Omeprazol
Gim u Opi (3)

di nng thuc trong khi nghin cu trn ng vt)

Trnh dng
Nh sn xut khuyn co ng c
c ch h hp sinh gy t, iu dng dng cc thuc tr
s sinh, cc b m ph thuc thuc gy d dy v vim
phi do ht kh dch cho b m trong khi chuyn d sinh.

Parasetmol
Penicillin
Cephalosprin
Cimetidin
Clayrthromycin

Cha bit tc hi
Cha bit tc hi
Cha bit tc hi
Nn trnh s dng ngoi tr tht cn thit
Cha bit tc hi, tuy nhin nn trnh dng tr khi li ch

Corticosteroid
Thuc li tiu (1)

cao hn nguy c.
Ch dng khi li ch cao hn nguy c.
Khng dng trong khi iu tr tng huyt p trong thai k,
nn trnh dng Actnzolamio v toracemid thuc Thiazid

c th gy gim tiu cc s sinh.

Cp Pht Thuc
Theo di thuc
Mebenelazol
Khuyn co ng c qua nghin cu trn ng vt.
Vitamin a(1)
Qu liu gy qui thai
IV. Mi quan h Y Bc s, dc s v y t trong s dng thuc an
K n

tonDc
cho lm
ngi
bnh
sng

T vn theo di ADR
ang gi s dng thuc
theo di thuc iu tr,
phng phi thuc v
tng

Cc vn
lin quan
ti thuc

C khng iu tr thuc sai,

thuc di liu, thuc qu liu,
phn ng tng tc thuc,
khng phc tng ch nh khng
hiu qu

Nhn
bit

Gii quyt

Ngn nga

Hiu qu ca thuc tt nht v

khng c hi hoc t c hi, cc
phn ng c hi
SVTH: ng Th Thu Tho
Cht lng cuc sng bnh nhn rt tt

Trang 18

Trng Trung Cp Y k Lk

V. Mt s n thuc
1. n 1:
H tn bnh nhn: T Th Thy Lan
Nm sinh: 2007

Chun on: Hi chng ly

- Klion (Metronicdazol) 0,25g x 7 vin

- Ung:
- Amoxcillin 0,25g x 10 gi
- Ung:
- L Bio 1g x 10 gi
- Ung:
- Hupacol (paracetunol) 150mg x 10 gi
- Ung:
- Bameplex 100ml x 1 chai
- Ung: Sng 1 tha c ph Chiu 1 tha c ph.
2. n 2:
H tn bnh nhn: V Xun Cng
Nm sinh: 1936

Chun on: Cao huyt p

- Trofurid (Furosemid) 40mg x 10 vin

- Ung: sng 1 vin Chiu 1 vin
- Catoril 25mg x 10 vin
- Ung: Sng 1 vin Chiu 1 vin
- Magie B6 x 20 vin
SVTH: ng Th Thu Tho

Trang 19

Trng Trung Cp Y k Lk

- Ung: Sng 2 vin Chiu 2 vin

3. n 3:
H tn bnh nhn: Nguyn Minh Tn
Nm sinh: 1994

Chun on: Hi chng d dy

- Amoxcillin 500mg x 10 vin

- Ung: Sng 1 vin Chiu 1 vin
- Klion (Metronidazol) 250mg x 10 vin
- Ung: sng 1 vin Chiu 1 vin
- Omeprazol 20mg x 5 vin
- Ung: Sng 1 vin
- Grangel x 10 gi
- Ung: Sng 1 gi chiu 1 gi
4. n 4:
H tn bnh nhn: Trng Quc Minh
Nm sinh: 1980

Chun on: Chm bi nhim

- Cefalexin 500mg x 20 vin

- Ung: Sng 2 vin Chiu 2 vin
- Clophenisamin 4mg x 10 vin
- Ung: Sng 1 vin Chiu 1 vin
- Serazyl 10mg x 10 vin
- Ung: Sng 1 vin Chiu 1 vin
- Bar x 10 vin
- Ung: Sng 1 vin Chiu 1 vin
- Hankocin x 10 vin
- Ung: Sng 1 vin Chiu 1 vin
5. n 5:
H tn bnh nhn: Bi Vn Qu
Nm sinh: 1954

Chun on: Vim khp bn ngn 1 tay/vim d dy

- Pemicillin 1.000.000VI x 18 vin

- Ung:
SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

- Pesnisolon 5mg x 16 vin

- Ung:
- Meloxicam (Melotop) 7,5mg x 15 vin
- Ung:
- Omeprazol 20mg x 10 vin
- Ung:
- Gromgel x 10 gi
6. n 6:
H tn bnh nhn: Phan ng Hng
Nm sinh: 2005

Chun on: Vim h hp trn

- Cefuroxim 125mg x 10 gi
- Ung: Sng 1 gi Chiu 1 gi
- Presnisolon 5mg x 10 vin
- Ung: Sng 1 vin Chiu 1 vin
- Mitux (Acetylsystein) 200mg x 5 gi
- Ung: Sng gi Chiu gi
- Hapacol (paracetamol) 125mg x 10 gi
- Ung: Sng 1 gi Chiu 1 gi
7. n 7
H tn bnh nhn: Nguyn Th Vn
Nm sinh: 1966

Chun on: Vim mi d ng

- Bar x 60 vin
- Ung: Sng 2 vin Chiu 2 vin
- Cetirizin 10mg x 10 vin
- Ung: Sng 1 vin Chiu 1 vin
- Hankocin x 30 vin
- Ung:
- Ginrokin x 30 vin
- Ung:
8. n 8
SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

H tn bnh nhn: Nguyn Vn Sn

Nm sinh: 1986

Chun on: Vim i trng

- Amoxcillin 500mg x 20 vin

- Ung:
- Klion (Metronidazol) 200mg x 20 vin
- Ung:
- L-Bio x 10 gi
- Ung:
- Buscopan 10mg x 10 vin
- Ung:
9. n 9
H tn bnh nhn: Nguyn Th Thanh T
Nm sinh: 2007

Chun on: Vim phi

- Ibamentin x 10 gi
- Ung:
- Preolnisolin 5mg x 10 vin
- Ung:
- Bameplex 100ml x 1 chai
- Ung: Sng 1 tha c ph Chiu 1 tha c ph
- Porox 10 vin
- t hu mn
10. n 10
H tn bnh nhn: Nguyn Th Hng
Nm sinh: 1960

Chun on: Thiu nng tun hon no

- Piracetum 0,4mg x 20 vin

- Ung:
- Deupmin 25mg x 10 vin
- Ung:
- Ginsokin x 10 vin
- Ung:
SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

- Diclofenac 50mg x 10 vin

- Ung:
VI. Mt s thuc bn hng dn s dng
1. Serrazyme 10mg (Sessstiopeptidase)
Ch nh: Chng vim sau chn thng v phu thut.
- Gim vim trong nhng bnh l sau: Vim xoang, sng huyt phi, vim
mng quang, vim mo tinh hon, p xe chn rng, vim nha chu.
- Khc m kh trong nhng bnh l sau: Vim ph qun, hen ph qun
lao phi.
- Khc m kh sau gy m.
- Chng ch nh: bt thng v chc nng ng mu
- Suy gan, thn nng.
Liu dng: 10mg x 3 ln/ ngy, ung sau mi ba n.
2. Glumeform 500mg (Metformin hydroclorid)
Ch nh: iu tr bnh i tho ng tup 2 (khng ph thuc Insullin),
c bit ngi bo ph sau khi p dng ch n king khng hiu qu.
Chng ch nh:
- Mn cm vi cc thnh phn ca thuc.
- Ngi bnh c trng thi d ha cp tnh, nhim khun nng, nhim
khun huyt, chn thng, suy thn bnh gan nng, bnh tim mch nng, bnh
h hp nng vi gim oxygen gan huyt, ngi nghin ru, thiu dinh dng,
ngi c thai cho con b, nhim axit chuyn ha cp tnh hoc mn tnh.
- Liu dng: Ty theo mi bnh nhn da trn hiu qu v s dung np
nhng khng vt qu 2 vin/ ngy
- Ung 1 vin x 2 3 ln/ ngy, ung trong cc ba n.
3. Gliclarid:
Ch nh:
- iu tr i tho ng tup 2.
Chng ch nh:
- Qu mn cm vi bt k thnh phn no ca thuc.
SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

- i tho ng ph thuc Insulin.

- Hn m hay tin hn m do i tho ng.
- Suy gan, thn nng.
- C tin s d ng vi Sulfonamid v cc Sulfonylure khc.
- C thai v cho con b.
Liu dng:
- Dng ng ng.
- Ty theo lng ng huyt ca ngi bnh i tho ng s c ch dn
thch hp. Tuy nhin c th dng liu nh sau:
+ Liu thng thng: 1 vin/ ngy.
+ C th bt u liu - 1 vin/ ngy sau tng liu.
+ Trong a s trng hp: Ung liu duy nht 2 vin vo bui sng.
+ Trong trng hp iu tr cha hiu qu c th tng dn ln liu ti a l
4 vin/ ngy, chia lm 2 ln.
+ Trong qu trnh iu tr c th thay i liu hoc l ngng thuc ty theo
liu lng ng huyt ca ngi bnhh.
+ Ung vo ba n sng.
4. Captyril 25mg
Ch nh:
- Cc th can huyt p.
- Suy tim khng p ng hoc khng th ch ng c bng cc liu php
thng thng vi thuc li tiu hoc digitalis.
Chng ch nh:
- Liu s ph mch, mn cm vi thuc, sau nhi mu c tim (nu huyt
ng khng n).
- Hp ng mch thn 2 bn hoc hp ng mch thn thn c nht.
- Hp ng mch ch hoc hp van 2 l, bnh c tim tc nghn nng.
Liu dng:
- Cao huyt p: liu khi u 25mg x 2 3 ln/ ngy, trng hp nng c
th tng ti 50mg x 3 ln/ ngy, liu thng thng khng qu 150mg/ ngy.
SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

