LP Dan Asuhan Keperawatan Cva Infark

 

INSO[ND SHDLNGXIXND LND NUXGND AHSH[NRN\ND SHDX[XDND ANSNUM\NU NLNS\M@ MD\[NA[NDMNI SNLN SNUMHD EPN (Ehrhkrovnsauihr Neemlhdt) MD@N[A 

LMUXUXD OIHG6 UHS\MND ]OBN SH[JNDN DMJ6 >=;535>3;>=3

S[OB[NJ U\XLM LMMM AHSH[NRN\ND @NAXI\NU AHSH[NRN\ND AHSH[NRN\ND XDMPH[UM\NU FHJKH[ ANJSXU AO\N SNUX[XND

;3;>

 

IHJKN[ SHDBHUNGND INSO[ND SHDLNGXIXND LND NUXGND AHSH[NRN\ND

Nsugnd Ahphrnwntnd Shdurudnd Anpnsmtns Nlnptm` Mdtrnarndmni Snln Snsmhd EPN (Ehrhkrovnsauihr Neemlhdt) Md`nra 

\hing lmsngand pnln6 Gnrm \ndbbni

6 6

Jngnsmswn

Shjkmjkmdb Mdstmtusm

(Uhptmnd ]obn Shrjndn)  DMJ. >=;535>3;>=3 >=;535>3;>=3

(Ds. Joag. Uufnrwnlm, U.Ahp., J.Ahp)  DMS. >=20>;53 >==735 > 338

Jhdbhtngum Aoorlmdntor Srobrnj Utulm Lmpiojn MMM Ahphrnwntnd Xdmvhrsmtns Fhjkhr Anjpus Aotn Snsurund

Ds. Durui Guln, U.Ssm., U.Ahp., J.Um. DMS. >=233=;< >==53; > 33>

 

IHJKN[ SHDBHUNGND INSO[ND SHDLNGXIXND LND NUXGND AHSH[NRN\ND

Nsugnd Ahphrnwntnd Shdurudnd Anpnsmtns Nlnptm` Mdtrnarndmni Snln Snsmhd EPN (Ehrhkrovnsauihr Neemlhdt) Md`nra 

\hing lmsngand pnln6 Gnrm \ndbbni

6 6

Jngnsmswn

Shjkmjkmdb Mdstmtusm

(Uhptmnd ]obn Shrjndn)  DMJ. >=;535>3;>=3 >=;535>3;>=3

(Ds. Durui Guln, U.Ssm., U.Ahp., J.Um.)  DMS. >=233=;< >==53; > 33>

Jhdbhtngum Aoorlmdntor Srobrnj Utulm Lmpiojn MMM Ahphrnwntnd Xdmvhrsmtns Fhjkhr Anjpus Aotn Snsurund

Ds. Durui Guln, U.Ssm., U.Ahp., J.Um. DMS. >=233=;< >==53; > 33>

 

INSO[ND SHDLNGXIXND EPN (Ehrhkrovnsauihr Neemlhdt ) N. Aods Aodshp hp EPN EPN (Ehrhkrovnsauihr Neemlhdt ) >. Lh`mdmsm

EPN (Ehrhkrovnsauihr (Ehrhkrovnsauihr Neemlhdt ) nlning bndbbund `udsmodni otna yndb thrfnlm shenrn jhdlnlna jhdlnlna (lninj khkhrnpn khkhrnpn lhtma) lhtma) ntnu shenrn ehpnt (lninj khkhrnpn fnj) lhdbnd lhdb nd tndln lnd bhfnin aimdms aimdms knma `oani jnupud biokni yndb khrindbsudb khrindbsudb ihkmg lnrm ;< fnj, lmshknkand oihg thrgnjkntdyn nimrnd lnrng ah otna anrhdn phrlnrngnd (ghjornbma)   ntnupud sujkntnd (msahjma) lhdbnd bhfnin lnd tndln shsunm knbmnd (ghjornbma) otna yndb thrahdn, yndb lnpnt shjkug shjpurdn lhdbnd enent, ntnu ahjntmnd (Fudnmlm, ;3>>). EPN nlning phdynamt ntnu bndbbund phrhlnrnd lnrng otna yndb jhdyhknkand lh`msmt  dhuroiobms jhdlnlna shknbnm namknt msahjma ntnu ghjornbma smrauinsm snrn`  lh`msmt otna (Nru, ;3>0). ;. Htmoiobm

Jhdurut Uhtyoprndoto (;3>>) `nator yndb jhdyhknkand EPN ynmtu6 >) @nator yndb tmlna lnpnt lmrukng ( Dod  Dod [hvhrsmkih) [hvhrsmkih) n) Fhdms Fhdms ahinjmd ahinjmd 6 prmn prmn ihkmg shrmdb shrmdb lmthj lmthjuan uand d jhdlhrmt jhdlhrmtnn stroah lmknd lmkndlmd lmdb b wndmtn.  k) Xsmn 6 jnamd tmdbbm usmn jnamd tmdbbm puin puin rhsmao thrahdn EPN. e) Ahturu Ahturudnd dnd 6 nlndy nlndynn rmwnynt rmwnynt ahiu ahiunrb nrbnn yndb yndb thrahdn thrahdn EPN. EPN. ;) @nator yndb lnpnt lmrukng (rhvhrsmkih) n) Gmphrthdsm  k) Shdynamt fndtudb e) Aoihs oihstr tro oi tmd tmdbb bbmm l) Okhsmtns h) Lmnk Lmnkht hths hs jhim jhimtu tuss `)

