Xem mẫu
- CHAÊM SOÙC HAÄU SAÛN :
ÑAU VUÙ
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- ÑOÁI TÖÔÏNG :
- Sinh vieân Y4
- Hoïc nhoùm nhoû, moãi nhoùm 10 – 15 sv
- Do 1 giaûng vieân höôùng daãn, coù söï trôï giuùp
cuûa 1 Bs. Noäi truù
- Thôøi löôïng : 1 tieát (45 phuùt)
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- MUÏC TIEÂU:
1. Coù khaû naêng hoûi beänh söû moät tröôøng hôïp ñau vuù
trong nhöõng ngaøy ñaàu haäu saûn
2. Coù khaû naêng thaêm khaùm moät tröôøng hôïp ñau vuù
3. Lieät keâ ñöôïc caùc nguyeân nhaân gaây ñau vuù trong
thôøi kyø haäu saûn
4. Coù khaû naêng chaån ñoaùn phaân bieät caùc nguyeân
nhaân gaây ñau vuù trong thôøi kyø haäu saûn
5. Phaân bieät ñöôïc ngaäm baét vuù ñuùng caùch hay khoâng
ñuùng caùch
6. Tö vaán ñöôïc cho saûn phuï caùch giaûi quyeát moät
tröôøng hôïp cöông töùc tuyeán vuù
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- aùc
h
TÖØ KHOAÙ :
- Caêng söõa
- Cöông töùc tuyeán vuù (breast engorgement)
- AÙp-xe vuù (breast abcess)
- Nöùt ñaàu vuù (cracked nipple)
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- HÖÔÙNG DAÃN :
Tröôùc khi tham döï buoåi hoïc, hoïc vieân phaûi ñoïc tröôùc :
- Taøi lieäu baét buoäc phaûi ñoïc :
- Saùch “Saûn Phuï Khoa” – baøi “Nuoâi con baèng söõa
meï” (tr.180)
- Saùch “Thöïc haønh saûn phuï khoa” – baøi “Caùch
cho con buù” (tr.71)
- Taøi lieäu ñoïc theâm :
- Breastfeeding: how to support success
(tìm taïi trang web www.who.int)
- Hepatitis B and breastfeeding
(www.who.int/child-adolescent health/New-
Publication/...)
- Thoâng tin treân maïng : Hinary, Cochcrane..
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- ÂA
TRÖÔØNG HÔÏP LAÂM SAØNG :
Saûn phuï A. tuoåi, sanh con so, sanh thöôøng
caùch nay 4 ngaøy, coù caét may taàng sinh moân.
Hoâm nay saûn phuï than ñau nhöùc nhieàu hai vuù
raát khoù chòu
Caâu hoûi 1 : baïn caån hoûi theâm nhöõng ñieàu gì veà
tình traïng ñau vuù cuûa saûn phuï
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- Caâu hoûi 2 : baïn haõy moâ taû caùch khaùm
vuù trong tröôøng hôïp naøy ñeå coù theå xaùc
ñònh ñöôïc nguyeân nhaân
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- TRÖÔØNG HÔÏP LAÂM SAØNG (tieáp theo)
Sau khi hoûi beänh söû, baïn ñöôïc bieát coâ A. khoâng cho
buù ngay sau sanh vì chöa coù söõa. Coâ ta chæ môùi cho beù
buù 2 ngaøy sau sanh khi thaáy vuù ñaõ caêng. Tuy nhieân khi
beù ngaäm vuù meï chæ moät laùt laø beù nhaû ra vaø khoâng chòu
buù theâm. Do ñoù coâ A. phaûi cho buù daëm theâm söõa coâng
thöùc. Töø ngaøy hoâm qua, coâ thaáy vuù caêng ñau nhieàu hôn
vaø moãi khi beù buù, coâ caûm thaáy ñau raùt nôi ñaàu vuù.
Khi khaùm, baïn ghi nhaän ñöôïc nhöõng daáu hieäu sau :
hai vuù caêng cöùng, da caêng boùng. Treân ñaàu vuù thaáy coù
veát nöùt. Sôø naén thaáy beân döôùi moâ vuù 2 beân coù nhöõng
cuïc cöùng. Naën vuù thaáy söõa chaûy ra raát ít vaø saûn phuï raát
ñau. Khoâng coù haïch naùch vaø saûn phuï khoâng bò soát.
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- Caâu hoûi 3 : baïn haõy lieät keâ caùc nguyeân
nhaân gaây ñau vuù trong thôøi kyø haäu saûn.
Trong tröôøng hôïp naøy, chaån ñoaùn cuûa
baïn laø gì vaø haõy lyù giaûi taïi sao baïn laïi coù
chaån ñoaùn aáy ?
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- Caâu hoûi 4 : theo baïn, nguyeân nhaân cuûa
tình traïng naøy do ñaâu vaø caàn theâm ñieàu gì
ñeå coù theå xaùc ñònh ñöôïc nguyeân nhaân cuûa
tình traïng naøy
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- TRÖÔØNG HÔÏP LAÂM SAØNG (tieáp theo)
Quan saùt coâ A cho beù buù, baïn thaáy coâ naèm
nghieâng cho beù buù. Em beù ngaäm vuù theo nhö
hình veõ
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- Caâu hoûi 5 : theo baïn, beù ngaäm vuù coù ñuùng
caùch khoâng, döïa vaøo nhöõng trieäu chöùng naøo ?
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- Caâu hoûi 6 : Baïn haõy tö vaán cho coâ A caùch
giaûi quyeát tình traïng ñau vuù cuûa coâ ta.
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- TRÖÔØNG HÔÏP LAÂM SAØNG (tieáp theo)
Sau khi höôùng daãn saûn phuï veà caùch cho
beù ngaäm vuù nhö treân, baïn ñöôïc coâ ta cho bieát
laø trong luùc khaùm thai coù ñöôïc thöû HbSAg,
keát quaû (+). Coâ ta hoûi baïn lieäu coù neân tieáp tuïc
cho beù buù meï ñöôïc khoâng
Caâu hoûi 7: yù kieán cuûa baïn veà vaán ñeà naøy nhö
theá naøo
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