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Samenvatting vitale parameters (M.De Winter)
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Duidelijke, uitgebreide samenvatting van de cursus: Verpleegkundig redeneren en handelen over het onderdeel vitale parameters.
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Vitale parametersINHOUDSOPGAVE
VITALE FUNCTIES EN VITALE PARAMETERS
1. Vitale functies............................................................................................................................................ 7
Levensreddend handelen.................................................................................................................................7
Klinische situatie...............................................................................................................................................7
2. Vitale parameters...................................................................................................................................... 7
2.1 Soorten............................................................................................................................................................7
2.2 Belang.............................................................................................................................................................7
2.3 B-1 handeling..................................................................................................................................................8
1. Kern en schil.............................................................................................................................................. 9
Homiotherm.....................................................................................................................................................9
2. Thermoregulatiesysteem........................................................................................................................... 9
Daling lichaamstemperatuur..............................................................................................................................10
Stijging lichaamstemperatuur............................................................................................................................10
3. Meten v.d. lichaamstemperatuur............................................................................................................. 11
Rectale meting....................................................................................................................................................11
Orale meting.......................................................................................................................................................11
Axillaire meting...................................................................................................................................................11
Tympanische meting...........................................................................................................................................11
Slaaptemperatuurmeting....................................................................................................................................12
4. Normaalwaarden..................................................................................................................................... 12
Kinderen..............................................................................................................................................................12
Ouderen...............................................................................................................................................................13
5. Koorts...................................................................................................................................................... 13
Koortsaanval.......................................................................................................................................................13
3 stadia...........................................................................................................................................................13
6. Koortspatronen........................................................................................................................................ 14
Intermitterende koorts........................................................................................................................................14
Aanvalsgewijze koorts........................................................................................................................................14
Relapsing koorts..................................................................................................................................................14
Continue koorts...................................................................................................................................................14
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,Vitale parameters
Symptomen van koorts.......................................................................................................................................15
Meest voorkomend.............................................................................................................................................15
7. Behandeling............................................................................................................................................. 15
Complicaties........................................................................................................................................................15
8. Hypothermie............................................................................................................................................ 16
Interventies: directe oorzaken wegnemen..........................................................................................................16
9. Hyperthermie........................................................................................................................................... 17
Complicaties........................................................................................................................................................17
Hyperthermie ≠ koorts........................................................................................................................................17
Interventies.........................................................................................................................................................17
10. Verpleegkundige interventies bij afwijkende temperatuur.....................................................................17
Interventies.........................................................................................................................................................17
1. Circulatie.................................................................................................................................................. 19
2. Begrippen................................................................................................................................................ 19
3. Meten v.d. pols........................................................................................................................................ 19
3.1 Locatie...........................................................................................................................................................19
3.2 Polskwaliteiten.........................................................................................................................................20
Polsfrequentie................................................................................................................................................20
Regelmaat v.d. pols........................................................................................................................................20
Kracht v.d. pols...............................................................................................................................................20
Gelijkmatigheid v.d. pols................................................................................................................................21
4. Normale en afwijkende waarden.............................................................................................................. 21
5. Aandachtspunten bij het meten v.d. pols.................................................................................................. 22
6. Verpleegkundige interventies bij een afwijkende pols..............................................................................22
6.1 Afwezigheid v.d. pols....................................................................................................................................22
6.2 Afwezige perifere pols...................................................................................................................................22
6.3 Tachycardie (HF > 100sl./min)......................................................................................................................22
6.4 Bradycardie (HF < 60sl./min)........................................................................................................................22
1. Begrippen................................................................................................................................................ 23
1.1 Druksysteem binnen de circulatie.................................................................................................................23
1.2 Systolische en diastolische druk....................................................................................................................23
Systolische druk..............................................................................................................................................23
Diastolische druk............................................................................................................................................23
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,Vitale parameters
2. Normale en afwijkende bloeddrukwaarden.............................................................................................. 24
Volwassenen...................................................................................................................................................24
Ouderen..........................................................................................................................................................24
Kinderen.........................................................................................................................................................24
2.1 Afwijkende bloeddrukwaarden.....................................................................................................................24