Soimshthjmn

b) Utrh Utrhss ss hjos hjosmo mod dni 5)  Ahkmnsnnd gmlup n) Jhroaoa  

 

 k) Shjmduj niaogoi e) Oknt Oknt-o -okn kntn tnd d thri thrinr nrnd ndb b l) Natmvmtns Natmvmtns yndb yndb tmlna tmlna shgnt 6 aurndb aurndb oing rnbn, jnandnd jnandnd khraoihsthr khraoihsthroi. oi. 5. Ndnt Ndntoj ojmm & @msm @msmoi oiob obmm Otna Otn a jndusm jndusmnn amrn-am amrn-amrn rn jhdenp jhdenpnm nm ;% lnrm lnrm khrnt khrnt knlnd knlnd lhwnsn. lhwnsn. Otna  Otna 

jhdhrmjn >8% lnrm eurng fndtudb jhjhriuand shamtnr ;3% phjnanmnd oasmbhd tukug, lnd shamtnr 6 Ndntojm Utroah Bnjknr ;.> 6 Ndntojm Utroah Bnjknr ;.> 6 Otna lm imgnt lnrm mrmsnd 6 (n) Inthrni lnd (k) Unbmtni.

n) Ot Otna na Khsn Khsnrr (Uh (Uhrhk rhkru ruj) j) Jhrupn Jhr upnand and knbmnd knbmnd thrkhs thrkhsnr nr lnd thrlhp thrlhpnd nd lnrm lnrm otna otna jndusm jndusmn. n. Otna Otna khsnr  khsnr  jhjpudynm `udbsm lninj jhdbntur shjun natmvmtns jhdtni, yndb khranmtnd lhdb lhdbnd nd

ahpn ahpndl dlnm nmnd nd

(mdt (mdthi hihb hbhd hdsm sm), ),

md mdbn bntn tnd d

(jhj (jhjor orm) m),,

ah ahsn snln lnrn rnd, d,

ln lnd d

 phrtmjkndbnd. Otna khsnr thrlmrm ntns Iokus Oasmpmtnims  Oasmpmtnims   shk shknbn nbnmm pu pusnt snt  phdlhdbnrnd, lnd Iokus `rodtnims yndb khr`udbsm shknbnm pusnt ahprmknlmnd lnd pusnt aojudmansm.

 

 k) Otna Ahemi (Uhrhkhiuj) Jhjpu Jhj pudyn dynmm `udbsm `udbsm utnjn utnjn lninj lninj aoorlm aoorlmdnsm dnsm thrgnln thrgnlnp p otot otot lnd todus todus otot, otot, ahshmjkndbnd lnd posmsm tukug. Kmin nln rndbsndbnd yndb jhrubmand ntnu  khrkngnyn jnan bhrnand snlnr yndb dorjni tmlna judbamd lminasndnand. Otna  ahemi fubn khr`udbsm jhdbaoorlmdnsmand bhrnand yndb gnius lnd ehpnt. e) Ot Otna na \hdb \hdbng ng (Jhs (Jhshd hdsh` sh`ni niod od)) \hriht \hr ihtna na lm lhpnd lhpnd otna otna ahemi ahemi lnd fhjknt fhjkntnd nd vnroi. vnroi. Otna Otna thdbng thdbng khr`ud khr`udbsm bsm  phdtmdb pnln rh`ihas jntn, todus otot shrtn `udbsm posmsm ntnu ahluluand ahluluand tukug. l) Ot Otna na Lhpn Lhpnd d (Lmhd (Lmhdsh sh`ni `niod od)) \hrlmr \hr lmrmm ntns lun knbmnd knbmnd,, ynmtu ynmtu tgninj tgninjus us yndb yndb khr`ud khr`udbsm bsm jhdhrm jhdhrmjn jn shjun shjun rndbsndb lnrm rhshptor aheunim knu, lnd gmpotninjus yndb khr`udbsm lninj  phdbnturnd sugu, phdbnturnd dutrmhd, phdfnbnnd nbnr thtnp kndbud, lnd  phdujkugnd smanp nbrhsm`d. h) Fhjkn Fhjkntn tnd d Pnroi Pnroi (Sod (Sodss Pnroi Pnroim) m) Jhrupn Jhr upnand and shrnkut shrnkut snrn` snrn` yndb yndb jhdbgu jhdbgukud kudban band d otna otna ahemi ahemi knbmnd knbmnd amrm amrm lnd andnd. Uhinmd mtu, jhdbgukudband otna khsnr lnd sujsuj tuindb khinandb. Khkhrnpn jnenj snrn` khshrtn `udbsmdyn shknbnm khrmaut 6 >) Dhrv Dhrvus us Ern Erndm dmni nims ms n) Dhrv Dhrvu us Oivna Oivnato torm rmus us Unrn` Unr n` phjknu phjknu yndb ahiunr ahiunr lnrm lnrm otna otna lmknwn lmknwn oihg oihg lngm, lngm, jhjknw jhjknwnn rndbsndbnd nrojn (knu-knund) lnrm rodbbn gmludb ah otna.  k) Dhrvus Optmaus Jhdsnrn`m koin jntn, jhjknwn rndbsndbnd phdbhimgntnd ah otna. e) Dhrv Dhrvus us Oaui Oauioj ojot otor orms ms Khrsm`n Khr sm`ntt jotorm jotorms, s, jhdsnrn jhdsnrn`m `m otot-ot otot-otot ot orkmtni orkmtni (otot (otot phrbhr phrbhrnan nand d koin koin jntn) jn tn) jhdb jhdbgn gndt dtnra nrand nd sh shrnk rnkut ut-sh -shrn rnku kutt snrn` snrn` pn pnrn rn smjp smjpntm ntm ud udtu tua  a  jhinyndm otot smimnrms lnd otot mrms. l) Dhrv Dhrvus us \roa \roaih ihnrm nrmss Khrsm`ntt jotorms, Khrsm`n jotorms, jhdsnrn`m jhdsnrn`m otot-otot otot-otot orkmtni orkmtni (otot-otot (otot-otot orkmtni. Unrn`   phjutnr jntn yndb pusntdyn thrihtna lmkhinandb pusnt snrn` phdbbhrna  jntn. h) Dhrv Dhrvu us \rmb \rmbhj hjmd mdus us

 

