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ASUHAN KEPERAWATAN GERONTIK
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ASUHAN KEPERAWATAN GERONTIK
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Riska Nango
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AMA F \HOKMNXBXMO M/ Bm{mq Ahbmcmoi Uhfqfoi khoimo `hofoicm{ovm cxmbf{mu |hbmvmomo chuhnm{mo kf ohimqm `mjx kmo ohimqm ahqch`amoi" `mcm ahq{m`amnbmn xufm nmqm|mo nfkx| |hokxkxc ohimqm {hquhax{/ Nmb fof ahqmq{f" mcmo ahq{m`amnovm |g|xbmuf |hokxkxc bmojx{ xufm .bmoufm&/ Kf Fokgohufm kmo ahahqm|m ohimqm ahqch`amoi bmfoovm uhuhgqmoi kfchbg`|gccmo ch kmbm` igbgoimo bmoufm jfcm x`xq cqgogbgifuovm uxkmn 4< {mnxo .Cmoh" =66;&/
\hovmcf{ |mkm xufm bmojx{ khoimo ihjmbm cnmu vmf{x `xb{f|m{gbgif .bhafn kmqf um{x |hovmcf{&" ch`m`|xmo dfufgbgifu {xaxn vmoi uxkmn `hoxqxo" {m`|fbmo ihjmbm vmoi {fkmc cnmu' `hovf`|moi" kmo |hoxqxomo u{m{xu dxoiufgomb .ch`m`|xmo cqhqmc{ftf{mu&/ \hovmcf{|hovmcf{ vmoi kf{h`xcmo |mkm |mufho ihqfm{qf x`x`ovm mkmbmn |hovmcf{ khihohqm{fd cqgofc .Cmoh" =66;&/
Uh{fm| gqmoi |mu{f foifo `h`fbfcf `mum {xm vmoi amnmifm {h{m|f chfoifomo {fkmcbmn uhbmbx km|m{ `hojmkf ovm{m/ \mkm chnfkx|mo ovm{m" amovmc
uhcmbf
bmoufm-bmoufm
vmoi
`hojmkf
kh|qhuf"
u{qhuu"
kmo
ahq|hovmcf{mo/ Amovmc cf{m {h`xcmo bmoufm vmoi kfcfqf` ch |mo{f jg`|g kmo {fkmc {hqxqxu gbhn chbxmqim" mkm bmoufm vmoi kfmufoicmo kmqf chnfkx|mo momc exexovm `hucf|xo nfkx| kmbm` bfoicxoimo vmoi um`m" mkm bmoufm vmoi `mufn nmqxu ahchqjm chqmu `hucf|xo uxkmn {xm" kmo `mufn amovmc nmb-nmb bmfoovm vmoi `hojmkf |hovhama .Bxhechog{{h" 1<<<3 Nmbb $ Nmuuh{{" 1<<1&/
\hqmym{ uhamimf {homim chuhnm{mo vmoi |gqdhufgomb `h`|xovmf chuh`|m{mo
|mbfoi ahumq
xo{xc
`h`ahqfcmo
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
|hbmvmomo'muxnmo
\mih =
ch|hqmym{mo vmoi cg`|qhnhoufd khoimo `h`amo{x cbfho `h`hoxnf chax{xnmo kmumq vmoi ngbfu{fc/ \hqmym{ `h`mokmoi cbfho uhamimf `mnbxc afg-|ufcg-ugufgcxb{xqmb kmo u|fqf{xmb vmoi ahqhu|go uhemqm ngbfu{fc kmo xofc {hqnmkm| |hqxamnmo chuhnm{mo m{mx |mkm chmkmmo cqfufu/ Muxnmo ch|hqmym{mo vmoi kfahqfcmo gbhn |hqmym{ {fkmc afum {hqbh|mu kmqf mu|hc u|fqf{xmb vmoi `hqx|mcmo amifmo fo{hiqmb kmqf fo{hqmcuf |hqmym{ khoimo cbfho/ \hqmym{ ahqxumnm xo{xc `h`amo{x `h`hoxnf chax{xnmo u|fqf{xmb cbfho uhamimf amifmo kmqf chax{xnmo vmoi `hovhbxqxn" cbfho mo{mqm bmfo khoimo `h`dmufbf{muf |h`hoxnmo chax{xnmo u|fqf{xmb cbfho {hquhax{" ymbmx|xo |hqmym{ kmo cbfho {fkmc `h`|xovmf chvmcfomo u|fqf{xmb m{mx chmim`mmo vmoi um`m/ Chax{xnmo \ufcgugufmb jxim ohqx|mcmo chax{xnmo kmumq amif bmoufm/ Kf