- Suy tim, huyt: nn dng km theo thuc li tiu theo ch dn ca thy

thuc.
- Ung 1 gi trc khi n.
5. Vastec 20mg (Trimetazidin dihydroclosid)
Ch nh:
- iu tr d phng cn au tht ngc.
- iu tr h tr cc triu chng: chng mt, tai, gim th lc v ri lon
th trng do nguyn nhn h mch.
Chng ch nh
- Trong trng hp qu mn cm hoc khng dung np vi trimetazidin.
- Thn trng vi ngi c thai cho con b.
Liu dng:
Ung vo u cc ba n.
- Ung mi ln 1 vin x 2 3 ln/ ngy hoc theo ch dn ca thy thuc.
6. Dolocep (ofloxacin)
Ch nh:
- Tr nhim khun nng do vi khun gram m, t cu khun lu cu khun.
- Tr cc nhim khun ng h hp, ti mi hng mn tnh nhim khun
huyt, niu, thn, tuyn tin lit, ph khen xng, khp, gan, mt.
- Nhim khun da, m mm
Chng ch nh:
- D ng vi thuc hoc qu mn cm vi Guinolon.
- Tr em di 15 tui.
- C thai, cho con b.
- Ngi ng kinh thiu men G6PD.
Liu dng:
- Ngi ln ung 1 vin/ ln, ngy 2 ln.
- Ngi gi, ngi suy gan thn 1 vin/ ngy, ung cch 2 ngy.
- Bnh nng c th dng 4 vin/ ngy.
- Ung gia ba n sng v chiu vi nhiu nc.
SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

7. Amoxicillin 500mg
Ch nh:
- Ngi bnh c tin s vi bt k Penecillin no.
Liu dng:
- Ngi ln ung 1 2 vin/ ln, ngy 3 ln.
- Tr em 20 40 mg/kg th trng/ ngy, chia 3 ln.
- Bnh lu: ung liu duy nht 3g cng vi 1g probenecid.
8. Buscopan.
Ch nh:
- iu tr au bng co tht trong hi chng kch thch rut.
Chng ch nh:
- Mn cm vi hot cht thuc hoc cc thnh phn khc ca thuc, hp c
hc ng tiu ha, to tit trng, b tiu do chn p di bng quang, glaucom
gi hp, nhp tim nhanh v chng nhc c nng.
Liu dng:
- Ngi ln v tr em tui n trng 1 2 vin nen bao ng, 3 ln/
ngy.
- Liu n: 10 20 mg, liu hng ngy ti a 60mg hyoscime N
Butylbromid).
- Vin nn bao ng nn c nut nguyn vin nhiu nc.
9 Hapacol 500mg (paracetamol)
Ch nh:
- iu tr cc triu chng au nhc v st trong cc trng hp.
+ Cm lnh, cm cm, au u, au c xng, bong gn, au khp, au
lng, au rng, au bng kinh, au do chn thng, au thn kinh.
+ Nhim khun ng h hp trn: au tai, au hng, vim mi xoang do
nhim khun, hay thi tit.
+ Sau phu thut nha khoa, nh rng, ct abiclan.
Chng ch nh

SVTH: ng Th Thu Tho

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- Qu mn cm vi paracetamol, ngi bnh thiu mu, c bnh tim, phi,

thn.
- Cc trng hp: Thiu ht glucose 6 Phosphat dehydrogenase, suy
chc nng gan.
Liu dng
- Ngi ln, tr em > 12 tui: ung 1 vin/ ln, au nhiu ngi ln c th
ung 2 vin/ ln, khong cch gia hai ln ung phi hn 4 gi v khng ung
qu 8 vin/ ngy.
- Trng hp bnhnhn suy thn nng ( thanh thi creatinin < 10ml/
pht) khong cch gia cc liu ung phi t nht 8 gi, hoc theo ch dn ca
bc s.
10 Baromezole 20mg (pmeprazole)
Ch nh:
- iu tr ngn hn lot d dy t trng.
- Cc triu chng tro ngc thc qun, tro ngc nng v lot d dy
kh tr.
- iu tr kt hp vi khng sinh n vi lot t trng ti pht do nhim vi
khun Hpylori.
- Phng nga ti pht vim thc qun tro ngc.
Chng ch nh
- Mn cm vi omeprazole, lot d dy c th km theo u c tnh.
Liu dng:
- Lot d dy 1 vin/ ngy x 4 tun.
- iu tr ngn hn lot t trng 1 vin/ ngy x 2 tun.
- Bnh l tro ngc d dy thc qun: 1 vin/ ngy x 2 4 tun.
- Thi gian iu tr c th thay i ty theo tnh trng ca bnh nhn ung
vi hn 1 ly nc.
11. Pms Probio
Ch nh:

SVTH: ng Th Thu Tho

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- B sung vi khun c ch rut, gip tiu ha thc n, h tr s tiu ha

lactose (c nhiu trong sa).
- Cn bng h vi sinh ng rut b ph v do, ru, stress, nhim trng,
s dng khng sinh hoc thuc ha tr liu.
- S ln men bt thng rut, ri lon tiu ha.
- Vim rut cp tnh hay mn tnh: tiu chy, to bn.
Chng ch nh:
Mn cm vi cc thnh phn ca thuc
Liu dng:
Ngi ln v tr em: 1 2 gi mi ngy, pha trong sa, nc sp hoc
ng
12. Hot huyt dng no Nam dc
Ch nh:
Phng v iu tr cc trng hp:
- Suy gim tr nh, thiu nng tun hon no, hi chng ri lon tin nh
- Suy tun ton no vi cc biu hin: au u, mt ng, chng mt hay
mt thng bng.
- Gim chc nng no b: gim tr nh, suy nhc thn kinh, nhn no
- Ngi lm vic tr c cng thng b au u, hoa mt, chng mt, mt
mi.
- Chng run git ca bnh nhn Paskinson
Chng ch nh:
Ngi ln v tr em > 12 tui, ngy ung 2 3 ln, mi ln 1 vin, ung
sau ba n
13. Vitamin PP 500mg
Ch nh:
Cc bnh v da do nhy cm vi nh sng
- iu tr cc trng hp thiu nicotiamid
Chng ch nh:
- Qu mn cm vi nicotiamid
SVTH: ng Th Thu Tho

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- Bnh gan nng, lot d dy tin trin

- Xut huyt ng mch, h huyt p nng
Liu dng:
- Ung 1 3 vin ngy chia lm 3 ln
VII. TI CC PHNG BNH CA BNH VIN
S mi quan h gia khoa dc vi cc khoa phng khc
BAN GIM C BNH VIN

KHOA LM SNG

KHOA DC CN LM SNG

PHNG T CHC HNH

CHNH QUN TR

PHNG K HOCH TNG HP

VT T THIT B Y T

1. Gim c bnh vin

- L ngi trc tip lnh o cc hot ng ca khoa dc v ng li,
chnh sch, ch trng.
- Khoa dc tham mu cho Ban Gim c v cng tc dc, qun l vic
s dng thuc, ha cht, y c, hng dn gim st kim tra s dng thuc an
ton, hp l.
* i vi khoa cn lm sng:
- Cung cp trang thit b my mc, ha cht cho khoa, gip cho vic chn
on t hiu qu.
- Lp k hoch danh mc thuc hng nm
* i vi khoa lm sng:
- L mt khoa phng chuyn mn tham mu cho y bc s iu tr thc
hin cc quy ch v dc.
- Cung cp thuc, theo di qun l s dng thuc an ton, hp l, hiu
qu.
SVTH: ng Th Thu Tho

Trang 29

Trng Trung Cp Y k Lk

* Phng k hoch tng hp dng c y t:

- Dng c y t:
+ L ni qun l chuyn mn y, ln k hoch thc hin cung ng thuc,
dng c y t trong bnh vin.
+ Sau khi nm bt tnh hnh, s dng thuc phn nh ln y, phi hp
tham mu ln Ban Gim c kp thi.
+ Kim tra vic thc hin quy ch chuyn mn ti khoa phng.
+ Phng dng c y t ln k hoch kim tra vic cung ng thuc ha
cht, dng c y t v kim tra vic thc hin.
- Phng k hoch tng hp.
+ Nhu cu v kinh ph mua thuc, ha cht, dng c y t quan trng l
i chiu s dng thuc.
+ Phng k hoch tng hp cung cp kinh ph mua thuc, ha cht
dng c y t, vt liu y t v thanh quyt ton ph cp.
5. i vi phng t chc, hnh chnh, qun tr.
xut kin, kin ngh tu sa kho, c s vt cht, phn b, rn luyn v
bi dng cn b, nng cao trnh , thchin cc quy ch, chnh sch cho cn
b.
1. Khoa ni nhim
- Khoa ni l khoa lm sng, thc hin cc phng php, khng phu
thut cha bnh. Trong cha bnh kt hp lm sng, cc xt nghim cn lm
sng v kt hp chuyn khoa.
* T thuc trc ca khoa
STT
1
2
3
4
5
6

TN THUC, HM
LNG
Diazepam 5mg
Ampicillin 1g
Atropun 0,25mg
Cefotaxime 1g
Calcichlorua 5ml
Gentunycin 80mg

SVTH: ng Th Thu Tho

VT
Vin
L
ng
L
ng
ng

LNG

Ghi ch

10
10
10
10
5
5
Trang 30

Trng Trung Cp Y k Lk

7
8
9
10
11
12
13
14
15
16
*
17
18
19
*
20
21
22
23
24

Paracetamol + Diclophenac ng
Primral 10mg
ng
Frurocemid 20mg
ng
Hyoscin 20mg
ng
Insulin 400VI
ng
Nc ct
ng
Glucoza 5%
Chai
Glucoza 10%
Chai
Ringerlactat
Chai
Nacl 0,9%
Chai
Thuc st rt
Astecan
Vin
Cloroquin 250mg
Vin
Frimaquin 13,2mg
Vin
Vt t tiu hao
Dy oxy 2 nhnh
Dy
ng ht m
Dy
Sondenelaton
Ci
Sonde poley
Ci
Dy truyn dch
Dy
* Mt s bnh n ti khoa ni nhim

5
5
5
5
1
10
5
5
5
5
20
20
2
2
2
2
5

* Bnh n 01:
- H tn ngi bnh: Trn Vn Tng, tui 1984, Nam/n: Nam
- a ch: Thn 9, P.Tn An, TP.BMT, k Lk.
- L do vo vin: St
- Chun on: Vim amydan cp
- Nhp vin: 01/04/2012
* iu tr
Ngy, gi
15h30

Din Bin Bnh

- Bnh pht 3 ngy nay vi st

Y Lnh
- Claminat 625mg x 3v

01/04/2012

nng, c lnh run khng thnh

ung 15h30 21h30 2h

cn, km au hng.

- Alpha trimotrypsin 4,2mg

- Cha iu tr g khi nhp vin.

x 4v ung 16h-21h.

- Lc vo:

- Paracetamol 0,5g x 3v

+ T: 39OC

ung 15h30 21h 4h.