Khrsm`nt jnfhjua (shdsorms jotorms) snrn` mdm jhjpudynm tmbn kung enkndb. @udbsmdyn shknbnm snrn` ahjknr tmbn, snrn` mdm jhrupnand snrn`  otna khsnr, snrn`dyn ynmtu6 (>) Dhrvus Dhrvus Oitnjma Oitnjmaus us Um`ntdyn Um`ntd yn shdsorma, shdsorma, jhdsnrn`m auimt ahpnin knbmnd knbmnd lhpnd ahiopna  jntn ntns, shinput ihdlmr ahiopna jntn lnd koin jntn. (;) Dhrvus Dhrvus Jnasminr Jnasminrms ms Um`ntdyn shdsorm, jhdsnrn`m bmbm ntns, kmkmr ntns, pnintuj, kntndb gmludb, rodbn gmludb lnd smdus jnasminrms. `) Dhrv Dhrvu us Nkl Nklus ushd hd Um`ntdyn jotorms, jhdsnrn`m otot-otot orkmtni. @udbsmdyn shknbnm snrn`   phdbboyndb smsm jntn. b) Dhrv Dhrvu us @ns @nsmn mnim imss Um`ntdyn Um`ntd yn jnfhjua jnfhjua (shdsorm (shdsorm lnd jotorms) jotorms) shrnkut-shrnku shrnkut-shrnkutt jotormsdyn jotormsdyn jhdsnrn`m otot-otot imlng lnd shinput ihdlmr rodbn juiut. Lm lninj snrn`  mdm thrlnpnt shrnkut-shrnkut snrn` otodoj (pnrnsmjpntms) udtua wnfng lnd auimt ahpnin `udbsmdyn shknbnm jmjma wnfng udtua jhdbgndtnrand rnsn phdbhenp. g) Dhrv Dhrvu us Nulm Nulmto torm rmss Um`ntdyn shdsorm, jhdsnrn`m nint phdlhdbnrnd, jhjknwn rndbsndbnd lnrmm phdlhd lnr phdlhdbnr bnrnd nd lnd lnrm lnrm thimdbn thimdbn ah otna. otna. `udbsm `udbsmdyn dyn shknbn shknbnmm snrn`  snrn`   phdlhdbnr. m) Dhrv Dhrvu us Bios Bioso` o`nr nrmd mdbh bhus us Um`ntdyn jnfhjua (shdsorm lnd jotorms) jhdsnrn`m `nrmdb, todsmi lnd imlng, snrn` mdm lnpnt jhjknwn rndbsndbnd emtn rnsn ah otna.  f) Dhrvus Pnbus Um`ntd Um` ntdyn yn jnfhju jnfhjua a (shdsor (shdsormm lnd jotorm jotorms) s) jhdbnd jhdbndlud ludb b snrn`-sn snrn`-snrn`  rn`  jotorma, shdsorma lnd pnrnsmjpntms `nrmdb, inrmdb, pnru-pnru, hso`nbus, bnsthr mdthstmduj jmdor, ahihdfnr-ahihdfnr phdehrdnnd lninj nklojhd. @udbsmdyn shknbnm snrn` phrnsn. a) Dhrv Dhrvu us Nshs Nshsor ormu muss Unrn`

mdm

jhdsnrn`m

jusauius

sthrdoaihmlojnstoml

jusauiustrnphsmuj `udbsmdyn shknbnm snrn` tnjkngnd. jusauiustrnphsmuj  i) Dhrv Dhrvu us Gmpo Gmpobi bio osu suss

lnd

 

Unrn` mdm jhdsnrn`m otot-otot imlng, `udbsmdyn shknbnm snrn` imlng. Unrn`  mdm thrlnpnt lm lninj sujsuj phdynjkudb. -; jhdmt Shind (fnj/gnrm) Undbnt ghknt [mdbnd/tna nln Uhrm Uhrmdb db \ml \mlna na,, ah aheu euni nimm  kntndb otna  Kmnsndyn tmlna Uhrmdb anim Kmsn gmindb Lnpnt gmindb shkhdtnr Kmsn n ln pnln \mlna nln  phrjuinnd \mln \mlna a nln Uhrm Uhrmdb db lnrm lnrm nwn wnii \mlna nln Judbamd nln Fnrndb Uhrmdb Uhiniu khrlnrng Fhrdmg Kmsn nln \na nln Judbamd(+)

ih ihsm sm

lm

 

 

\nkhi ;.> 6 Shrkhlnnd EPN ghjornbma lnd EPN dod-ghjornbma  0. Aojpimansm n. Ndbm Ndbmob obrn rn`m `m sh shrh rhkr krmm

Jhjkndtu jhdhdtuand phdyhknk lnrm EPN shenrn sphsm`ma shphrtm phdlnrngnd nrthr nrthrmo movh vhdn dn ntnu ntnu nl nlnd ndyn yn ru rupt ptur ur

ln lnd d ud udtu tua a jhde jhdenrm nrm ph phrl rlnr nrng ngnd nd shphrt shphrtmm

ndhurmsjn ntnu jni`orjnsm vnsauihr   k. Iujkni pudbsm, E\ Uend, HHB, Jnbdhtme Mjnbmb [hsdndeh (J[M) e. XUB Lo Loppihr  Xdtua jhdbmlhdtm`mansm nlndyn phdynamt nrthrmovhdn (jnsning smsthj anrotms) (Juttnqmd, ;337).  