ufof |hqmym{ `h`|xovmf |hqmomo |ho{foi `hoimkmcmo |hokhcm{mo hkxcm{fd|mkm cbfho bmojx{ xufm" |hqmym{ km|m{ ahq|hqmo uhhamimf ux||gq{hq" fo{hq|qh{hq {hqnmkm| uhimbm uhuxm{x vmoi mufoi" uhamimf |hom`|xoi qmnmufm vmoi |qfamkf kmo uhamimf umnmam{ vmoi mcqma/ \hqmym{ nhokmcovm `h`fbfcf chumamqmo kmo ymc{x vmoi excx| amovmc xo{xc `hohqf`m ahqamimf aho{xc chbxnmo mimq |mqm bmojx{ xufm `hqmum |xmu/ \hqqmym{ nmqxu uhbmbx `h`himoi |qfouf| ‒[qf||bh U‐" vmf{x Umamq" Uf`|m{fc" kmo Uhqtfeh/ Ahqkmumqcmo nmb {hquhax{ kf m{mu `mcm cm`f {hq{mqfc xo{xc `hoim`afb jxkxb `mcmbmn Muxnmo Ch|hqmym{mo Bmoufm [hqnmkm| Imoiixmo \ufcgugufmb/ /
A/ Qx`xumo @mumbmn Ahqkmumqcmo bm{mq ahbmcmoi kf m{mu" `mcm `mcm
qx`xumo `mumbmn
kmbm` `mcmbmn fof mkmbmn amimf`mom muxnmo ch|hqmym{mo |mkm bmoufm .Bmojx{ Xufm& khoimo imoiixmo |ufcgugufmb /
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
\mih 1
E/ [xjxmo \hoxbfumo =/ [xjxmo x`x` : Xo{xc `hoifkho{fdfcmuf |h`mnm`mo |hqmym{ {hqnmkm| |h`hoxnmo chax{xnmo |ufcgugufmb cbfho |mkm |mufho bmoufm/ 1/ [xjxmo Cnxuxu : m/ @hoih{mnxf |h`mnm`mo |hqmym{ {ho{moi |hoihq{fmo chax{xnmo |ufcgugufmb cbfho |mkm |mufho bmoufm/ a/ @hoih{mnxf |h`mnm`mo |hqmym{ {ho{moi fo{hqthouf muxnmo ch|hqmym{mo |ufcgugufmb vmoi kfahqfcmo {hqnmkm| |mufho bmoufm e/ @hoih{mnxf
|h`mnm`mo
|hqmym{
{ho{moi
amimf`mom
uhnmqxuovm `h`ahqf |hqbmcxmo {hqnmkm| Bmoufm/
K/ @modmm{ \hoxbfumo =/ Amif \qgdhuf \hqmym{ @h`ahqfcmo chumkmqmo amif |hqmym{ {ho{moi |ho{foiovm chax{xnmo |ufcgugufmb |mkm |mufho bmoufm uhnfoiim kfnmqm|cmo |hqmym{ ahqxumnm xo{xc `hoig|{f`mbcmo |hqmoovm kmbm` `h`ahqfcmo muxnmo ch|hqmym{mo |ufcgugufmb |mufho bmoufm/ 1/ Amif \hbmvmomo Chuhnm{mo .QU& Uhamimf `muxcmo cnxuxuovm amif afkmoi |hqmym{mo QUX uhq{m uhamimf kmumq xo{xc |hqhoemommo `hofoicm{cmo muxnmo ch|hqmym{mo |ufcgugufmb uhemqm g|{f`mb/ 5/ Amif fou{f{xuf |hokfkfcmo @h`ahqfcmo fodgq`muf ch|mkm |hohbf{f xo{xc `hbmcxcmo |hohbf{fmo bhafn bmojx{ `hoihomf cxmbf{m muxnmo ch|hqmym{mo |ufcgugufmb kf uh{fm| xof{ |hqmym{mo/ ;/ Amif |hohbf{f Uhamimf |qguhu ahbmjmq kmbm` `hoim|bfcmufcmo fb`x ch|hqmym{mo vmoi kfkm|m{ kmbm` |qgiqm` u{xkf fb`x ch|hqmym{mo ahqcmf{mo khoimo |h`hoxnmo chax{xnmo |ufcgugufmb bmoufm kmo |qguhu ch|hqmym{moovm/
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
\mih 5
AMA FF \H@AMNMUMO M/ KHDFOFUF \qguhu muxnmo ch|hqmym{mo |mkm xufm bmojx{ mkmbmn chifm{mo chifm{mo vmoi
kf`mcuxkkcmo
xo{xc
`h`ahqfcmo
amo{xmo"
af`afoimo"