+ M: 100 nhp

- Sumiton x 2v ung 16h

+ HA: 120/70

21h.

SVTH: ng Th Thu Tho

Trang 31

Trng Trung Cp Y k Lk

- Bnh nhn tnh to, st cao,

- Dung dch ORS 100mlm

khng nn i.

ung ri rc.

- i tiu tin bnh thng, nhp

- Cho tht

tim u.
- Phi khng nghe sau, bng
mm.
- Gan lch khng ln, c m.
- Amyden sng to, .
- XN mu: BC: 10.900/mmg
N: 67%; CRN: dng tnh.
- Kt lun: Vim Amydan cp
2/04/2012

- Claminat 625mg x 3v
ung 8h-16h-20h.
- Alphachymotrypsin 4,2mg
x 4v ung 8h-16h.
- Paracetamol 0,5g x 4v
ung 8h khi st cch 6h.
- Sumiton x 2v ung 8h
16h.
- Dung dch ORS x
1000ml.
- Ung ri rc.
- Cho, sa, chm sc cp
3.

03/04/2012

- Bnh nhn st, n ung c.

- M: 90ln/ pht
- To: 37oC
- HA: 100/60mmHg
- Tim: T172 u.
- Phi khng nghe, bng mm,
gan lch.

SVTH: ng Th Thu Tho

Trang 32

Trng Trung Cp Y k Lk

- Bnh nhn tnh to khi tip xc.

- Dch mang no (-)
- Bnh nhn st, n ung c. - Claminat 625mg x 3 v

04/04/2012

- M: 90 ln/ pht

ung 9h-16h-22h.

- To: 37oC

- Alphachymotrypsim

- HA: 100/60 mmHg

4,2mg x 4v ung 9h-12h.

- Tim: T172 u.

- Paracetamol 0,5g x 3v

- Phi khng nghe ral, bng mm, ung lc ti 1 v.

gan lch.

- Suniton x 2v ung 9h

- Bnh nhn tnh to khi tip xc.

16h.

- Dch mng no (-)

05/04/2012
- Bnh n
* Phn tch pht iu tr:

Cho xut vin

- Claminat: khng sinh iu tr vim amydan.

- Alpha trymotrypsin: iu tr cc trng hp ph n
- Paracetamol: gim au
- Suniton: b sung vitamin
- Dung dch ORS: b nc
* Bnh n 02:
H tn ngi bnh

: TRN KIM NGA

Tui: 1956

Nam/N:

N
a ch

: Phng Khnh Xun, BMT, k Lk

L do vo vin

: au bng i ngoi nhiu

Chun on

: Nhim khun rut

Nhp vin

: 02/04/2013

* iu tr:
NGY/GI
DIN BIN BNH
15h
Bnh nhn tnh, khng st, mt
02/04/2013

Y LNH
Ringerlactat x 500ml

M: 72 ln/ pht

NaCl 0,9% x 500ml

To: 37oC

Truyn TM: 40 git/pht

NT: 20 ln/ pht

GT: 15 gi

SVTH: ng Th Thu Tho

Trang 33

Trng Trung Cp Y k Lk

H/A: 100/60 mmHg

- Amoxicilin 500mg x 4v, ung

- Tim: u, r, phi khng ral

15h 22h

- Bng: mm, khng phn ng

- LbiO 1g x 2 gi, ung 15h 22h

- au rm ran ton bng

- ORS 1000ml ung dn

- Gan, l lch khng ln

- Hankocin x 1v, ung 15h

- i cu lng ton nc, khng nn, - Papaverin 40mg x 2v, ung 15h

03/04/2013

tiu t ch

- Negram 0,5g x 4v, ung 15h

Chun on: Tiu chy cp

22h

Xt nghim: mu, phn

- Cho CSC3

- Siu m bng
- Bnh nhn tnh, khng st, cn i - Ringerlactat x 500ml
lng phn nc

NaCl 0,9% x 500ml

- au qun bng tng cn

Truyn TM: 40 git/pht

- Bng mm, sinh tn n, tim u, GT: 9 gi

phi m th.

- Amoxicilin 500mg x 4v, ung

9h 16h
- LbiO 1g x 1 gi, ung 10h 17h
- ORS 1000ml ung dn
- Hankocin x 2v, ung 9h 16h
- Negram 0,5g x 4v, ung 9h
16h

04/04/2013

- Cho : chm sc cp 3
Bnh nhn tnh, khng st, cn i - Ringerlactat x 500ml
lng phn nc.

NaCl 0,9% x 500ml

- au qun bng tng cn.

Truyn TM: 40 git/pht

- Bng mm, sinh tn n, tim u, GT: 9 gi

phi m th.

- Amoxicilin 500mg x 4v, ung

9h 16h
- LbiO 1g x 2 gi, ung 10h 17h
- ORS 1000ml ung dn
- Hankocin x 2v, ung 9h 16h

SVTH: ng Th Thu Tho

Trang 34

Trng Trung Cp Y k Lk

- Negram 0,5g x 4v, ung 9h

16h
- Cho : chm sc cp 3
- Ringerlactat x 500ml

05/04/2013

NaCl 0,9% x 500ml

Truyn TM: 40 git/pht
GT: 9 gi
- Amoxicilin 500mg x 4v, ung
9h 16h
- LbiO 1g x 2 gi, ung 10h 17h
- ORS 1000ml ung dn
- Hankocin x 2v, ung 9h 16h
- Negram 0,5g x 4v, ung 9h
16h
06/04/2013

- Cho : chm sc cp 3
Bnh nhn tnh, khng st, tim u, - Ringerlactat x 500ml
r, phi khng ral.

NaCl 0,9% x 500ml

- Bng mm, cu st 2 ln/ ngy, Truyn TM: 40 git/pht

cn au lm rm bng.

GT: 9 gi
- Amoxicilin 500mg x 4v, ung
9h 16h
- LbiO 1g x 2 gi, ung 10h 17h
- ORS 1000ml ung dn
- Hankocin x 2v, ung 9h 16h
- Negram 0,5g x 4v, ung 9h
16h
- Cho : chm sc cp 3

07/04/2013

Bnh nhn tnh, khng st, tim u,

08/04/2013

r, bng mm, cu c
Bnh n nh

Cho ra vin

Chun on ra vin: Tiu chy cp

* Phn tch pht iu tr
SVTH: ng Th Thu Tho

Trang 35

Trng Trung Cp Y k Lk

- Ringerlactat: cung cp nc v cht in gii cho c th

- Amoxicilin: iu tr nhim khun ng tit niu
- Hankocin: tng cng sinh lc c th do mt mi
- LbiO: Men tiu ha, iu tr chng ri lon tiu ha nh tiu chy, to bn
- Negram: iu tr nhim khun tiu ha
- Papaverin: iu tr chng co tht c trn ng tiu ha
* Bnh n s 03:
H tn ngi bnh:

TRN THANH PHNG

Tui: 1957

Nam/N:

Nam
a ch: khi 19, phng Ha Khnh, TP.BMT, k Lk
L do vo vin: St
Chun on: St siu vi
Nhp vin ngy: 29/04/2013
* iu tr:
NGY/GI
DIN BIN BNH
Y LNH
8h
Bnh nhn tnh to, tip xc tt, Dung dch Ringerlactat x 1000ml
29/04/2013

khng sng hch ngoi vi, khng ho

Truyn tnh mch xxx git/pht,

To: 37oC

ung tch cc.

HA: 130/80 mmHg

- Cm - cho

NT: 20 ln/ pht

TD: NT, HA, SPO2 2h/ln; nc

Spo2: 95%

tiu 24h.

Tim nhp r

Paracetamol 500mg x 1,5v ung

9h

Kt lun: st cha r nguyn nhn

lc 9h.

12h

Bnh nhn st 38oC

Diclomine x 1 ng

Bnh nhn au nhiu

Tim bp

19h

2h
30/04/2013

Hng lng (T) c mt vt ct y Dung dch Ringerlactat x 500ml

vy mu en, khng sng hch.

Truyn TM x 5 git/pht

Ht dung dch Ringerlactat

Viramol x 450mg x 1 ng tim

Bnh nhn st 38,5oC

Bnh nhn st 38oC, au u nhiu

bp lc 12h.
Paracetamol 0,5g x 1,5v ung lc

6h30
SVTH: ng Th Thu Tho

6h30.
Trang 36

Trng Trung Cp Y k Lk

7h40

- Bnh nhan tnh to, da nim mc Dung dch RingerLactat

hng, ph n

Truyn tnh mch xxx git/pht

To: 38,5oC

Doxycylin: 100mg x 3v, ung

HA: 130/90 mmHg

chia 3 ln.

NT: 23 ln/ pht

Paracetamol 0,5g x 1,5v ung lc

SPO2: 94%

st cao >= 38,5oC

Nhp tim r

Dung dch ORS x 1000ml ung

Phi khng nghe ral

dn

- Bng mm khng au, gan, lch Cho, chm sc cp 3

khng ln

Theo di: M, To, HA, NT

Tiu tin bnh thng

SPO2 2h/ln

- C vt so vng lng bn (T) =, Nc tiu 24h

nghi st m.
Kt lun: st cha r nguyn nhn
14h

Bnh nhn tnh to, au u vng Thm thuc

thi dng

Flunarizon 5mg x 2v, ung lc

M: 71 ln/pht

16h30

To: 38,5oC
NT: 20 ln/ pht
SPO2: 96%
Nhp tim r, phi khng nghe ral
Kt lun: st cha r nguyn nhn
17h

Bnh nhn tnh to

Thm thuc :

M: 71 ln/pht

Paracetamol 0,5g x 1,5v, ung lc

To: 38,5oC

17h30

NT: 20 ln/ pht

SPO2: 96%
Nhp tim r, phi khng nghe ral
31/04/2013 Bnh n
* Phn tch pht iu tr:

Cho ra vin

- Ringerlactat: cung cp nc v cht in gii cho c th

SVTH: ng Th Thu Tho

Trang 37

Trng Trung Cp Y k Lk

- Dung dch ORS: b mt lng nc cn thit cho c th

- Paracetamol: gim au, h st
- Viramol: iu tr cc cn au va v nh, cc cn st
- Diclomine: gim au, h st
- Doxycylin: khng sinh iu tr nhim khun
- Flunarizin: iu tr chng au u, chng mt
* Bnh n s 04:
H tn ngi bnh:

L TH VN Tui: 1937

Nam/N: N

a ch: s nh 97 Trn Hng o, phng T An, TP.BMT, k Lk

L do vo vin: Kh th
Chun on: t cp tng huyt p
Nhp vin ngy: 02/05/2013
* iu tr:
NGY/GI
DIN BIN BNH
Y LNH
15h
Bnh nhn c tin s PD iu tr Nm u cao 30o
02/05/2013

lin tc ngoi tr.