\nkhi ;.;6 Aojpimansm EPN Lmdm (3-->< gnrm) Sdhujodmn namknt mjjokmiimsnsm injn Md`nra jmoanrl Hjkoim Hjk oim pnru. pnru. Ehdlhr Ehdlhrud udb b thrfnl thrfnlmm 2->< 2->< gnrm gnrm pnsen pnsenstr stroah oah,, shrmdb shrmdb anim anim thrfnl thrfnlmm pn pnln ln phdlhrmtn juinm jokmimsnsm EPN rhaurhd6 lnpnt thrfnlm pnln shtmnp snnt Fndban pndfndb (4>< gnrm) EPN rhaurhd Md`nra jmoanrl Bndbbund vnsauihr inmd 6 phdynamt vnsauihr phrm`hr

2. Shjh Shjhrm rmas asnn nnd d Lmnbdo Lmnbdost stma  ma  n. E\ Uend

Jhjp Jh jphr hrim imgnt gntan and d shenr shenrnn sphsm sphsm`m `ma a ih ihtn tna a hl hlhj hjn, n, po posm smsm sm gh ghjn jnto tojn, jn, nl nlnd ndyn yn  fnrmdbnd otna yndb md`nra ntnu msahjmn, shrtn posmsmdyn shenrn pnstm. Gnsmi  phjhrmasnnd kmnsndyn lmlnpntand gmphrlhds `oani, anlndb-anlndb jnsua ah vhdtrmahi, ntnu jhdyhknr ah phrjuannd otna.

 k. J[M Lhdbnd jhdbbudnand bhiojkndb jnbdhtma udtua jhdhdtuand posmsm shrtn  khsnr/iuns thrfnlmdyn phrlnrngnd otna. Gnsmi phjhrmasnnd kmnsndyn lmlnpntand nrhn yndb jhdbninjm ihsm lnd md`nra lnrm ghjornbma.

 

e. Ndbm Ndbmob obrn rn`m `m Uh Uhrh rhkr krmm Jhjkndtu jhdhjuand phdyhknk lnrm EPN shenrn sphsm`ma shphrtm phrlnrngnd nrthrmovhdn ntnu nlndyn ruptur lnd udtua jhdenrm sujkhr phrlnrngnd shphrtm ndhurmjsn ntnu jni`orjnsm vnsauihr. l. XUB Loppihr  Xdtua jhdbmlhdtm`mansm nlndyn phdynamt nrthrmovhdn (jnsning smsthj anrotms) h. HHB Shjhrmasnnd mdm khrtufund udtua jhimgnt jnsning yndb tmjkui lnd lnjpna  lnrm fnrmdbnd yndb md`nra shgmdbb shgmdbbnn jhduruddy jhduruddynn mjpuis mjpuis imstrma lninj fnrmdbnd fnrmdbnd otna. `. Um Umd dnr W thd thdba baor orna  na  Jhdbbnjknrand phrukngnd ahihdfnr ihjphdb pmhdni lnhrng yndb khrinwndnd lnrm jnssn yndb iuns, anism`mansm anrotms mdthrdn thrlnpnt pnln trojkosms shrhkrni1 anism`mansm pnrsmni lmdlmdb ndhurmsjn pnln phrlnrngnd suknrnagdoml. b. Sud Sudbs bsmm Iuj Iujkn knii \han \h andn dnd d yn yndb db jhdm jhdmdb dban antt ln lnd d lmshr lmshrtn tnmm kh khre rena na ln lnrn rng g pn pnln ln enmrn enmrnd d iu iujk jkni ni jhdudfuaa jhdu dfuaand nd nlndyn nlndyn ghjornbma ghjornbma pnln suknrnagdo suknrnagdoml ml ntnu phrlnrngnd phrlnrngnd pnln mdtrn mdtrnar arnd ndmni mni..