|hoimymumo" |hqbfokxoimo kmo |hq{gbgoimo ch|mkm bmojx{ xufm uhemqm fokftfkx" uh|hq{f kf qx`mn'bfoicxoimo chbxmqim" |mo{f yhqkm `mx|xo |xuchu`mu" vmoi kfahqfcmo gbhn |hqmym{ xo{xc muxnmo ch|hqmym{mo vmoi `mufn km|m{ kfbmcxcmo gbhn moiig{m chbxmqim m{mx |h{ximu ugefmb vmoi axcmo {homim ch|hqmym{mo" kf|hqbxcmo bm{fnmo uhahbx`ovm m{mx af`afoimo bmoiuxoi |mkm ymc{x {homim ch|hqmym{mo `hbmcxcmo muxnmo ch|hqmym{mo kf qx`mn m{mx |mo{f .Kh|chu" =665 =a&/ A/ CBMUFDFCMUF Mkm|xo muxnmo ch|hqmym{mo kmumq vmoi kfahqfcmo" kfuhuxmfcmo |mkm chbg`|gc bmojx{ xufm" m|mcmn bmojx{ xufm mc{fd m{mx |mufd" mom{qm bmfo3 =/
Bmojx{ xufm mc{fd" muxnmo ch|hqmym{mo km|m{ ahqx|m kxcxoimo {ho{moi |hqugomb nvifhoh" chahqufnmo ifif kmo `xbx{ m{mx |h`ahqufnmo ifif |mbux" chahqufnmo kfqf {hq`muxc ch|mbm" qm`ax{" amkmo" cxcx" `m{m" uhq{m {hbfoim3 chahqufnmo bfoicxoimo uh|hq{f {h`|m{ {fkxq kmo qxmoimo3 `mcmomo uhuxmf" `fumbovm |gquf chefb ahqifzf" ahqtmqfmuf kmo `xkmn kfehqom" kmo chuhimqmo jmu`mof/
1/
Bmojx{ xufm |mufd" vmoi {hqimo{xoi |mkm gqmoi bmfo/ Nmb vmoi |hqqbx kf|hqnm{fcmo kmbm` `h`ahqfcmo muxnmo ch|hqmym{mo |mkm bmojx{ xufm |mufd |mkm kmumqovm um`m uhh|hq{f |mkm bmojx{ xufm mc{fd" khoimo amo{xmo |hoxn gbhn moiig{m chbxmqim m{mx |h{ximu/
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
\mih ;
E/ \HOKHCM[MO \HQMYM[MO BMOJX[ XUFM \hokhcm{mo |ufcfu Kf ufof |hqmym{ `h`|xovmf |hqmomo |ho{foi `hoimkmcmo |hokhcm{mo hkxcm{fd|mkm cbfho bmojx{ xufm" |hqmym{ km|m{ ahq|hqmo uhhamimf ux||gq{hq" fo{hq|qh{hq {hqnmkm| uhimbm uhuxm{x vmoi mufoi" uhamimf |hom`|xoi qmnmufm vmoi |qfamkf kmo uhamimf umnmam{ vmoi mcqma/ \hqmym{ nhokmcovm `h`fbfcf chumamqmo kmo ymc{x vmoi excx| amovmc xo{xc `hohqf`m ahqamimf aho{xc chbxnmo mimq |mqm bmojx{ xufm `hqmum |xmu/ \hqqmym{ nmqxu uhbmbx `h`himoi |qfouf| ‒[qf||bh U‐" vmf{x Umamq" Uf`|m{fc" kmo Uhqtfeh/ \mkm kmumqovm cbfho bmojx{ xufm `h`ax{xncmo qmum m`mo kmo efo{m cmufn kmqf bfoicximo" {hq`muxc |hqmym{ vmoi `h`ahqfcmo |hqmym{mo/ Xo{xc f{x |hqmym{ nmqxu uhbmbx `hoef|{mcmo uxmumom m`mo" {fkmc imkxn" `h`afmqcmo `hqhcm `hbcxcmo chifm{mo kmbm` am{mu ch`m`|xmo kmo ngaf vmoi kf`fbfcfovm/ \hqmym{ nmqxu km|m{ `h`amoicf{cmo uh`moim{ kmo cqhmuf cbfho bmojx{ xufm kmbm` `h`hemncmo kmo `hoixqmoif qmum |x{xu mum" qmum qhokmn kfqf" qmum ch{hqam{mumo uhamimf mcfam{ kmqf ch{fkmc`m`|xmo dfufc" kmo chbmfomo vmoi kfkhqf{movm/ Nmb fof |hqbx kfbcxcmo cmqhom |hqxamnmo |ufcgbgif {hqjmkf ahqum`m khoimo ahqbmojx{ovm xufm/\hqxamnmo-|hqxamnmo fof `hbf|x{f ihjmbm-ihjmbm" uh|hq{f `hoxqxoovm kmvm foim{ xo{xc |hqfu{fym vmoi amqx {hqjmkf
"
ahqcxqmoiovm
chimfqmnmo
chfoifomo
"
|hofoicm{mo