Th oxy 30 ln/pht qua smd mi

Bnh nhn ln cn kh th t ngy Berodual x 3ml

hm qua, s dng thuc khng Natriclorua 9o/oo x 2ml x 2 ln th
nn vo vin.

kh dung lin tc.

- Ti khoa, bnh nhn tnh to, ni Dung dch Natriclorua 9o/oo x

thnh cu ngn; kh th cp 2,3; 500ml
khng v m hi, co ko hn c nh

Truyn tnh mch xx git/pht

M: 100 ln/pht

Hydrocostison 100mg x 1 l tim

HA: 170/70 mmHg

TM lc 15h30

To: 37,5oC

Amlodipin 5mg x 1v, ung lc

NT: 28 ln/ pht

15h30

Tim nhp khng r, phi gim thng Acetylsystein 0,2g x 4v, ung
kh, c t ral m, ral rt hai bn.

chia 2 ln 15h30 22h30.

- Cm, cho, CSC 3

16h30

Bng mm, gan, lch khng ln

SVTH: ng Th Thu Tho

Theo di M, HA, To, NT

Trang 38

Trng Trung Cp Y k Lk

Kt lun: t cp co PD mc SPO2 2 ln/h

TB-THA

nc tiu 24h

Kt qu xt nghim:

Thm thuc

BC: 12700/mm3

Cefotaxim 1g x 4 l

N: 84%

tim TM lc 16h30 3h30

CRD: Dng tnh

Gentamycin 80mg x 2 ng

Ure: 38

tim TM lc 16h30

Creatinin: 118

Kaleorid 10% x 2 ng ha vo

Ghure:120

dung dch

AST: 293,6 mg/de

Natriclorua 9o/oo ang truyn

ACT: 24 u/l

truyn xx git/pht

Na+: 137

Berodual x 3ml

K+: mEg/l

Natriclorua x 1ml 9o/oo x 4 ln th

Cl-: 110

kh dung.

Kt lun: t cp do PD mc 19h 23h 3h 7h

trung bnh bi nhim THA
03/05/2013

H K+ mu
Bnh nhn tnh to, theo di ti khoa
khng ln cn kh th
M: 81 ln/pht
To: 37oC
HA: 130/80 mmHg
NT: 20 ln/ pht
SPO2: 96%
Chuyn khoa ni iu tr tip
Kt lun: Co PD trung bnh, THA/

04/05/2013

h K+ mu
Bnh nhn tnh to, da, nim mc Nm u cao
hng

Berodual x 6ml

Cn kh th II

Natriclorua 9o/oo x 3ml, th kh

To: 37oC

dung 10h 20h 4h

SVTH: ng Th Thu Tho

Trang 39

Trng Trung Cp Y k Lk

M: 80 ln/pht

Cefotaxim 4 l, tim TM lc 10h

HA: 130/80 mmHg

12h.

NT: 22 ln/ pht

Gentamycin 80mg x 2 ng

Khng ph

tim bp lc 10h

TMC: -45o

Acetylsystein 0,2g x 3v, ung 10h

Tiu nhiu

20h 4h

Tim p u

Cetizidin 10mg x 4v ung 8h

Phi ral ngy, m, ri rc 2 phi

Amlodipin x 1v, ung lc 10h

Bng mm

Suniton x 2v, ung 18h 20h

Gan, lch khng ln

Salbutamol 2mg x 2v, ung 10h

Kt lun: t cp co PD mc 20h
trung bnh/THA.
05/05/2013 Bnh tm n
* Phn tch pht iu tr

Cm nht
Cho ra vin

- Berodual: phng nga, iu tr kh th

- Natriclorua: b sung Natriclorid v nc
- Hydrocortison: chng vim
- Amlodipin: iu tr tng huyt p, d phng cn au tht ngc
- Acetylcystein: tiu nhy trong cc bnh vim ph qun
- Cefotaxim: iu tr nhim khun nng
- Gentamycin: khng sinh iu tr t nhim khun
- Kaleorid: b sung Kali, ch nh tng Kali mu
- Suniton: b sung vitamin
- Salbutamol: c tc dng lm gim ph qun gip thng thong ng th
* Bnh n s 05:
H tn ngi bnh:

NGUYN TH HNG

Tui: 1937

Nam/N: N

a ch: phng Tn Li, TP.BMT, k Lk

L do vo vin: Hp mn v, suy kit, lot d dy, i tho ng tup II
Chun on: t cp tng huyt p
Nhp vin ngy: 02/06/2013
* iu tr:
SVTH: ng Th Thu Tho

Trang 40

Trng Trung Cp Y k Lk

NGY/GI
DIN BIN BNH
Y LNH
02/06/2013 Bnh nhn vo khng st, ngi mt Ringer lactate 500ml x 1 chai
mi, rt hu mn, th trng gy, tiu Natriclorua 9o/oo x 2 chai

03/06/2013

t ch.

Amoxicilin 0,5g x 4v

HA: 100/60 mmHg

Clanftheomycin 0,5g x 2v

Mch: 86 ln/pht

Omeprazole 20mg x 2v

Nhit : 37oC

Diamicron 30mg x 2v

Nhp tim u, r, khng nghe ral

Ginrokin 40mg x 2v

Bng mm, tiu bnh thng

- Cho, sa, CSC 3, ch tiu

ng.
Bnh nhn mt, khng st, nhp Ringer lactate 500ml x 1 chai
tim u, r, bng mm, gan lch Natriclorua 9o/oo x 2 chai
khng ln.

Amoxicilin 0,5g x 4v

HA: 100/70 mmHg

Clanftheomycin 0,5g x 2v

Mch: 85 ln/pht

Omeprazole 20mg x 2v

Nhit : 37,5oC

Diamicron 30mg x 2v
Ginrokin 40mg x 2v
Cho, sa, chm sc cp 3

04/06/2013

Ch tiu ng
Bnh nhn mt, khng st, nhp Ringer lactate 500ml x 1 chai
tim u, r, bng mm, gan lch Natriclorua 9o/oo x 2 chai
khng ln.

Amoxicilin 0,5g x 4v

HA: 100/70 mmHg

Clanftheomycin 0,5g x 2v

Mch: 85 ln/pht

Omeprazole 20mg x 2v

Nhit : 37,5oC

Diamicron 30mg x 2v
Ginrokin 40mg x 2v
Cho, sa, chm sc cp 3

05/06/2013

Sinh tn n nh

Ch tiu ng
Cho ra vin

Tim: u, r
Phi khng nghe rale
SVTH: ng Th Thu Tho

Trang 41

Trng Trung Cp Y k Lk

Khng nn, bng mm

Ngi nh bnh nhn xin ra vin
* Phn tch pht iu tr:
- Ringer lactate : dng b nc v cht in gii cho c th, gip c th hp
thu nhanh.
- Natriclorua : cung cp b sung nc, cht in gii
- Amoxicilin : l khng sinh dng trong cc trng hp nhim khun ng h
hp trn, nhim khun ng tit niu, nhim khun da, nhim khun ng
mt.
- Clanftheomycin : l khng sinh dng trong cc trng hp nhim khun ng
h hp, m mm, nhim trng da, vim lot d dy t trng do nhim H.pylori.
- Omeprazole : iu tr lot d dy t trng tin trin, vim thc qun do hi lu
d dy thc qun.
- Diamicron : iu tr i tho ng
- Ginrokin : l thuc b, iu tr gim tr nh, tai, chng mt
2. Khoa Sn:
- Khoa Sn l ni thc hin cc nhim v sanh thng, sanh kh phu thut, m
ly thai, m ly thai vt m c, khng au.
- iu tr cc bnh ph khoa
- Xt nghim sng lc trc khi sinh v cc d tt bm sinh thai nhi
* T thuc trc ti khoa
STT

1
2
3
4
5
6
7
8
9
10

TN THUC
Morphin 10mg/1ml
Dolargan 100mg/2ml
Diazepam 10mg/2ml
Diazepam 5mg
Alphatrimotripsin 5mg
Adrenalin 1mg/1ml
Ampixilin 1g
Atropin 0,25mg/1ml
Doxycillin 100mg
Drotaverin 40mg

VT
ng
ng
ng
vin
vin
ng
l
ng
vin
ng

P. SANH
PK SN
1
5
5
5
100
5
15
5
10
(no spa)
10

GHI CH
Thuc gy nghin
Thuc gy nghin
Thuc hng thn
Thuc hng thn

Biseptol 48mg

11

Sunfamethoxa+trimethoprin
SVTH: ng Th Thu Tho

vin

10
Trang 42

Trng Trung Cp Y k Lk

12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37

Canciclorua 0,5g/5ml
Cefalexim 500mg
Cefotuxim 1g
Clopheniramin 4mg
Cefado
Methyldopa 250mg
Furrosemide 20mg
Gentamycin 80mg/2ml
Lidocain 2%
Magnesium 15%
Methyl Frgometrin 0,2mg
Metronidazole 250mg
Nc ct 5ml
Naloxon 0,4mg/1ml
Nifedipin 10mg
Oxytocin 5UI/1ml
Hyorin 20mg
Hydrocorthyson 100mg
Paracetamol+Diclofenac
Paracetamol 500mg
Primperan 10mg/2ml
Transamine 250mg/5ml
Acetylcystein 200mg
Simethyson 250mg
St Furmarat+Flic+B12+C
Vitamin

A,E,B1,B2,B6,PP,acid
38
Vitamin K1 10mg/1ml
*Dch truyn
39
Gelatin 500ml
40
Glucoza 5%, 500ml
41
Glucoza 10%, 500ml
42
Ringerlactat 500ml
43
NaCl 0,9%, 500ml
44
Nabicarbonat 1,4%
45
Metronidazole 100ml

ng
vin
l
vin
vin
vin
ng
ng
ng
ng
ng
vin
ng
ng
vin
ng
ng
ng
ng
vin
ng
ng
vin
vin
vin
vin

5
200
50
10
50
10
2
100
50
10
10
10
50
1
5
150
20
5
10
60
10
10
10
20
20
100

ng

20

chai
chai
chai
chai
chai
chai
chai

2
20
4
50
8
1
6

1
2

* MT S BNH N TI KHOA SN:

* Bnh n s 01:
- H v tn: NGUYN TH NHUNG
- Sinh nm: 1987
SVTH: ng Th Thu Tho

Gii tnh: N
Trang 43

Trng Trung Cp Y k Lk

- a ch: Nguyn Vn C, TP.BMT, k Lk

- Ngy vo vin: 10/09/2013
- L do vo vin: c thai + ra nc m o
- Chun on: thai con so 37 tun ngi u chuyn d
* iu tr:
NGY/GI
DIN BIN BNH
Y LNH
9h
Sn ph mang thai ln u, qu trnh Theo di st du hiu chuyn d
10/09/2013

mang thai khe, nay thy ra nc Nghe tim thai bng my dopler
m o, vo vin.