Shdm Shdmdb dban antn tnd d

fuji fujing ng pr prot othm hmd d

jhdu jhdudf dfua uaan and d

nl nlnd ndyn yn pr pros oshs hs

md`inj md` injnsm. nsm. Gnsmi Gnsmi phjhrm phjhrmasn asnnd nd imauor imauor yndb yndb jhrng jhrng kmnsnd kmnsndyn yn lmfujp lmfujpnm nm pnln pnln  phrlnrngnd yndb jnsm`, shlndband phrlnrngnd yndb ahemi kmnsndyn wnrdn imauor jnsmg dorjni (xndtoaroj) shwnatu gnrm-gnrm phrtnjn. g. Shjh Shjhrma rmasnn snnd d Inkor Inkornto ntorm rmuj uj >. Lnrn rng g rutmd ;. Buin ln lnrng 5. Xrm rmd dh ru rutmd -; imthr/jhdmt snjpnm lmlnpntand gnsmi ndnimsms bns lnrng. Fman phriu, lminauand mdtuknsm. Lhjnj lmntnsmm lhdb mdtuknsm. lhdbnd nd aojprhs aojprhs lnd ndtmpmrhtma ndtmpmrhtma,, ahjulmnd ahjulmnd lmenrm  phdyhknkdyn1 fman andludb ahjmg phdug, lmaosodband (shknmadyn lhdbnd anththr mdthrjmthd). Shjkhrmnd dutrmsm lhdbnd enmrnd msotodma, armstnioml ntnu ao aoio ioml ml >8 >833 33-; -;33 333 3 Ji ln lnd d hiha hihatr troi oimt mt sh shsu sunm nm ah ahku kutu tugn gnd, d, gm gmdl dlnr nrmm en enmr mrnd nd jhdbndludb biuaosn ntnu snimd msotodma. Shjkhrmnd dutrmsm phr orni gndyn fman `udbsm jhdhinddyn knma1 fman lmlnpntand bndbbund jhdhind ntnu ahsnlnrnd jhdurud, lmndfurand jhinium shindb dnsobnstrma. Anlnr buin lnrng 4>83 jb% gnrus lmaorhasm snjpnm kntns buin lnrng shwnatu >83 jb% lhdbnd mdsuimd lrmp mdtrnvhdn aodtmdu shinjn ;-5 gnrm phrtnjn. Gmpobimahjm (anlnr buin lnrng 903 jb% ntnu 973 jb% lhdbnd bhfnin) lmntnsm shbhrn lhdbnd lhastrosn ;3 jjGb, Jhnd jjGb, Jhnd Nrthrmni Kiool Srhssurh (JNS) ≨>53 jjGb (pnln ; anim  phdbuaurnd lhdbnd shindb wnatu 53 jhdmt), ntnu lmlnpntand md`nra jmoanrl naut, bnbni fndtudb aodbhstm` shrtn bnbni bmdfni aodbhstm` shrtn bnbni bmdfni. Shdurudnd tha hanndnd lnrng jnasm smj jni nlning ;3%, lnd oknt yndb lmrhaojhdlnsmand6 dntrmuj dmtroprusml, phdyhant rhshptor ni`n-khtn, phdyhant NEH, ntnu ndtnbodms ssanismuj. Fman thrfnlm gmpothdsm, ynmtu thandnd smstoima  ≬=3 jjGb, lmnstoima ≬23 jjGb, lmkhrm DnEi 3,=% ;83 Ji shinjn > fnj, lmindfutand 833 jI shinjn < fnj lnd 833 jI shinjn 7 fnj ntnu snjpnm gmpoth gmp othdsm dsm lnpnt lnpnt lmntnsm lmntnsm.. Fman Fman khiuj khiuj thraorh thraorhasm asm,, ynmtu ynmtu thandn thandnd d lnrng lnrng smstoim smstoima  a  jnsmg 9=3 jjGb, lnpnt lmkhrm lopnjmd ;-;3 ¸b/ab/jhdmt snjpnm thandnd lnrng smstoi ≨>>3 jjGb. Fman ahfndb, lmkhrm lmnzhpnj 8-;3 jb mv phind-phind shin shinjn jn 5 jhdm jhdmt, t, jnas jnasmj mjni ni >33 >33 jb ph phrr gn gnrm rm11 lm lmni nidf dfut utan and d ph phjk jkhr hrmn mnd d ndtmaodvuisnd ndtmaodvu isnd phr orni (`hdmtomd, (`hdmtomd, anrknjnzhpmd anrknjnzhpmd). ). Fman ahfndbjud ahfndbjudeui eui shthing ; jmdbbu jmd bbu,, lmkhrm lmkhrmand and ndtmao ndtmaodvu dvuisnd isnd prorni prorni fndban fndban pndfnd pndfndb. b. Fman Fman lmlnpn lmlnpntan tand d thandnd thand nd mdtrnarndmni mdtrnarndmni jhdmdbant, jhdmdbant, lmkhrm jndmtoi jndmtoi koius koius mdtrnvhdn mdtrnvhdn 3,;8 snjpnm > b/abKK b/a bKK phr 53 jhdmt, jhdmt, lnd fman fman lmeurm lmeurmbnm bnm `hdojh `hdojhdn dn rhkoud rhkoudl l ntnu ahnlnnd ahnlnnd ujuj jhjkurua, lmindfutand 3,;8 b/abKK phr 53 jhdmt shtmnp 0 fnj shinjn 5-8 gnrm. gnrm. Gnrus Gnrus lminau lminauand and phjndt phjndtnun nund d osjoin osjoinimtn imtnss (95;3 (95;3 jjoi)1 jjoi)1 shknbn shknbnmm nithrdntm`, lnpnt lmkhrmand inrutnd gmphrtodma (DnEi 5%) ntnu `uroshjml. \hrnpmm agusus \hrnp agusus 6 lmtudfuaa lmtudfuaand nd udtua rhphr`usm lhdbnd phjkhrmnd ndtmpinthiht ndtmpinthiht shphrtm nspmrmd lnd ndtm aonbuind, ntnu yndb lmndfurand lhdbnd trojkoimtma  rtSN (rheojkmdndt (rheojkmdndt tmssuh Sinsjmdobhd Netmvntor ). ). Lnpn Lnpntt fubn fubn lmkh lmkhrm rm dhuroprothasm, ynmtu smtmaoimd ntnu pmrnshtnj (fman lmlnpntand n`nsmn).

nbhd nbhd

 k. EPN Ghjornbma \hrnpm Xjuj6 pnsmhd EPN ghjornbma gnrus lmrnwnt lm MEX fman voiujh ghjnto ghj ntojn jn 453 jI phrlnr phrlnrngn ngnd d mdtrnv mdtrnvhdt hdtrmau rmauihr ihr lhdbnd lhdbnd gmlrosh gmlrosh`ni `nius, us, lnd ahnlnnd aimdms ehdlhrudb jhjkurua. \handnd lnrng gnrus lmturudand snjpnm thandn tha ndnd d lnrng lnrng prhjor prhjorkml kml ntnu >8-;3% >8-;3% kmin kmin thandn thandnd d smstoim smstoima a 4>73 4>73 jjGb, jjGb, lmnstoima 4>;3 jjGb, JNS 4>53 jjGb, lnd voiujh ghjntojn khrtnjkng. Kmin thrlnpnt bnbni fndtudb, thandnd lnrng gnrus shbhrn lmturudand lhdbnd inkhtnioi mv >3 jb (phjkhrmnd lninj ; jhdmt) snjpnm ;3 jb (phjkhrmnd lninj >3 jhdmt) jnasmjuj 533 jb1 hdninprmi mv 3,0;8->,;8 jb phr 0 fnj1

 

anptoprmi 5 anim 0,;8-;8 jb phr orni. Fman lmlnpntand tndln thandnd mdtrnarndmni jhdmdbant, posmsm ahpnln lmdnmaand 53³, posmsm ahpnin ld lnln lm sntu kmlndb,  phjkhrmnd jndmtoi lnd gmphrvhdtminsm (Seo, ;3-58 jjGb). Shdntninasndnnd ujuj uju j snjn snjn lhdbnd lhdbnd pnln pnln stroah stroah msahjm msahjma, a, tuana tuana injkud injkudb b lmntns lmntnsmm lhdbnd lhdbnd ndtnbodms G; pnrhdthrni, suarni`nt, ntnu mdgmkmtor pojpn protod1 aojpimansm sniurnd sniur nd dn dnpn pnss lmehb lmehbng ng lh lhdb dbnd nd `msmo `msmoth thrnp rnpmm ln lnd d lm lmok oknt ntmm lh lhdb dbnd nd nd ndtm tmkm kmot otma  ma  sphatruj iuns. \hrn \h rnpm pm agus agusus us66 dhur dhurop opro rotr trat ator or lnpn lnpntt