chymu|mkmmo" |hqxamnmo |gbm {fkxq khoimo uxm{x chehokhqxoimo xo{xc {fkxqmo kf ymc{x ufmoi" kmo |hqihuhqmo bfafkg/ \hqmym{ nmqxu umamq `hokhoimqcmo ehqf{m-ehqf{m kmqf `mum bm`|mx vmoi `h`agumocmo" jmoimo `ho{hq{mymcmo m{mx `h`mqmnf cbfho bmojx{ xufm afbm bx|m bx|m m{mx chumbmnmo/ Nmqxu kffoim{" ch`xokxqmo ch`xokxqmo foim{mo jmoimo kf`modmm{cmo xo{xc {xjxmo-{xjxmo {hq{ho{x/
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
\mih 8
Afbm |hqmym{ foifo `hoixamn {foicmn bmcx kmo |mokmoimo `hqhcm {hqnmkm| chuhnm{mo" |hqmym{ afmu `hbmcxcmoovm uhemqm |hqbmnmo-bmnmokmo ahq{mnm|" |hqmym{nmqxu km|m{ `hokxcxoi `ho{mb `hqhcm chm qmn |h`xmumo |qfamkf uhnfoiim uhbxqxn |hoimbm`mo vmoi kfbmbxfovm {fkmc `hom`amn ahamo" afbm |hqbx kfxmumnmcmo mimq kf `mum bmojx{ xufm fof `hqhcm km|m{ `hqmum |xmu kmo amnmifm/
\hokhcm{mo ugefmb @hoimkmcmo kfucxuf" {xcmq |fcfqmo" kmo ahqehqf{m `hqx|mcmo umbmn um{x x|mvm |hqmym{ kmbm` |hokhcm{mo ugefmb/ @h`ahqfcmo chuh`|m{mo xo{xc ahqcx`|xb ahqum`m khoimo uhum`h ccbfho bmojx{ xufm ahqmq{f `hoef|{mcmo ugufmbfumuf `hqhcm/ Jmkf" |hokhcm{mo ugefmb fof `hqx|mcmo
uxm{x
|himoimo
amif
|hqmym{
amnym
gqmoi
vmoi
kfmnmkm|fovm mkmbmn `mcnbxc ugefmb vmoi `h`ax{xncmo gqmoi bmfo/ Kmbm` |hbmcumommoovm |hqmym{ km|m{ `hoef|{mcmo nxaxoimo ugefmb mo{mqm bmojx{ xufm kmo bmojx xufm kmo |hqmym{ uhokfqf/ \hqmym{ `h`ahqfcmo chuh`|m{mo vmoi uhbxmu-bxmuovm ch|mkm |mqm bmojx{ xufm xo{xc `hoimkmcmo cg`xofcmuf kmo `hbmcxcmo qhcqhmuf" `fuumb jmbmo |mif" `hogo{go dfb`" m{mx nfaxqmo-nfaxqmo bmfo/ \mqm bmojx{ xufm |hqbx kfqmoiumoi xo{xc `hoih{mnxf kxofm bxmq" uh|hq{f `hogo{go {hbhtfuh" `hokhoimqcmo qmkfg" m{mx `h`amem uxqm{ cmamq kmo `mjmbmn/ Km|m{ kfumkmqf amnym |hokhcm{mo cg`xofcmuf kmbm` |hqmym{mo {fkmc cmbmn |ho{foiovm khoimon x|mvm |hoigam{mo `hkfu kmbm` |qguhu |hovhoaxnmo m{mx ch{homoimo |mqm cbfho bmojx{ xufm/ [fkmc uhkfcf{ cbfho {fkmc km|m{ {fkxq cmqhom u{qhuu" u{qhuu `h`fcfqcmo |hovmcf{" afmvm nfkx|" chbxmqim vmoi kf qx`mn uhnfoiim `hof`axbcmo chchehymmo" ch{mcx{mo m{mx chcnmym{fqmo" kmo qmum cheh`mumo/ Xo{xc `hoinfbmoicmo qmum jh`x kmo `hof`axbcmo |hqnm{fmo {hqnmkm| uhchbfbfoiovm |hqbx kfahqf chuh`|m{mo ch|mkm
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
\mih 4
bmojx{ xufm xo{xc `hofc`m{f chmkmmo kf bxmq" mimq `hqmum `mufn mkm nxaxoimo khoimo kxofm bxmq/ [fkmc jmqmoi {hqjmkf |hq{hoicmqmo kmo |hqchbmnfmo kf mo{mqm bmojx{ xufm .{hqx{m`m vmoi {foiimb kf| mo{f yhqkm&" nmb fof km|m{ kfm{muf khoimo ahqamimf xumnm" mo{mqm bmfo uhbmbx `hoimkmcmo cgo{mc khoimo `hqhcm" uhomufa kmo uh|homoiixoimo" kmo |xovm nmc kmo chymjfamo ahqum`m/ Khoimo kh`fcffmo kh`fcffmo |hqmym{ {h{m| {h{m| `h`|xovmf nxaxoimo cg`xofcmuf amfc uhum`m `hqhcm `mx|xo {hqnmkm| `h`|xovmf nxaxoimo cg`xofcmuf amfc uhum`h `hqhcm `mx|xo {hqnmkm| |h{ximu vmoi uhemqm bmoiuxoi ahqcmf{mo khoimo |hbmvmomo chuhjmn{hqmmo ugefmb amif bmojx{ xufm kf| mo{f yhqkm/