Xt nghim huyt , TS-TC,

- Sn ph tnh, nim mc da hng, HbsAg, 10 thng s nc tiu

khng ph.

- Cm

Mch: 90 ln/pht

- Cefotaxime 1g x 1l

Nhit : 37oC
Huyt p: 170/80 mmHg
- Tim phi bnh thng
- Khm sn: t cung hnh trng, t
th trung gian c t cung t lt
ngn tay, u cao, i v t nhin gi Glucoza 5% 500ml x 1 chai
th 5.
11h

Oxytocin 5UI x 1 ng

- Cc c quan khc cha pht hin Calciclorid 0,5g x 1 ng

bnh l.

Buscoban 20mg x 2 ng

- Bnh nhn tnh khng st

- Theo di st du hiu chuyn

- Tim thai: 145 ln/pht

d, CSC 1.

BC/VB: 26/84cm

Glucoza 5% 500ml x 1 chai

21h

Tim thai 140 ln/pht

Buscoban 20mg x 2 ng

11/09/2013

Theo di st du hiu chuyn d

Sn ph au dn, c cm gic mt Oxytoxin 5UI x 4 ng
rn, khm trong c t cung m trn, Gentamycin 80mg x 2 ng
u lt thp, hng dn sn ph rn, Cefotuxime 1g x 3 l
sau 5 sinh thng 1 b trai, appar Vitamin A x 1v
7/10, x tr tch cc giai on 3, Theo di chm sc hu sn 6 gi

SVTH: ng Th Thu Tho

Trang 44

Trng Trung Cp Y k Lk

12/09/2013

kim tra tng sinh mn ct may.

sau

Chun on: mt thai t nhin

Sn ph tnh, khng st

Gentamycin 80mg x 2 ng
Cefotaxime 1g x 3 l
Oxytoxin 5UI x 2 ng
St folic x 1v
Cm, chm sc cp 3

Sn ph tnh, khng st, t cung go Gentamycin 80mg x 2 ng

hi hi tt, sn dch ra t

Cefotaxime 1g x 2 l
St folic x 1v
lm thuc m

13/09/2013

Cm, CSC 3
T cung go hi tt, sn dch ra t, n Avacan 1g x 2v
ng tt

14/09/2013

lm thuc m, CSC 3
T cung go hi tt, sn dch ra t, n Avacan 1g x 2v
ng tt

15/09/2013

St folic x 1v

lm thuc m, CSC 3
T cung go hi tt, sn dch ra t, n Avacan 1g x 2v
ng tt

16/09/2013

St folic x 1v

St folic x 1v

lm thuc m, CSC 3
T cung go hi tt, sn dch ra t, n Avacan 1g x 2v
ng tt

17/09/2013 Bnh n
* Phn tch pht iu tr:

St folic x 1v
lm thuc m, CSC 3
Cho ra vin

- Cefotaxime: l khng sinh cha nhim khun ng niu, sinh dc phng

nhim khun khi phu thut.
- Glucoza: b sung lng ng cho c th
- Oxytocin: c tc dng thc
- Gentamycin: cha nhim khun
- St folic: tng nhu cu to mu, b sung st cho c th
SVTH: ng Th Thu Tho

Trang 45

Trng Trung Cp Y k Lk

- Avacan: iu tr nhim trng da, m mm, ng tiu di

- Buscopan: iu tr co tht ng tiu ha hoc niu sinh dc
- Calci clorid: b sung mt lng calci cho sn ph
* Bnh n s 02:
- H v tn: NGUYN TH MAI
- Sinh nm: 1992

Gii tnh: N

- a ch: phng Tn Tin, TP.BMT, k Lk

- Ngy vo vin: 02/10/2013
- L do vo vin: c thai au bng + ra nhy m o
- Chun on: thai con so 37 tun ngi u chuyn d
* iu tr:
NGY/GI
DIN BIN BNH
Y LNH
5h30
Sn ph sinh con so, qu trnh mang Calciclorid 0,5g x 1 ng
02/10/2013

thai khe, au bng + ra nc m Buscoban 20mg x 2 ng

o, xin vo vin.
- Tim thai: 140 ln/ pht
- Go 30 2
- GC: 09cm

6h45

- u cao

Oxytocin 5UI x 2 ng

- Sn ph au dn, c t cung m Lidocain 2% x 4 ng

trn, sau 15 sinh thng 1 b trai p Cefotacin 1g x 2 l
ga 8/10, cn nng 2,9 kg, b khc Gentamycin 80mg x 2 ng
03/10/2013

ngay, x tr tch cc giai on III

Vitamin A 200000 UI x 1v
Sn ph tnh, t cung co tt, sn Gentamycin 80mg x 2 ng
dch ra va

Cefotaxime 1g x 2 l
Oxytocin 5UI x 2 ng
Mgie B6 x 2v

04/10/2013

Bnh nhn tnh, khng st

lm thuc m, cm, CSC 3

Gentamycin 80mg x 2 ng
Cefotaxime 1g x 2 l
Mgie B6 x 2v

SVTH: ng Th Thu Tho

Trang 46

Trng Trung Cp Y k Lk

lm thuc m, cm, CSC 3

Cho ra vin

05/10/2013 Bnh n
* Phn tch pht iu tr:
- Buscopan: chng co tht ng niu, sinh dc

- Oxytocin: thuc tc dng thc , lm cho qu trnh din ra nhanh

- Lidocaine: tc dng gy t
- Cefotaxime: l khng sinh cha nhim khun ng niu, sinh dc, phng
nhim khun khi phu thut.
* Bnh n s 03:
- H v tn: NGUYN BCH NGC

Tui: 1990

Nam/N: N

- a ch: Nguyn Th nh, phng Khnh Xun, TP.BMT, k Lk

- Chun on vo vin: sy thai
- Ngy vo vin: 09/11/2013
* iu tr:
NGY/GI
DIN BIN BNH
Y LNH
8h
Bnh nhn sau sy thai vo khoa Ringerlactat x 500ml
09/11/2013

tnh to

Glucoz 5% x 500ml

M: 80 ln/pht

TTM 40 git/pht

To: 37oC

GT 8h

HA: 120/80 mmHg

Gentamycin 80mg x 2 ng

GH: 16h

Khng ph c nn i, TV, CTC h TB: 9h

16h

c mu, thn t cung ln hn bnh Cefotaxim 1g x 2 ng

thng.

TB: 9h

16h

Thai 8 tun sy

Oxytocin 5UI x 2 ng
TB: 9h
Varocomin x 2v
ung 9h

10/11/2013

16h

Tnh, ht au bng

Cm, CSC2
Ringerlactat x 500ml

Sn dch ra t

Glucose 5% x 500ml

Sinh tn n nh

TTM 30 git/pht

SVTH: ng Th Thu Tho

Trang 47

Trng Trung Cp Y k Lk

GT 9h
Gentamycin 80mg x 2 ng
TB: 9h
Cefotaxim 1g x 2 ng
TMC: 9h

16h

Varocomin x 2 vin
TMC: 9h
11/11/2013

16h

Cm, CSC2
Ngi bnh tnh, khng st, than Gentamycin 80mg x 2 ng
mt, t cung go tt, sn dch ra va

TB: 8h
Cefotaxim 1g x 2 ng
TMC: 8h

16h

Varocomin x 2 vin
ung: 8h
12/11/2013

16h

Cm, CSC3
Ngi bnh tnh, khng st, cn Gentamycin 80mg x 2 ng
mt, t cung go tt, sn dch ra va

TB: 8h
Cefotaxim 1g x 2 ng
TMC: 8h

16h

Varocomin x 2 vin
ung: 8h
13/11/2013

16h

Cm, CSC3
Gia nh xin chuyn tuyn trn iu Gentamycin 80mg x 2 ng
tr

TB: 8h
Cefotaxim 1g x 2 ng
TMC: 8h

16h

Varocomin x 2 vin
ung: 8h

16h

Cm, CSC3
* Phn tch pht iu tr:
- Gentamycin: iu tr nhim khun
SVTH: ng Th Thu Tho

Trang 48

Trng Trung Cp Y k Lk

- Cefotaxim: iu tr nhim khun ng tit niu sinh dc, phng nhim

khun do phu thut.
- Varocomin: thuc b, c tc dng bi b sc khe
* Bnh n s 04:
- H v tn: TRN H VY

Tui: 1982

Nam/N: N

- a ch: X Ha Thng, TP.BMT, k Lk

- L do vo vin: au bng
- Chun on: thai ln 5; 38 tun chuyn d
* iu tr:
NGY/GI
DIN BIN BNH
Y LNH
9h
Qu trnh mang thai khe, nay thy Theo di st cc du hiu chuyn
02/11/2013

au bng vo vin, sn ph vo vin d, nghe tim thai bng my

tnh to, da, nim mc hng.

doppher, xt nghim huyt ,

M: 80 ln/pht

TS-TC, test HIV, test HBSAg, 1

To: 37oC

thng s nc tiu, siu m thai,

HA: 120/80 mmHg

ECG.

Tim, phi bnh thng

Cm, chm sc cp 3

Khm sn: t cung hnh trng

BCTC/VB: 29/90cm
Ngi u, th tri
Tim thai: 140 ln/pht

Buscopan 20mg x 2 ng

C t cung h, c nhy mu hng Sonde nc tiu + tht tho

15h

16h

theo gng, u cao, cc c quan Ringerlactat x 1 chai

khc cha pht hin g l.

CSC 2

Tim thai: 140 ln/pht

Oxytocin 5% UI x 2 ng

G: 40 3

Lidocaine 2% x 4 ng

CTC: 80cm, mp dy, i v t nhin Gentamycin 80mg x 2 ng

mu trng c.

Cefoxime 0,5g x 4v

u: cht

Vitamin K1 10mg x 1/10 ng

Sn ph au d di, c cm gic Vim gan siu vi B x 1 liu

SVTH: ng Th Thu Tho

Trang 49

Trng Trung Cp Y k Lk

mun rn, khm li c t cung m Theo di, chm sc hu sn trong

trn, u rt thp.