lm lmkh khrm rman and d

ah aheu euni nimm yn yndb db kh khrs rsm` m`nt nt

vnsmlmintor vnsmlm intor.. \mdlnand khlng khlng jhjphrtmjkndba jhjphrtmjkndband nd usmn lnd ihtna

phrlnrngnd phrlnrngnd

yn ynmt mtu u pn pnln ln pn pnsm smhd hd yn yndb db ao aodl dlmsm msmdy dynn am amnd nd jhjk jhjkur urua ua ld ldbn bnd d ph phrl rlnrn nrngn gnd d shrh shrhkh khiu iuj j

khrl khrlmn mnjh jhth thrr

45 ejµ, ejµ, gm gmlr lros osh` h`ni nius us na naut ut na namk mknt nt ph phrl rlnr nrng ngnd nd

mdtrnvhdtrmahi ntnu shrhkhiuj, lminauand PS-sgudtdb, lnd phrlnrngnd ioknr  403 Ji lhdbnd lhdbnd tndln tndln phdmdb phdmdbant antnd nd thandn thandnd d mdtrna mdtrnarnd rndmni mni naut naut lnd ndenjn ndenjnd d ghrdmnnsm. Snln phrlnrngnd suknrnadoml, lnpnt lmbudnand ndtnbodms anismuj (dmjolmpm (dmjol mpmd) d) ntnu tmdlna tmdlnand nd khlng khlng (imbns (imbnsm, m, hjkoim hjkoimsnsm snsm,, hastmrp hastmrpnsm, nsm, jnupud jnupud bnjjn adm`h) fman phdyhknkdyn nlning ndhurmsjn ntnu jni`orjnsm nrthrm vhdn (nrthrmovhdous jni`orjntmod, NPJ). e. Ut Utnl nlmu muj j Uuk Uukna nau ut \mdlnand jhlms lnpnt khrupn thrnpm aobdmtm`, tmdbang inau, jhdhind thrnpm wm wmen enrn, rn, lnd lnd kinl kinllhr lhr trnmdmdb  trnmdmdb   (thrjnsua thrnpm `msma). Jhdbmdbnt phrfnindnd  phdynamt yndb pndfndb, lmkutugand phdntninasndnnd agusus mdthdsm` pnsen stroah lm rujng snamt lhdbnd tufund ahjndlmrmnd pnsmhd, jhdbhrtm, jhjngnjm lnd jhinasndnand probrnj prhvhdtm` lnd shaudlhr. \hrnpm `nsh suknaut ndtnrn inmd6 >) Jhindf Jhindfuta utand nd thrnp thrnpmm shsunm shsunm aodlm aodlmsm sm naut naut shkhi shkhiujd ujdyn. yn. ;)

Shdn Shdntn tnin inas asnd ndnn nnd d ao aojp jpim iman ansm. sm.

5)

[h [hsto storn rnsm/ sm/rh rhgn gnkm kmim imtn tnsm sm (shsu (shsunm nm ah ahku kutu tugn gnd d pn pnsmh smhd) d) yn ynmt mtu u `msmo `msmoth thrnp rnpmm thrnp thrnpmm wmenrn, thrnpm aobdmtm`, lnd thrnpm oaupnsm.

;) jhimputm jhimputm 6

>) Aodtro Aodtroii thandnd thandnd lnrng lnrng shenrn shenrn rutmd/thr rutmd/thrntu ntur  r  ;) Jhdb Jhdbgh ghdt dtma mand nd jhr jhroa oaoa  oa 

 

5) Jhdurudand Jhdurudand aodsujsm aodsujsm aoihsthro aoihsthroii lnd aodtro aodtroii aoihsthroi aoihsthroi rutmd rutmd =;535>3;>=3 >=;535>3;>=3 6-

SHDBANFMND AHSH[NRN\ND AHSH[NRN\ND

N. MLHD\M\NU AIMHD

 Dnjn

6 \d.]

Fhdms Ahinjmd

6 Inam-inam

Xjur

6 8; tgd

Shahrfnnd

6 Rmrnswnstn

Uuau

6 Fnwn

Nbnjn

6 Msinj

Sh Shdl dlml mlma mand nd \hrna \hrnagm gmrr

6 UJS UJS

Ninjnt

6 \hjkoarhfo

 Do. rhbmstrnsm

6 ;37 Fndunrm ;3;>

\bi. phdbanfmnd

6 >7 Fndunrm ;3;>

Lmnbdosn jhlms

6 EPN Md`nra  

K. [MRN]N\ AHSH[NRN\ND

>.

Ahiu Ahiugn gnd d utn utnjn jn / nin ninsn snd d jns jnsua ua ru rujn jng g snam snamtt UJ[U UJ [U66 Ai Aimh mhd d jhdb jhdbntn ntnan and d ; gn gnrm rm yn yndb db in iniu iu an anam am ln lnd d tn tndb dbnd nddy dynn tmln tmlna a km kmsn sn lmbhrnaand lnd kmkmr jmrmdb ah andnd. J[U6 Hasthrjmdns knwng lnd ntns jhdbninjm ahihjngnd pnln aimhd.

;.

[mwny nynnt Sh Shdynamt Uh Uhanrndb Snln tndbbni >7-3>-;> fnj ;3.33 RMK. Aimhd lntndb ah MBL lhdbnd lmthjndm ahiunrbn. Ahiunrbn aimhd jhdbntnand aimhd jhdbninjm susng tmlur lnd snamt

 

ahpnin, ahjulmnd hastrhjmtns ntns lnd knwng susng lmbhrnaand, lnd kmenrn tmlna   fhins, shgmdbbn ahiunrbn jhjutusand aimhd lmknwng ahrujng ahrujng snamt. 5.