K/ [XJXMO MUXNMO CH\HQMYM[MO BMOJX[ XUFM =/
Mimq bmojx{ xufm km|m{ `hbmcxcmo chifm{mo uhnmqf-nmqf uhhemqm `mokfqf
1/
@h`|hq{mnmocmo chuhnm{mo kmo ch`m`|xmo kmqf `hqhcm vmoi xufmovm {hbmn bmojx{ xufm kmo jmbmo |hqmym{mo kmo |hoehimnmo
5/
@h`amo{x `h`|hqq{mnmocmo uhq{m `h`ahumqcmo uh`moim{ nfkx| cbfho bmojx{ xufm
;/
@hqmym{ kmo `hogbgoi cbfho bmojx{ xufm vmoi `hokhqf{m |hovmcf{ m{mx `hoimbm`f imoiixmo {hq{ho{x .cqgofu `mx|xo mcx{&
8/
@hqmoiumoi |mqm |h{ximu chuhnm{mo xo{xc km|m{ `hoihomb kmo `hohimccmo kfmioguh vmoi {h|m{ kmo kfof" afbm `hqhcm `hojx`|mf uxm{x chbmfomo {hq{ho{x
4/
@hoemqf x|mvm uh`mcuf`mb `xoicfo" mimq |mqm cbfho bmojx{ xufm vmoi `hokhqf{m uxm{x |hovmcf{ m{mx imoiixmo " `mufn km|m{ `h`|hq{mnmocmo chahamumo vmoi `mcuf`mb {mo|m |hqqbx uxm{x |hq{gbgoimo
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
\mih 9
H/ DGCXU CH\HQMYM[MO BMOJX[ XUFM =/
\hofoicm{mo chuhnm{mo .nhmb{n |qg`g{fgo&
1/
\hoehimnmo |hovmcf{ .|qhtho{fd&
5/
@hoig|{f`mbcmo dxoiuf `ho{mb
;/
@hoim{muf imoiixmo chuhnm{mo vmoi x`x`
D/ MUXNMO CH\HQMYM[MO BMOJX[ XUFM F/ \HOICMJFMO \mkm |hoicmjfmo cbfho khoimo imoiixmo nxaxoimo ugufmb : `homqfc kfqf `hbmbxf gauhqtmuf .km{m gajhc{fd& kmo cg`xofcmuf .km{m uxajhc{fd&/ Kmbm` chmkmmo cbfho `hogbmc xo{xc ahqcg`xofcmuf" `mcm mcmo uxcmq kfkm|m{ km{m uxajhc{fd/ @xoicfo cbfho mcmo `hojmyma |hq{movmmo cf{m khoimo ufoicm{ uh|hq{f : {fkmc" vm " {fkmc {mnx/ \hoicmjfmo kfmqmncmo |mkm |hqfbmcx `homqfc kfqf" dmc{gq |hoeh{xu" u{qhugq |hoeh{xu" ux`ahq cg|foi" kmo `hcmofu`h cg|foi/ Uhemqm gajhc{fd km|m{ kf{h`xcmo km{m uh|hq{f : =/ M|m{fu" hcu|qhuf uhkfn" mdhc {x`|xb 1/ @hoinfokmqf kmqf gqmoi bmfo .`hovhokfqf&/ Cbfho {m`|mc `h`fumncmo kfqf kmqf gqmoi bmfo : |mkm umm{ `mcmo/ 5/ Cg`xofcmuf cxqmoi'{fkmc mkm/ Cbfho {fkmc {m`|mc ahqemcm|emcm| khoimo cbfho bmfo m{mx |hqmym{/ ;/ [fkmc mkm cgo{mc `m{m/ Cbfho bhafn uhqfoi `hoxokxc 8/ Ahqkfm`
kfqf
kf
cm`mq'{h`|m{
{hq|fumn/
Cbfho
cxqmoi
`gafbf{muovm 4/ @hogbmc ahqnxaxoimo khoimo gqmoi bmfo/ Cbfho `h`x{xucmo |hqemcm|mo m{mx |hqif jfcm kfmjmc ahqemcm|-emcm|/ 9/ [fkmc `hbmcxcmo chifm{mo uhnmqf-nmqf/ Mq{fovm |hqmym{mo kfqf kmo chifm{mo qx`mn {moiim uhnmqf-nmqf {fkmc kfbmcxcmo/ >/ \gufuf jmofo |mkm umm{ {fkxq/ Ymymoemqm
\mokmoimo bmojx{ xufm {ho{moi chuhnm{moovm
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
\mih >
Chifm{mo vmoi `m`|x kfbmcxmco bmojx{ xufm
Chafmummo bmojx{ xufm `hqmym{ kfqf uhokfqf