6 gi sau .

Hng dn sn ph rn sau 5 sinh

thng 1 b gi, p ga 8/10. Cn
nng: 2,8kg, x tr tch cc giai on
03/11/2013

3.
Sn ph tnh, khng st, t cung go Cefoxime 80mg x 2 ng
hi tt, sn dch ra t, b khe, b tt Cefoxime 0,5g x 4v
Oxytocin 5% UI x 2 ng
St folic x 1v
lm thuc m, rn b

04/11/2013

Cm, CSC 3
Sn ph tnh, khng st, t cung go Cefoxime 80mg x 2 ng
hi tt, sn dch ra t, b khe, b tt Cefoxime 0,5g x 4v
Oxytocin 5% UI x 2 ng
St folic x 1v
lm thuc m, rn b
Cm, CSC 3
Cho ra vin

05/11/2013 Bnh n
* Phn tch pht iu tr:
- Buscopan: chng co tht ng niu sinh dc
- Ringerlactat: b nc v in gii cho c th
- Lidocaine: tc dng gy t

- St folic: tng nhu cu to mu, b sung st cho c th

- Gentacymin: iu tr nhim khun
- Cefalexine: iu tr nhim khun
- Vitamin K1: iu tr chy mu trc khi sinh, d phng thiu vitamin K1 cho
tr s sinh.
* Bnh n s 05
- H v tn: L TH THU THY

Tui: 1985

Nam/N: N

- a ch: X Ha Thun, TP.BMT, k Lk

SVTH: ng Th Thu Tho

Trang 50

Trng Trung Cp Y k Lk

- L do vo vin: au bng tng cn

- Chun on: thai con so, 34 tun da sanh non
- Ngy vo vin: 14/11/2013
* iu tr:
NGY/GI

DIN BIN BNH

Y LNH
Thai ph c thai ln u, khong 34 Papaverin 40mg x 1 ng

14/11/2013

tun, ngy nay au bng lm rm, Papaverin 4mg x 2v

au tng dn xin vo vin, bnh Ngh ngi tuyt i, chm sc cp
nhn vo vin tnh to.

M: 80 ln/pht

Xt nghim huyt , TS-TC,

To: 37oC

nghe tim thai bng my.

HA: 120/80 mmHg

Tim, phi bnh thng
Cc c quan khc cha pht hin g
l.
Khm sn:
BCTC/VB: 24/84cm
Tim thai: 140 ln/pht
C t cung h, c nhy mu hng
theo gng, u cao, cc c quan
khc cha pht hin g l.
Tim thai: 140 ln/pht
Cn go: 20 4
15/11/2013

m h, m o bnh thng
Bnh nhn tnh, tip xc tt

Papaverin 40mg x 1 ng

Tim thai: 140 ln/pht

Vitamin E 400 x 2v

C t cung ng kn,khng c mu Salbutamol 1mg x 1v

theo gng, cn au bng t, khng ra Ngh ngi tuyt i, CSC 3
16/11/2013

dch bt thng.
Xt nghim nc tiu ECG
Bnh nhn tnh, khng st, khng Papaverin 40mg x 1 ng
au bng, khng ra dch bt thng.

SVTH: ng Th Thu Tho

Vitamin E 400 x 2v
Trang 51

Trng Trung Cp Y k Lk

Vitamin C 0,5g x 2v
Ngh ngi tuyt i, cm, CSC 3
Cho ra vin

17/11/2013 Bnh nhn tm n

* Phn tch pht iu tr:

- Papaverin: chng co tht c trn ng tiu ha, ng niu, ng mt, au

bng do ng rut.
- Vitamin E
- Salbutamol: c tc dng gim c t cung run
- Vitamin C: tng sc khng cho c th, cung cp vitamin C cho c th
3. Khoa Ngoi Tng Hp
- Tip nhn cc bnh l ngoi khoa v: tiu ha, gan mt, tit niu, cc loi u
bu,
- M cp cu v m phin i vi cc bnh l ngoi khoa.
* T thuc trc ngoi khoa
STT TN THUC

VT

NGOI PK

GHI CH

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23

ng
ng
vin
ng
ng
vin
ng
vin
vin
vin
l
vin
vin
vin
l
vin
vin
vin
gi
vin
ng
vin
ng

1
1
10
5
5
20
5
100
5
20
10
20
5
10
50
10
20
20
10
20
2
20
5

Thuc gy nghin
Thuc gy nghin
Thuc hng thn
Thuc hng thn

Dolargan 100mg
Morphin 10mg
Seduxen 5mg
Ephedrin 10mg
Adrenalin 1mg
Acetyleystein 200mg
Alphachymotripsin 500 UI
Alphachymotripsin 5mg
Amlodipin 5mg
Amoxcillin 500mg
Ampicillin 1g
Biseptol 480mg
Triobex
Cefadroxil 500mg
Cefotaxime 1g
Chlopheniramin 4mg
Ciprofloxacin 500mg
Amoxcillin+Acidclauvulamid
Amoxcillin+Acidclauvulamid
Cefuroxim 600mg
Diaphylin 4,5%
Dlosmin+Hosperidin
Hydrocortison 100mg
SVTH: ng Th Thu Tho

500mg+125mg
250mg+625mg

5
Trang 52

Trng Trung Cp Y k Lk

24
Gentamycin 80mg/1ml
25
Lidocain 2%
26
M: Tetracylin 1%
27
Nc ct 5ml
28
Nifedipino 10mg (Adalat)
29
Ofloxacin 200mg
30
Oxy gi
31
Hyoscin 20mg
32
Methylprednisolon 5mg
33
Primperan 10mg/2ml
34
Paracetamol+Dclofenac
35
Paracetamol 500mg
36
Paracetamol 250mg
37
Tenidazol 500mg
* Dch truyn:
38
Glucoza 5% 500ml
39
Glucoza 10% 500ml
40
Glucoza 30% 500ml
41
Lactat zinger 500ml
42
NaCl 0,9% 500ml

ng
ng
tube
ng
vin
vin
l
ng
vin
ng
ng
vin
gi
vin

40
30
2
50
2
10
5
5
30
5
10
50
10
20

chai
chai
chai
chai
chai

15
5
2
15
5

70

3
3
3
5

* MT S BNH N KHOA NGOI TNG HP

* Bnh n s 01:
- H v tn bnh nhn: NGUYN VN TNG

Tui: 45

Nam/N: Nam

- a ch: Krng Pk, k Lk

- L do vo vin: au bng
- Chun on vo vin: si bng quang
- Ngy nhp vin: 20/1/2013
* iu tr:
NGY/GI
DIN BIN BNH
Y LNH
20/01/2013 - Bnh nhn khai bnh khi pht Claminat 625mg x 1v ung 20h
lu, au tc vng bng di km Alphachymotripsin 4,2mg x 2v,
theo tiu kh, bnh cng nng nn ung 20h
xin nhp vin.

Paracetamol 0,5g x 1v, ung 20h

- Bnh nhn vo vin tnh, da nim Triobex x 1v, ung 20h

mc hng, hch ngoi v kh sng.

Ung nhiu nc, cm, cho

M: 80 ln/pht
SVTH: ng Th Thu Tho

Trang 53

Trng Trung Cp Y k Lk

To: 37oC
HA: 120/80 mmHg
Tim, nhp th r
Phi khng nghe ral
Bng mm, gan lch khng ln, s
bng au tc vng bng di, tiu
21/01/2013

kh.
Bnh nhn tnh to, sinh liu n, n Claminat 625mg x 2v, ung 9h
au tc h v, tiu but rt

16h
Alphachymotripsin 4,2mg x 6v,
ung 9h 16h.
Paracetamol 0,5g x 2v, ung 9h
16h
Triobex x 2v, ung 9h 16h
Ung nhiu nc, cm, cho
Tip tc iu tr

22/01/2013 Bnh , gim

* Phn tch pht iu tr:
- Claminat: iu tr nhim khun ng tit niu
- Alphachymotripsin: chng vim, ph n,
- Triobex: thuc b
* Bnh n s 02:
- H v tn bnh nhn: L NGC LAN

Tui: 62

Nam/N: N

- a ch: phng Tn An, TP.BMT, k Lk

- L do vo vin: U ngn III tay (P)
- Chun on: U b ngn tay III tay (P)
- Ngy nhp vin: 27/03/2013
* iu tr:
NGY/GI
DIN BIN BNH
Y LNH
27/03/2013 Bnh nhn c m ct cung b Penturex x 250mg x 4 v
ngn III tay (P), cch y khong 2 Pparacetamol 0,5g x 2v
nm. Nay khi u sng to nn nhp Alphaohymotripism x 4v
SVTH: ng Th Thu Tho

Trang 54

Trng Trung Cp Y k Lk

vin.

Triobex x 2v

- Hin ti bnh nhn tnh to, da Ung chia 2 ln

nim mc hng, sinh liu n, khi u Lidocein 2% x2 ng
mt lng ngn III tay (p) c kch Tim gi ngn tay
thc 1,5 x 1,5 c 1cm. gii hn r, M ct ung ba ngn III tay (p)
khng au, i ng n mm.
- Tim, phi bnh thng.
Kt lun: Ung b ngn III tay (p),
t pht.
28/03/2013

iu tr: M ct, ung b

Bnh nhn tnh to, vt m khng - Pentrirox 250mg x 4v
cn au t, sinh liu n

- Paracetimol 0,5g x2v

- Alphachy motripsin x4v
- Triobex x2, ung chia 2 ln
- Pentirox 250mg x 2v
- Paracetamol 0,5g x 2v
- Alphachymotrpim x 4v

01/04/2013 , gim
* Phn tch pht iu tr

- Tiobex x 2 v, ung chia 2 ln

Ra vin

Pentrirox: Chng vim

Paracetimol: Gim au
Alphachymotripsin: Chng vim, ph n sau chn thng.
Triobex: iu tr v d phng triu chng thiu vitamin b.
lidecain: Thuc tim gy t trong phu thut.
* Bnh n s: 03
H v tn bnh nhn: HLen BYa, Tui: 24, Nam/n: Nam
a ch: C Kuin, TP.BMT, k Lk.
L do vo vin: au bng
Chun on: TD thot i bn (P)
Ngy vo vin: 10/04/2013
SVTH: ng Th Thu Tho

Trang 55

Trng Trung Cp Y k Lk

* iu tr
Ngy, gi
3h

Din bin bnh

Y lnh
Bnh nhn khai au bng lc 12h Cefofaxim 1g x 1lo TB.
ngy 9/04/2013, au ngy cng tng Gentamycin 80mg x 1 ng TB.
nn xin nhp vin.