[mwny nynnt Sh Shdynamt Lnguiu Ahiunrbn Ahiunr bn aimhd jhdbntnand jhdbntnand \d.] tmlna phrdng jhdbninjm jhdbninjm ahfnlmnd shphrtm mdm, lnd tmlna jhjpudynm rmwnynt phdynamt jhduinr shphrtm GMP/NMLU, \K pnru, ghpntmtms, lii, ntnu phdynamt jhdurud shphrtm gmphrthdsm, nsjn, lmnkhthsjmiimtus, lii.

73/=3 jjGb

[[ 6 ; 0

 D

6 >;3

x/jhdmt

U

KK

6 23

ab

6 50,2 E

USO; 6 =7% Krhntg (K>)

>. Shrb hrbhrna hrnand nd Lnln Lnln 6 Umj Umjhtrm htrmss ;. Shjnan Shjnanmnd mnd otot otot kndtu kndtu dn`ns dn`ns 6 \mlna \mlna nln nln 5. Uunr Uunrnn dn`n dn`nss 6 vh vhsm smau auih ihr  r  . Uunr Uunrnn fndt fndtud udb b 6 \udb \udbbn bnii ;. Mrnj Mrnjnn fndt fndtud udb b 6 [hbu [hbuih ihr  r  5. E[\ 6 4 ;l ;lhtm htma  . \mdbant \mdbant Ahsnlnrn Ahsnlnrnd d Aundtmtn Aundtmtntm` tm` (BEU) (BEU) 6 H. 5 P.; P.; J.; J.; ;. [hn hna asm pu pupmi n) Andnd Andnd lnd amrm6 amrm6 Nln, Nln, lmnjht lmnjhthr hr ¾ ; jj 5. [h`i [h`iha hass `msm `msmoi oiob obms ms 6 Nln Nln . Juao Juaosn sn kmk kmkmr mr 6 Ahr Ahrmd mdb b ;. Iml mlng ng 6 Aot Aoto or 5. Ahnl Ahnlnnd nnd bmbm bmbm 6 Ihd Ihdba banp np 3. Jhihdn 6 \mlna \mlna nln nln jhihdn >>. \hrpnsndb \hrpnsndb DB\ 6 \mlna \mlna thrpnsndb DB\ DB\ >;. Lmnrh 6 \mlna \mlna jhdbninjm jhdbninjm lmnrh lmnrh >5. Aodstmpnsm Aodstmpnsm 6 \mlna nln aodstmp aodstmpnsm nsm >. \urb \urbo or 6 Knma  nma  ;. Shrl Shrlnr nrng ngnd nd aui auimt mt 6 \ml \mlna na nln nln 5. Meth Methru russ 6 \ml \mlna na nln nln = Fndunrm ;3;> Gnsmi Shjhrmasnnd Dminm [u [ufuand Lhtnmi Shjhmasnnd KXD Erhntmdmd UBO\ UBS\ LI (Lnrng Ihdbanp) Ihuaosmt Ghjobiokmd \rojkosmt Hihatroimt Enismuj Eiormln Enimuj Dntrmuj

;;,= >,0 58 >2

>3-;3 jb/li 3,8->,2 jb/li 9 5> X/M 9 5> X/M

>>.533 >8,5 >77.333

>.333 /ejj I >5->7 S >;->0 b/li >83.333-,; >32,; < >.>;->.5; Jj =0.3->30.3 Jj 5,0-8,8 Jjoi/t >58->88 Jjoi/t

H. INMD-INMD

-

@. \H[NSM

n.) Dnei 3,3% 833ee >< tpj e.) Dhkui eojkmvhd 5x> rhspuih l.) @uroshjml ;x>3 jb Shrnwnt h.) Indsoprnzoih ;x53 jb

UHS\MND ]OBN SH[JNDN  DMJ6 >=;535>3;>=3 >=;535>3;>=3

 

NDNIMUN LN\N

 Dnjn Snsmhd 6 \d.] Xjur 6 8; tgd  Do.[hbmsthr 6 ;3.

Aimhd hd jhdbhi jhdbhiug ug ; gnrm gnrm Ls 6 Aim iniu tmlna kmsn jhdbbhrnaand anam lnd tndbnddyn.

Nthrmosaihrosms

Shdurudnd Anpnsmtns Nlnptm`  Mdtrnarndmni

\grojkus / hjkoim lm ehrhkrni

Lo6

A/u 6 ihjng BEU 6 5, ;, ;

Utroah Dod Ghjornbma 

Kmenrn tmlna fhins Bndbbund kmenrn (+)

Sroshs jhtnkoimsjh lninj otna thrbndbbu

Aimhd tnjpna ndhjms  Dnlm thrnkn ehpnt

Uupinm lnrng lnd O; ah otna 

-\ndln-tndln vmtni 6 \L 6 >73/=3 >73/=3 jjGb [[ 6 ;0

x/jhdmt

 D

6 >;3 x/jhdmt

U

6 50,2 E

KK 6 23 ab USO; 6 =7% - \handnd JNS 6 >;3 jjGb

Shdurudnd Anpnsmtns Nlnptm` Mdtrnarndmni

 

LMNBDOUN AHSH[NRN\ND AHSH[NRN\ND

 Dnjn Snsmhd 6 \d.] Xjur 6 8; tgd  Do.[hbmsthr 6 ;3.

>7-3>-;3;>

LMNBDOUN AHSH[NRN\ND Shdurudnd Anpnsmtns Nlnptm`  Mdtrnarndmni

\BI \H[N\NUM

\\L

 

[HDENDN NUXGND AHSH[NRN\ND

 Dnjn Snsmhd 6 \d.] Xjur 6 8; tgd  Do.[hbmsthr 6 ;373>;3;>

>.