Chcxm{mo dfufc bmojx{ xufm: g{g{" uhokf" |hoibfnm{mo" kmo |hokhoimqmo
Chafmummo ihqmc amkmo'gbmn qmim'uhom` bmojx{ xufm
Chafmummo `mcmo" `fox`" fu{fqmnm{'{fkxq" axmoi mfq ahumq'chefb
\hqqxamnmo-|hqxamnmo dxoiuf {xaxn vmoi umoim{ ahq`mcom kfqmumcmo
Chafmummo bmojx{ xufm kmbm` `h`hbfnmqm chuhnm{mo kmo chafmummo kmbm` `fox` gam{
@mumbmn-`mumbmn uhcuxmb vmoi kfqmumcmo
\h`hqfcummo dfufc
\h`hqfcummo kfbmcxcmo khoimo emqm fou|hcuf" |mb|muf" |hqcxuf" kmo mxucxb{muf xo{xc `hoih{mnxf |hqxamnmo uvu{h` {xaxn
\hokhcm{mo vmoi kfixomcmo kmbm` |h`hqfcummo dfufc" vmf{x nhmk {g {gh kmo uvu{h` {xaxn \ufcgbgifu
M|mcmn `hoihomb `mumbmn-`mumbmn x{m`movm7
Amimf`mom ufcm|ovm {hqnmkm| |qguhu |hoxmmo7
M|mcmn kfqfovm `hqmum kfax{xncmo7
M|mcmn g|{f`fu kmbm` `h`mokmoi uxm{x chnfkx|mo7
Amimf`mom `hoim{muf u{qhuu vmoi kfmbm`f7
M|mcmn `xkmn kmbm` `hovhuxmfcmo kfqf7
M|mcmn bmojx{ xufm uhqfoi `hooimbm`f chimimbmo7
M|mcmn nmqm|mn |mkm umm{ fof kmo vmoi mcmo km{foi7
\hqbx kfcmjf jxim `hoihomf dxoiuf cgiof{fd: kmvm foim{" |qguhu |fchq" mbm` |hqmummo" gqfho{muf" kmo ch`m`|xmo kmbm` |hovhbhumfmo `mumbmn
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
\mih 6
FF/ Kfmiogum Ch|hqmym{mo =/ Nmqim kfqf qhokmn ahqnxaxoimo khoimo `hqmumcmo'`hoimo{fuf|muf chimimbmo |mkm |hqfu{fym-|hqfu{fym chnfkx|mo/ 1/ Cg|foi fokftfkx {fkmc hdhc{fd ahqnxaxoimo khoimo ch{fkmcuhf`amoimo ufu{h` umqmd3 chnfbmoimo `h`gqf3 ch{fkmcuhf`amoimo {foicmn bmcx mkm|{fd kmo ch`m`|xmo `h`hemncmo `mumbmn/ 5/ Moufh{mu ahqnxaxoimo khoimo cqfufu cqfufu uf{xmufgomb'`m{xqmufgomb/ ;/ Ch{fkmc|m{xnmo ahqnxaxoimo khoimo ufu{h` |hoinmqimmo |mufho3 chvmcfomo chuhnm{mo"ofbmf u|fqf{xmb" |hoimqxn cxb{xqmb/
FFF/ Fo{hqthouf ch|hqmym{mo =& Kfmiogum = [xjxmo : [fkmc [fkmc {hqjmkf \hoxqxomo Nmqim Kfqf" @m`|x `hoixoicm|cmo |hqmummo/ m/
Kgqgoi
|hoixoicm|mo
|hqmummo"
`hohqf`m
m|m
vmoi
kfcm{mcmoovm/ Qmufgombovm: Qmufgombovm:
`h`amo{x
|mufho'gqmoi
{hqkhcm{
xo{xc
`h`xbmf `hohqf`m |hqxamnmo kmo `hoixqmoif moufh{mu `hoihomf |hqxamnmo dxoiuf'imvm nfkx|/ a/
Amo{x |mufho khoimo `hojhbmucmo nmb-nmb vmoi kfnmqm|cmo kmo nmb-nmb {hquhax{ `xoicfo kf |hqbxcmo xo{xc kfbh|mucmo m{mx kfqxamn/ Qmufgombovm: Qmufgombovm: `h`ahqf chuh`|m{mo xo{xc `hoifkho{fdfcmuf chumbmnmo
cgouh|
kmo
`xbmf
`hbfnm{
|fbfnmo-|fbfnmo3
`hofoicm{cmo gqfho{muf qhmbf{m/ k/
Ahqfcmo
fodgq`muf
kmo
|hovhqmnmo
ch
ux`ahq-ux`ahq
cg`xof{mu/ Qmufgombovm: Qmufgombovm: `h`xoicfocmo |mufho xo{xc ahqnxaxoimo khoimo iqx| vmoi kf`fom{f khoimo emqm vmoi `h`amo{x kmo |hqbhoicm|mo |hokxcxoi" |hbmvmomo kmo cgouhbfoi/
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
\mih =<
1& Kfmiogum 1: [xjxmo : Cg|foi |guf{fd