Dclophenac 85g x 1 ng.

M: 10 ln/ pht

Prednisolen 4mg x 5v ng.

To: 38oC
HA: 120/70mmHg
Khm: Bnh nhn au bng h v
(P).
MC-Burney(-) Blumbesg (-)
- Tinh hon sng au

8h

- Cefotaxim 1g x 1 l

- Bnh nhn tnh to, sinh liu n, - TB 9h-16h

tinh hon sng to.

- Gentumycin 80mg x 2 l

- Tiu tin khng but rt, i tin - TB: 9h

c

- Diclofhenac 80mg x 2 ng
- TB 1 ng khi au
- Prednisolon 4mg x 2v
- Ung tra sau ba n
- Triobex x 2v
- Ung 9h-16h

11/04/2013

- Bnh nhn tnh to, sinh liu n

- Cefotuxim 1g x 2 l

- Cn au tc vng bng

- TB: 9h-16h

- Tinh hon cn sng

- Gentamycin 80mg x 2 ng
- TB: 9h
- Diclophenac 8mg x 2 ng
- TB: 1 ng khi au.
- Precl nisolon 4mg x 6v
- Sng ung 4v, tra 2v.
- Triobex x 2v

SVTH: ng Th Thu Tho

Trang 56

Trng Trung Cp Y k Lk

12/04/203
, gim
* Phn tch pht iu tr

- Ung: 9h 16h
Ra vin

Cefotuxim: iu tr nhim khun nng.

Gentamycin: iu tr nhim khun ng tit niu.
Diclophenac: Thuc iu tr vim khp, gim au, h st.
Preclnisolon: iu tr ri lon ni tit, bnh l thp khp.
Triobex: D phng v iu tr cc bnh v thiu vitamin b.
* Bnh n s: 04
H v tn bnh nhn: Nguyn Th Ngc, tui: 25, Nam/n: N
a ch: Tn lp, TP.BMT, k Lk
L do vo vin: u c tay (I) vo ngy th 20 ca bnh.
Chun on: u bao hot dch mu c tay (I).
Ngy vo vin: 10/04/2013
* iu tr
Ngy, gi
10/05/2013

Din bin bnh

Y lnh
- Bnh nhn khai, bnh khi pht - Claminat 625g x 2v
lu vi khi u vng c tay (I) - Ung: 9h30 16h 30
nh cha iu tr g, nhp vin, iu - Alphachymotripsin x 4v
tr bnh nhn vo khoa tinh to tip - Paracetimon 0,5g x 2v
xc tt.

- Triobex x2v

- M: 80 ln/ pht

- Ung 9h30-10h30

- To: 38oC
- HA: 110/60mmHg
- NT: 20 ln/ pht
- Khm: Khi u vng c tay (I)
- n khng au, gii hn r, khng
di ng.
- Kt lun: U bao hot dch c tay
11/05/2013

(I).
- Hi chun li hon thng nht.

SVTH: ng Th Thu Tho

- Gentamycin 80mg x 1 ng
Trang 57

Trng Trung Cp Y k Lk

- Chun on: u bao hot dch c tay - TB: 10h

tri (I)

- Claminat 625mg x 2v
- Ung 2 ln
- Paracetimol 0,5 x 6v
- Alphachymotripson x 6 v
- Triobex x 3v
- Chia 3 ln ung

12/05/2013 , gim
*Phn tch pht iu tr:

- Cm, cho
Cho ra vin

Claminat: iu tr nhim khun m mm, vt thng.

Alphachymotripsin: Chng ph n, sng sau phu thut.
Paracetimol: Gim au
Triobex: Thuc b
Gentamycin: iu tr nhim khun
* Bnh n s 05
H v tn bnh nhn: Nguyn Vn Nam, tui: 1945, Nam/N: Nam
a ch: Tn li, TP.BMT, k Lk
L do vo vin: D tt i (P)
Ngy vo vin: 22/06/2013
* iu tr
Ngy, gi
22/06/2013

Din bin bnh

Y lnh
- Bnh nhn vo khoa tnh, tip xc - Xt nghim huyt p, nhit ,
tt.

TS-TC, chp x quang tim phi.

- M: 85 ln/ pht

- Ch m

- To: 37oC
- HA: 130/90mmHg
- NT: 20 ln/ pht
- Tim u phi khng nghe ral bng
mm, gan lch khng ln.
- Vng i (P) c khi g ln, s
SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

thy d vt.
8h
22/06/2013

- Bnh nhn tnh, khng st

- Magie B6 x 02v
- D vt vng i g ln da, du hiu - Cm, CSC 3
sinh tn n nh

8h
23/06/2013

M ly d vt
Bnh nhn tnh, khng st thy cng Gii thch, cam oan
i (P) di dch s thy d vt qua da

- Natriclosia 0,9% x 800ml

- Cefotaxime 1g x 1 l
-Gentamycin 80mg x 2 ng

9h30

- Tm nhn, CSC 3
Sau m bnh n, chuyn hi sc sau - Alpha Chymobripsin 500 01x

23/06/2013

m, iu tr tip

2 l
- Diclofenac 85 mg x 3 ng

24/06/2013

- Cm, CSC 3
Bnh tnh khng st, vt thng r - Cefotaxmie 1g x l
dch, thm bng au

- Gentamyin 80mg x 2 ng
- Alpha-Chymotripsin 500 01x 2
l
- Hapacol 0,5g x 2v
- Magie B6 x 1v
- Tha bng

25/06/2013

- Cm, CSC 3
- Bnh tnh, khng st, vt m kh, - Cofotaxime 1g x 2 l
au t.

- Gentamyin 80mg x 2 ng

- Du hiu sinh tn n

- Alphatrymotripsin 500 01 x 2 l
- Hapacol 0,5g x 2v
- Magie b6 x 2 v Thay bng

26/06/2013 - Bnh n nh
* Phn tch pht iu tr

- Cm, csc 3
- Cho xut vin

- Natriclorua: b sung nc v cht in, gii cho cho c th.

SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

- Cefotaxime: l khng sinh cefalosposin th h 3, c tc dng chng vim m t

bo.
- Gentamyci: L khng sinh tr nhim vng da, xng khp.
- Diclofenac: iu tr ngn hn nhng trng hp vim au cp tnh do chn
thng hoc phu thut.
- Alphachymotrpin: iu tr cc trng hp ph n do chn thng.
- Hapacol: c tc dng gim au, h st.
- Magie B6: Thuc b.
4. KHOA NHI
- Tip nhn tt c bnh l ni nhi t s sinh n 15 tui gm c bnh l v h
hp tim mch, thn kinh, ng c, ngt nc
* T thuc trc ti khoa
STT
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25

TN THUC
Alphachymotripsin 5mg
Acetylaystein 200mg
Alimemazin 5mg
Ampcillin 1g
Amoxcillin 250mg
Amox 500 + Acidclauxulamid
Amox 250 + Acidclauxulamid
Besodaan 20ml
Cefuroxuim 250mg
Chiophesamin 4mg
Nc ct 5ml
Hydrocostison 100mg
ORS
Gentamycin 80mg
Penicillin 1.000.000 VI
Prednisolon 5mg
Paracetamol 500mg
Paracetamol 150mg
Paracetamol 80mg
Paracetamol 100mg
Salbutamol 20mg
Simethicone 15ml
Loratidime 10mg
Lactobacilus+Acidophilus
Glucoz 5% 500ml

SVTH: ng Th Thu Tho

VT
Vin
Vin
Vin
l
vin
Vin
Vin
Vin
L
Vin
ng
ng
Gi
ng
L
Vin
Vin
Gi
Gi
Vin
vin
l
vin
gi
chai

Lng
20
10
10
5
20
10
10
20
10
20
2
5
20
10
5
20
20
20
20
20
20
5
20
20
5

GHI CH

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Trng Trung Cp Y k Lk

26
Lactat ringer 500ml
27
NaCl 0,9% 500ml
28
Artesunat 50mg
29
Primaqui 13,2g
30
Chloroqui 250mg
31
Artecan
* VT LIU TIU HAO
32
Bm tim 5ml
33
Bm tim 10ml
34
Dy truyn dch
35
Dy oxyte
36
Cun cathete TE
37
Sonde hu mn
* MT S BNH N TI KHOA NHI

chai
chai
vin
vin
vin
vin

5
5
10
10
10
10

ci
ci
ci

20
5
5

ci

* Bnh n s 01:
- H v tn bnh nhn: TRN VN HONG Tui: 48 thng Nam/N: Nam
- a ch: khi 3, phng Tn Li, TP.BMT, k Lk
- L do vo vin: Nn i, i cu phn lng
- Chun on: vim rut
- Ngy nhp vin: 08/04/2013
* iu tr:
NGY/GI
DIN BIN BNH
Y LNH
8h30
Bnh 3 ngy, tr st, nn i, i cu (1) Ringer lactat x 500ml truyn
08/04/2013

phn lng ton nc >10 ln/ngy. TM 20 git/pht

ung thuc khng nn vo ORS x 100ml ung dn
vin.

Paracetamol 150mg x 3 gi, ung

Tr vo khoa trong tnh trng tnh

1 gi khi st cch 4h

M: 130 ln/pht

L-BiO x 2 gi, ung 9h 16h

To: 39oC

Metoclopramid 10mg x 1/4 ng,

NT: 30 ln/pht

TB: 9h

P: 13kg

- Sa, cho

Mt trng nh, mi kh, capper

Xt nghim mu, siu m bng

Bng chng nh, tim nhp u, (2) Negram x 1v, ung 10h
SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

phi khng ral.

L-BiO 1g x 2 gi, ung 10h

Kt lun: vim rut c mt nc nh Dung dch ORS ung ri rc

trong ngy
Cp IV:(1) Negram 0,5g x 2v
(2) L-BiO x 4 gi
09/04/2013 Bnh n
* Phn tch pht iu tr:

(3) ORS x 2 gi
Cho ra vin

- Ringer lactat: b nc v cht in gii cho c th

- ORS: b nc
- Paracetamol: gim au, h st
- L-BiO: men tiu ha
- Metoclopromid: iu tr ri lon nhu ng d dy, rut, bun nn
- Negram: iu tr tiu chy
* Bnh n s 02:
- H v tn bnh nhn: NGUYN VN BA

Tui: 4

Nam/N: Nam

- a ch: Ea Kao, TP.BMT, k Lk

- L do vo vin: Nn i, i cu phn lng
- Chun on: vim d dy rut
- Ngy nhp vin: 10/09/2013
* iu tr:
NGY/GI
DIN BIN BNH
Y LNH
10/09/2013 Bnh 2 ngy, tr st, nn i, i cu (1) Ringer lactat x 500ml truyn
phn lng ton nc >10 ln/ngy, ORS x 100ml ung u
phn tanh, ung thuc nhng Paracetamol 150mg x 3 gi, ung
khng nn xin nhp vin.