Hypotensie......................................................................................................................................................24
Vasovagale syncope........................................................................................................................................25
Orthostatische hypotensie.............................................................................................................................25
Hypertensie....................................................................................................................................................25
Geïsoleerde hoge bloeddruk..........................................................................................................................25
Essentiële hypertensie....................................................................................................................................25
Pseudohypertensie.........................................................................................................................................25
3. Methoden van bloeddrukmeting.............................................................................................................. 26
3.1 Non-invasieve methode................................................................................................................................26
Manueel ausculatoire methode.....................................................................................................................26
Palpatiemethode............................................................................................................................................26
Automatische (oscillatoire) digitale bloeddrukmeter....................................................................................26
3.2 Invasieve methode........................................................................................................................................26
4. Korotkovtonen......................................................................................................................................... 26
Systolische druk..............................................................................................................................................27
Diastolische druk............................................................................................................................................27
5. Beïnvloedende factoren........................................................................................................................... 27
5.1 Hartminuutvolume (HMV) of de cardiac output (CO)...................................................................................27
Contractiliteit v.d. hartspier...........................................................................................................................27
Bloedvolume...................................................................................................................................................27
5.2 De vasculaire weerstand...............................................................................................................................27
Diameter.........................................................................................................................................................27
Mate van uitzetten en elasticiteit...................................................................................................................28
Viscositeit (stroperigheid) v.h. bloed.............................................................................................................28
5.3 Overige factoren...........................................................................................................................................28
Hormonen.......................................................................................................................................................28
Baro- en chemosensoren...............................................................................................................................28
Leefstijl............................................................................................................................................................28
Biologische factoren.......................................................................................................................................29
6. Aandachtspunten tijdens manuele meting................................................................................................ 29
6.1 Materiaal......................................................................................................................................................29
6.2 Plaats v.d. meting.........................................................................................................................................29
6.3 Installatie v.d. zorgvrager.............................................................................................................................29
6.4 Evidence based practice................................................................................................................................30
Bloeddruk bij kinderen...................................................................................................................................30
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, Vitale parameters
Armhoogte......................................................................................................................................................30
Lig, zit of stand................................................................................................................................................30
Gekruiste benen.............................................................................................................................................30
Foute manchetmaat.......................................................................................................................................30
Praten tijdens de meting................................................................................................................................30
Mastectomie of lumpectomie........................................................................................................................31
Bloeddruk kan niet worden gemeten aan de bovenarmen...........................................................................31
Bloeddruk kan niet worden gemeten aan de armen.....................................................................................31
Korotkovtonen niet hoorbaar........................................................................................................................31
Links of rechts?...............................................................................................................................................31
Foutmelding elektronische bloeddrukmeting................................................................................................31
7. Verpleegkundige interventies bij afwijkende bloeddrukwaarden..............................................................32
7.1 Hypotensie....................................................................................................................................................32
Hypertensie.........................................................................................................................................................32
1. Gasuitwisseling........................................................................................................................................ 33
1.1 Diffusie..........................................................................................................................................................33
1.2 Homeostase..................................................................................................................................................33
2. In- en uitademen...................................................................................................................................... 33
2.1 Regeling v.d. ademhaling..............................................................................................................................33
2.2 De (ab)normale ademhaling.........................................................................................................................33
3. Meten v.d. ademhaling............................................................................................................................ 34
3.1 Frequentie.....................................................................................................................................................34
3.2 Regelmaat.....................................................................................................................................................35
3.3 Diepte............................................................................................................................................................35
Afwijkingen.....................................................................................................................................................35
3.4 Symmetrie.....................................................................................................................................................36
3.5 Hulpademhalingsspieren..............................................................................................................................36
3.6 Geluid............................................................................................................................................................36
3.7 Geur...............................................................................................................................................................36
3.8 Kleur v.d. huid...............................................................................................................................................36
4. Zuurstofsaturatie..................................................................................................................................... 36
4.1 Saturatiewaarden.........................................................................................................................................37
5. Meten van zuurstofsaturatie.................................................................................................................... 37
5.1 Pulse-oxymeter..............................................................................................................................................37
5.2 Aandachtspunten..........................................................................................................................................38
5.3 Indicatie.........................................................................................................................................................38
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