fokftfkx `hofoicm{" {fkmc {hqjmkf
chumbmnmo cgouh| m/
Cmjf
`xoexbovm
ch`m`|xmo
cg|foi
|guf{fd"
`fumbovm
|hoiixommo {hcofc qhbmcumuf chfoifomo xo{xc `hoihcu|qhufcmo |hqmummo/ Qmufgombovm: jfcm fokftfkx `h`fbfcf ch`m`|xmo cg|foi vmoi
ahqnmufb kfbmcxcmo kf`mum bm`|mx" `xoicfo km|m{ kfixomcmo uhcmqmoi xo{xc `hoim{muf {himoimo kmo `h`hbfnmqm qmum cgo{qgb fokftfkx a/
\hqamfcf chumbmnmo cgouh| vmoi `xoicfo kf`fbfcf |mufho/ Qmufgombovm: `h`amo{x `hoifkho{fdfcmuf kmo `h`ahomqcmo |hquh|uf
qhmbf{m
kmo
`h`xoicfocmo
kf`xbmfovm
xumnm
|h`hemnmo `mumbmn/
5& Kfmiogum 5: [xjxmo : @hoim{muf Moufh{mu ' qmum {mcx{ m/
\mnm`f qmum {mcx{'moufh{mu Qmufgombovm: Qmufgombovm: |hqmummo mkmbmn ovm{m kmo `h`amo{x |mufho xo{xc
{hqaxcm
uhnfoiim
km|m{
`hokfucxufcmo
kmo
`hoinmkm|fovm/ a/
Cmjf {foicm{ qhmbf{m amnmvm amif |mufho kmo {foicm{ moufh{mu/ Qmufgombovm: Qmufgombovm: qhu|go fokftfkx km|m{ ahqtmqfmuf {hqimo{xoi |mkm |gbm cxb{xqmb cxb{xqmb vmoi kf|hbmjmqf/ \hquh|uf vmoi `hovf`|moi kmqf uf{xmuf `xoicfo km|m{ `h`|hqahumq |hqmummo/
e/
Kgqgoi |mufho xo{xc ahqafemqm `hoihomf m|m vmoi {hqjmkf umm{ fof kmo m|m vmoi {hbmn {hqjmkf xo{xc `hoimo{fuf|muf |hqmummo {fkmc {hq{gbgoi kmo moufh{mu/ Qmufgombovm: Qmufgombovm: `hovhkfmcmo |h{xojxc xo{xc `h`amo{x |mufho kmbm` `hoih`amoicmo ch`m`|xmo cg|foi kmo `h`|hqamfcf hcxfbfaqfx`/
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
\mih ==
;& Kfmiogum ;: [xjxmo
:
@hofoicm{cmo
cxmbf{mu
U|qf{xmb"
cxb{xqmb
kmo
Chuhnm{mo m/
[ho{xcmo ch|hqemvmmo cxb{xqmb" u|fqf{xmb kmo chuhnm{mo/ Qmufgombovm: Qmufgombovm:
`h`ahqfcmo
ymymumo
`hoihomf
|h`fcfqmo'dmc{gq-dmc{gq vmoi ahqnxaxoimo khoimo uf{xmuf fokftfkx/ Ch|hqemvmmo mcmo `hofoicm{cmo |hquh|uf |mufho {ho{moi uf{xmuf kmo |mq{fuf|muf kmbm` qhif`ho ch|hqmym{mo/
a/
Cmjf ufu{h` |hokxcxoi vmoi {hquhkfm amif |mufho/ Qmufgombovm: Qmufgombovm:
mkmovm
chbxmqim'gqmoi
{hqkhcm{
vmoi
`h`|hqnm{fcmo'|hkxbf km|m{ `h`amo{x |mufho kmbm` |qguhu |hovh`axnmo/
H/ Htmbxmuf =/
\mufho `m`|x `hoifkho{fdfcmuf mkmovm chcxm{mo kmo |mokmoimo kfqf uhamimf gqmoi vmoi `m`|x `hoim{muf `mumbmnovm/
1/
\mufho
`m`|x
`hoxojxccmo
chymu|mkmmo
kmqf
cg|foi
|qfamkf'ch`m`|xmo `h`hemncmo `mubmn/ 5/
\mufho `m`|x `hbmcxcmo qhbmcumuf kmo `hbm|gqcmo ahqcxqmoiovm moufh{mu ch {foicm{ vmoi km|m{ kfm{muf/
;/
\mufho km|m{ `hoxojxccmo |hoih{mnxmo vmoi mcxqm{ mcmo |hovmcf{ kmo |h`mnm`mo qhif`ho |hoigam{mo/
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
\mih =1
AMA FFF \HOX[X\
M/
Chuf`|xbmo Ahqkmumqcmo nmufb |h`amnumo `mcm km|m{ kfuf`|xbcmo amnym : \qguhu muxnmo ch|hqmym{mo |mkm xufm bmojx{ mkmbmn chifm{mo chifm{mo vmoi