ULAM

UIAM

Shdurudnd Anpnsmtns Anpnsm Anpnsmtns tns Nln Nlnptm ptm`` Mdtrna Mdtrnarnd rndmni mni Nlnptm` Nlnp tm` Mdtrn Mdtrnarndm arndmni ni (I.303 x ;< fnj fnj

lmgnrnpand lmgnr npand pnsmh pnsmhd d lnpnt jhdenpnm jhdenpnm ah ahst stnk nkmi mind nd jhan jhandm dmsj sjhh lmdn lmdnjm jman an mdtr mdtrna narn rndm dmni ni ln lnin inj j jhin jhinau auan and d aojphdsnsm aojphd snsm thrgn thrgnlnp lnp stmju stmjuius ius yndb ln lnpn pntt jhdur hdurud udan and d an anpn pnsm smttns mdtrnarndmni lhdbnd armthrmn gnsmi6 \mdbant Ahsnlnrnd6 @udbsm aobdmtm`6 Jhin Jhinauand auand phdbuaurnd BEU ahpnln pnsmhd Unamt Ahpnin6 Bhimsng6 Jhdurudand ahbhimsngnd lnrm tmdbantnd tmdban tnd shlndb shlndb (5) jhdfnlm euaup jhdurud (x;< lnrm euaup jhjkurua (;)

UMAM N. Jndnfhjhd Shdmdbantnd \handnd Mdtrnarndmni (M.3=5;8)6

Lh`mdmsm6 Jhdbmlhdtm`mansm lnd jhdbhioin phdmdbantnd thandnd lninj rodbbn arndmni Okshrvnsm6 >. Mlhdtm Mlhdtm`ma `mansm nsm phdyhk phdyhknk nk phdmdb phdmdbant antnd nd \ha \handn ndnd d Mdtrnarndmni \MA  ;. Jodmtor tndln/bhfnin phdmdbantnd \MA  5. Jodmtor JNS (Jhnd JNS (Jhnd Nrthrmni Srhssurh) . Jmdm Jmdmjn jnia iand nd stmj stmjui uius us lhdb lhdbnd nd jh jhdy dyhl hlmn mnan and d imdbaudbnd yndb thdndb ;. Khr Khrman mand d posm posmsm sm sh shjm jm `o `owih wihr  r  5. Ehb Ehbng ng tthr hrfnl fnlmdy mdynn ah ahfnd fndb b =7)

Lh`mdmsm jhdbujpuiand lnd jhdbndnimsms lntn thranmt

 

jhdfnlm jhjknma (8) rhbuinsm thandnd lm lninj rundb mdtrnarndmni. \handnd \han dnd Dnlm6 Jhdbodtroi thand thandnd nd Okshrvnsm6 dnlm >x;< fnj >. Jod Jodmto mtorr phdm phdmdba dbantn ntnd d\ \L L \hand \handnd nd Mdt Mdtrna rnarnd rndmni mni66 Jhd Jhdbod bodtro troii ;. Jod Jodmto mtorr phih phihknr knrnd nd tha thandn ndnd d dnlm \handnd Mdtrnarndmni >x;< fnj 5. Jodmt Jodmtor or ph phdurudn durudnd d tmdbant tmdbant ahsnl ahsnlnrnd nrnd . Shrtn Shrtngndan gndand d posmsm ahpni ahpninn lnd ihghr ihghr dh dhtrni trni

\\

 

EN\N\ND AHSH[NRN\ND

 Dnjn Snsmhd 6 \d.] Xjur 6 8; tgd  Do.[hbmsthr 6 ;3.

\BI/FNJ >7-3>;3;>

 DO.LW. AHS ;3.33

;3.38

\MDLNAND >. Jhjkmdn gukudbnd snimdb phrenyn ndtnrn phrnwnt lhdbnd aimhd lhdbnd enrn jhjphrahdniand lmrm. ;. Jhihtnaand Jhihtnaand ahpnin lnd ihghr pnsmhd lninj posmsm dhtrni, jhdbgmdlnrm `ihasm pmdbbndb yndb khrihkmgnd 5. Jhjodmtor tndln-tndln vmtni

;3.>3

o o o o o o

\L [[  D U KK

6 >73/=3 jjGb 6 ;0 x/jhdmt 6 >;3 x/jhdmt 6 50,2 E 6 23 ab ;

USO  6 =7% 8

- \han \handn dnd d JNS JNS 6 >; >;3 3 jjGb jjGb (Dor (Dorjn jnii \han \handn dnd d JNS ndtnrn 23 ― ==) 8. Jhjodmtor stntus phrdn`nsnd 6 `rhauhdsm, mrnjn [ 6 ;0 x/jhdmt Mrnjn 6 Mrrhbuihr 

;3.53

0. Jhde Jhdent ntnt nt ph phru rukn kngn gnd d pn pnsm smhd hd ln lnin inj j kh khrs rshp hpod od thrgnlnp stmjuius

;3..33

Jhjkhr Jhjk hrma mand nd md`u md`ush sh ns nserm ermdb db ;> tp tpj j ln lnd d pn pndt dtnu nu  knineh enmrnd lninj tukug. =. Jhjkhrmand `nrjnaoiobm udtua jhjphrtngndand \MA lninj fndbanu thrthdtu6 n) Md`us nshrmdb ;> tpj  k) Mdfhasm emtmegoimd ;83 jb e) Mdfhasm ndtrnmd ; ji

\\

 

l) Mdfhasm topnzoi ji

 

HPNIXNUM AHSH[NRN\ND

 Dnjn Snsmhd 6 \d.] Xjur 6 8; tgd  Do.[hbmsthr 6 ;37-3>-;3;>)

AHS

>.

U6

- Aimh Aimhd d jhdb hdbhiug hiug ; gnr nrmm iniu iniu tml tmlna kmsn msn jhd hdb bbhrn bhrnaa aand nd an anam am ln lnd d tndbnddyn. O6

- a/u 6 ihjng -BEU 6 33 jjGb.

N 6 Shdurudnd Anpnsmtns Nlnptm` Mdtrnarndmni tmlna jhdfnlm natuni S 6 Mdthrvhdsm lmphrtngndand