1 gi khi st cch 4h

M: 130 ln/pht

L-BiO x 2 gi, ung 9h 16h

To: 39oC
NT: 30,8 ln/pht
P: 12kg
Mt trng nh, mi kh,
SVTH: ng Th Thu Tho

Metoclopramid 10mg x 1/4 ng,

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Trng Trung Cp Y k Lk

Bng chng, phi khng nghe ral.

TB: 9h

Kt lun: vim d dy rut c mt Tr vn mt, mt trng nh, i

nc nh

lng
Negramdicin 50g x 1v

11/09/2013 Bnh gim

* Phn tch pht iu tr:

Doperadol x 1v
Ra vin

- Ringer lactat: b nc v cht in gii cho c th

- ORS: b nc
- Paracetamol: gim au, h st
- L-BiO: men tiu ha
- Metoclopromid: iu tr ri lon nhu ng d dy, rut, bun nn
- Negramdicin: iu tr nhim trung ng tiu ha, tiu chy do nhim trng
* Bnh n s 03:
- H v tn bnh nhn: HQUYN BYA

Tui: 15 thng

Nam/N: N

- a ch: Ea Tu, TP.BMT, k Lk

- L do vo vin: Ho, kh kh
- Chun on: vim phi
- Ngy nhp vin: 14/02/2013
* iu tr:
NGY/GI
DIN BIN BNH
14/02/2013 Tr tnh, sinh liu n, phi ral t

Y LNH
Berudual x 2ml+Natri clorua 9% x

Tim u

2ml

Gan lch khng s c

Cefotaxim 2mg x 1v, ung 9h-16h

Tocemux 2g x 1 gi, ung 9h-16h
Salbutamol 2mg x 1v, ung 9h-16h
Gentamycin 80mg x 2/3 ng, ung
9h
Prednisolon 5mg x 2v, ung 9h

15/02/2013

Tr tnh

SVTH: ng Th Thu Tho

14h sau n
Berudual x 2ml+Natri clorua 9% x
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Trng Trung Cp Y k Lk

2ml
Cefotaxim 2mg x 1v, ung 9h-16h
Tocemux 2g x 1 gi, ung 9h-16h
Salbutamol 2mg x 1v, ung 9h-16h
Gentamycin 80mg x 2/3 ng, ung
9h
Prednisolon 5mg x 2v, ung 9h
20h30

16h sau n
Tr l , mi kh, mt hng, sinh Paracetamol 150mg x 3 gi, ung

16/02/2013

liu n

khi st

Tr nn, tiu chy

Natriclorua 0,9% x 500mg

Phi ral, mt nc TB

Truyn TM xxx git/pht

Actapuligot x 1/2 gi, ung 20h40

2h

Tr tnh, hi l , mi kh, sinh Xt nghim li GTM, OGD

liu n, phi ral.

Th oxy 15 pht
Actapuligit x 1/2 gi, ung 23h
Kaliorid 0,5g x 1/2 vin

17/02/2013 Bnh nhi n

* Phn tch pht iu tr:
- Berodual: phng nga, iu tr trong kh kh bnh phi, hen ph qun
- Natriclorua: b sung nc, cht in gii cho c th
- Cefotaxim: iu tr nhim khun
- Gentamycin: iu tr nhim khun
- Salbutamol: iu tr bnh v ng h hp nh vim ph qun
- Tocemux: iu tr bnh l h hp, c m, lm sch thng quy trong ph
qun
- Prednisolon: chng vim, iu tr ri lon ni tit
- Actapuligit: iu tr tiu chy
* Bnh n s 04:
- H v tn bnh nhn: V INH LAN

Tui: 10 thng

Nam/N: N

- a ch: Ea Kao, TP.BMT, k Lk

SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

- L do vo vin: st
- Chun on: vim mi hng cp
- Ngy nhp vin: 10/08/2013
* iu tr:
NGY/GI
DIN BIN BNH
Y LNH
10/08/2013 Bnh khi pht ngy 2 ln vi st Gentamycin 80mg x 1 ng IM
cao, km au bng, gia nh lo lng Cefalexin 1mg x 2v
cho vo vin.

Cefixim x 6v

Tr tnh

Alphanea x 6v

M: 130 ln/pht

Tocemux 2g x 6 gi

To: 37oC - 38oC

NT: 30 ln/pht
P: 17kg
11/08/2013 Bnh khi
* Phn tch pht iu tr

Ra vin

- Gentamycin: iu tr nhim khun nng

- Cefalexim: nhim khun h hp, tai, mi, hng
- Cefixim: iu tr vim phi cp mn tnh
- Tocemux: h hp c m
* Bnh n s 05:
- H v tn bnh nhn: V NG TM

Tui: 5

Nam/N: Nam

- a ch: Krong Ana, k Lk

- L do vo vin: st cao, au bng
- Chun on: vim mi hng
- Ngy nhp vin: 18/09/2013
* iu tr:
NGY/GI
DIN BIN BNH
Y LNH
18/09/2013 Bnh khi st ngy hm qua, st Gentamycin 80mg x 1 ng IM
cao, gy au bng, gia nh lo lng Cefalexin 1mg x 2v
cho nhp vin.

Cefixim x 6v

Tr tnh

Alphanea x 6v

SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

M: 130 ln/pht

Tocemux 2g x 6 gi

To: 37oC - 38oC

NT: 30 ln/pht
P: 17kg
19/09/2013 Bnh gim,
* Phn tch pht iu tr

Ra vin

- Gentamycin: iu tr nhim khun nng

- Cefalexim: nhim khun h hp, tai, mi, hng,
- Cefixim: iu tr vim phi cp mn tnh
- Alphanea:
- Tocemux: iu tr bnh l h hp c m

NHN XT CHUNG V TNH HNH S DNG THUC

TI BNH VIN A KHOA TNH K LK
- Thuc s dng ph hp vi chn on bnh
- Trong thi gian thc tp ti cc khoa trong bnh vin, khng thy c hin
tng tng tc thuc v phn ng c hi ADR ca thuc v trc khi dng
thuc cho bnh nhn, cc bc s nghin cu rt k khng xy ra cc tng
tc c th gy nguy him cho bnh nhn.
- Qua thi gian thc tp ti bnh vin A KHOA TNH K LK t ngy
17/12/2013 n ngy 17/01/2014, c s hng dn nhit tnh ca cc bc s,
y t, em hc hi v rt ra c nhiu kin thc b ch gip cho em trong
cng tc sau ny nh:
+ nng cao kin thc chuyn mn v hng dn s dng thuc an ton,
hp l, th em phi rn luyn kin thc c bn v s dng thuc v phng nga
nhng phn ng c hi (ADR) do thuc gy ra, trnh lm dng thuc trong iu
tr, trnh s dng thuc ba bi, c bit hiu bit hn v bin php phng nga.
+ S dng t thuc nu c th
SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

+ Ch s dng thuc khi nm r tc dng dc l

+ Khng thay i thuc nu khng cn thit, khi quyt nh dng thuc no
th phi nm chc v hiu r v thuc .
+ Nm vng v tng tc thuc trong iu tr
+ Ch cc loi thuc khi s dng d xy ra tng tc
+ phng tng tc thuc vi mt s thc n, ung nh: ru, bia, ha
cht, ch, sa, ung c ga,
+ Cng tc theo di ADR l cn thit mi ni, mi c s iu tr.
+ Trin khai rng ti mi c s iu tr nhm thc y s quan tm v nng
cao kin thc cho cn b y t v phn ng c hi ca thuc, qua gip cn b
y t c t liu tuyn truyn trong cng ng, trnh lm dng thuc.

LI KT
Trong qu trnh v thc tp ti Bnh vin A KHOA TNH K LK, em
hiu hn v trch nhim, nhim v ca mt dc s trung hc ang hc, s kt
hp gia l thuyt v thc hnh l mt phng php rt hay gip cho hc sinh
c nhn nhn v va chm thc t tip xc vi cc cn bnh, hc hi hng
iu tr ca cc bc s, ca cc c ch v anh ch trong ngnh.
Em xin chn thnh cm n Trng khoa Dc, Ni, Nhi, Truyn nhim, Ngoi,
cng tt c cn b nhn vin ca khoa nhit tnh gip v to iu kin
cho em hon thnh tt t thc tp ny.
Em xin cm n cc thy, cc c Trng trung cp Y Dc L Hu Trc to
iu kin cho chng em c thc t ti c s pht huy vn kin thc t cc
thy c truyn dy vo thc t. Em ha s c gng thc tp tt xng ng vi
cng sc ca cc thy c truyn dy.
Em xin chn thnh cm n, v knh chc cc thy, c, cc y, bc s ca Bnh
vin A KHOA TNH K LK li chc sc khe v cng tc tt.

SVTH: ng Th Thu Tho

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Trng Trung Cp Y k Lk

CNG HA X HI CH NGHA VIT NAM

c lp T Do Hnh Phc
---o0o--N XIN XC NHN
Knh gi: Ban Gim c Bnh vin a Khoa Tnh k Lk
Em tn l ng Th Thu Tho l sinh vin trng Trung cp Y Dc L Hu
Trc
Trong thng va qua, t ngy 17/12/2013 n ngy 17/01/2014 chng em
thc tp ti nm khoa ca bnh vin a khoa tnh k Lk l: Khoa Dc Khoa Ngoi Khoa ph sn - Khoa ni tim mch - Khoa nhi Khoa truyn
nhim.
Nay em lm n ny knh mong Ban gim c bnh vin a khoa tnh k
Lk xc nhn cho chng em l hon thnh vic thc tp ti bnh vin a khoa
tnh k Lk.
SVTH: ng Th Thu Tho

Trang 68

Trng Trung Cp Y k Lk

Chng em xin chn thnh cm n.

Xc nhn ca bnh vin

BMT, ngy 17 thng 1 nm 2014

Trng nhm

ng Th Thu Tho

SVTH: ng Th Thu Tho

Trang 69