kf`mcuxkkcmo
xo{xc
`h`ahqfcmo
amo{xmo"
af`afoimo"
|hoimymumo" |hqbfokxoimo kmo |hq{gbgoimo ch|mkm bmojx{ xufm uhemqm fokftfkx" uh|hq{f kf qx`mn'bfoicxoimo chbxmqim" |mo{f yhqkm `mx|xo |xuchu`mu" vmoi kfahqfcmo gbhn |hqmym{ xo{xc muxnmo ch|hqmym{mo vmoi `mufn km|m{ kfbmcxcmo gbhn moiig{m chbxmqim m{mx |h{ximu ugefmb vmoi axcmo {homim ch|hqmym{mo" kf|hqbxcmo bm{fnmo uhahbx`ovm m{mx af`afoimo bmoiuxoi |mkm ymc{x {homim ch|hqmym{mo `hbmcxcmo muxnmo ch|hqmym{mo kf qx`mn m{mx |mo{f .Kh|chu" =665 =a&/ Kf ufof |hqmym{ `h`|xovmf |hqmomo |ho{foi `hoimkmcmo |hokhcm{mo hkxcm{fd|mkm cbfho bmojx{ xufm" |hqmym{ km|m{ ahq|hqmo uhhamimf ux||gq{hq" fo{hq|qh{hq {hqnmkm| uhimbm uhuxm{x vmoi mufoi" uhamimf |hom`|xoi qmnmufm vmoi |qfamkf kmo uhamimf umnmam{ vmoi mcqma/ \hqmym{ nhokmcovm `h`fbfcf chumamqmo kmo ymc{x vmoi excx| amovmc xo{xc `hohqf`m ahqamimf aho{xc chbxnmo mimq |mqm bmojx{ xufm `hqmum |xmu/ \hqqmym{ nmqxu uhbmbx `h`himoi |qfouf| ‒[qf||bh U‐" vmf{x Umamq" Uf`|m{fc" kmo Uhqtfeh/ \mkm kmumqovm cbfho bmojx{ xufm `h`ax{xncmo qmum m`mo kmo efo{m cmufn kmqf bfoicximo" {hq`muxc |hqmym{ vmoi `h`ahqfcmo |hqmym{mo/ Xo{xc f{x |hqmym{ nmqxu uhbmbx `hoef|{mcmo uxmumom m`mo" {fkmc imkxn" `h`afmqcmo `hqhcm `hbcxcmo chifm{mo kmbm` am{mu ch`m`|xmo kmo ngaf vmoi kf`fbfcfovm/ \hqmym{ nmqxu km|m{ `h`amoicf{cmo uh`moim{ kmo cqhmuf cbfho bmojx{ xufm kmbm` `h`hemncmo kmo `hoixqmoif qmum |x{xu mum" qmum qhokmn kfqf" qmum ch{hqam{mumo uhamimf mcfam{ kmqf ch{fkmc`m`|xmo dfufc" kmo chbmfomo vmoi kfkhqf{movm/
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
\mih =5
A/ Umqmo Fo{hqthouf vmoi kfahqfcmo gbhn |hqmym{ bhafn bxmu {fkmc uham{mu |mkm |h`hoxnmo chymjfamo |ufcgugufmb / Fo{hqthouf ahbx` km|m{ kfbmcxcmo uhemqm g|{f`mb cmqhom mkmovm dmc{gq |hoinm`am{ vmoi ahqmumb kmqf |hqmym{" uf{xmuf qxmoi |hqmym{mo vmoi ufaxc gbhn {ximu qx{fof{mu" kmo mkmovm |h{ximu chqgnmofmo/ \hqahkmmo |hbmcumommo qf{xmb |mkm |mufho bmoufm kmbm` `h`hoxnf chax{xnmo |ufcgugufmb/ \hbmcumommo qf{xmb vmoi kfjmbmocmo gbhn |mufho bmoufm vmoi um{x khoimo |mufho bmoufm vmoi bmfo ahqahkm-ahkm vmoi kf|hoimqxnf gbhn {foicm{ |ufcgugufmb" |hqch`amoimo" |hoimbm`mo" cgokfuf umcf{" mim`m m{mx ch|hqemvmmo vmoi kfmox{ |mufho/
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
\mih =;
KMD[MQ \XU[MCM Oxiqgng" Ymnvxkf/ 1<< Ch|hqmym{mo Ihqgo{fc Hk: 1/ HIE/ Jmcmq{m
Uh{fmaxknf" [gov kmo Nmqkvyfog{g/ 1<<8/ \mokxmo Ihqgo{gbgif: [fojmxmo kmqf Ahqamimf Mu|hc / Iqm`hkfm \xu{mcm X{m`m/ Jmcmq{m/
Muxnmo Ch|hqmym{mo Bmoufm Khoimo Imoiixmo \ufcgugufmb
\mih =8
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