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Summary BAZ/BIAZ Circulation

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This summary was made in preparation for the BIAZ (Basic Introduction Acute Care). The summary is based on the Circulation theme one of the three parts of the BIAZ. The summary was made using theory from the books Anatomy and Physiology, an introduction and ProActive Nursing: clinical issues in sig...

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  • November 10, 2021
  • 95
  • 2021/2022
  • Summary

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Samenvatting – BIAZ-toets 1 - Circulatie




1

,Inhoudsopgave
Embryogenese van het cardiovasculaire stelsel.............................................................................................. 8
Embryogenese......................................................................................................................................................8
Het hart................................................................................................................................................................8
De foetale circulatie.............................................................................................................................................9
Placenta..............................................................................................................................................................10
Na de geboorte...................................................................................................................................................10

Anatomie van het hart................................................................................................................................. 11
Atria en ventrikels..............................................................................................................................................11
Hartwand...........................................................................................................................................................12
Hartkleppen........................................................................................................................................................12
Atrioventriculaire kleppen (AV-kleppen):......................................................................................................12
Halvemaanvormige kleppen..........................................................................................................................12
Coronairen..........................................................................................................................................................13

Circulatie..................................................................................................................................................... 14
De kleine circulatie.............................................................................................................................................14
De grote circulatie..............................................................................................................................................14
Optimale pompfunctie.......................................................................................................................................14
Normaalwaarden volwassenen (hartfrequentie, bloeddruk, harttonen, effect sympathicus en parasympaticus
op de vitale functies)..........................................................................................................................................15
Effect Sympathicus (gaspedaal van het lichaam)..........................................................................................15
Effect parasympaticus (rempedaal en acculader van het lichaam)...............................................................15

Hemodynamische drukken........................................................................................................................... 16
Verschillende drukken in het lichaam................................................................................................................17
Centraal veneuze druk (CVD).........................................................................................................................17
Cardiac Output (OC) / Hartminuutvolume (Hartfrequentie x slagvolume)...................................................17
Mean Aterial Pressure (MAP)........................................................................................................................17
Slagvolume.....................................................................................................................................................17
Pulmonal arterial pressure (PAP)...................................................................................................................17
Pulmonal vascular resistance (PVR)...............................................................................................................17
Pulmonaal veneuze druk (wedge).................................................................................................................17
Systematische vaatweerstand (SVR).............................................................................................................17
Lactaat...........................................................................................................................................................18
Frank Starling Curve...........................................................................................................................................19

Decompensatio cordis.................................................................................................................................. 20
Pathofysiologie...................................................................................................................................................20
Oorzaken............................................................................................................................................................20
4 categorieën van hartfalen...............................................................................................................................20
Lichamelijke kenmerken.....................................................................................................................................20
Links decompensatio cordis...............................................................................................................................21
Backward failure............................................................................................................................................21
Forward failure..............................................................................................................................................21

2

, Astma cardiale...............................................................................................................................................21
Rechts decompensatio cordis.............................................................................................................................21
Backward failure............................................................................................................................................21
Verpleegkundige observaties.............................................................................................................................22
Algemeen:......................................................................................................................................................22
Ademhaling....................................................................................................................................................22
Pols.................................................................................................................................................................22
Bloeddruk.......................................................................................................................................................22
Overvulling.....................................................................................................................................................22
Diagnostiek.........................................................................................................................................................22
Behandeling van hartfalen.................................................................................................................................23
Medicatie.......................................................................................................................................................23
Leefstijladviezen............................................................................................................................................23

Angina pectoris (AP).................................................................................................................................... 24
Pathofysiologie...................................................................................................................................................24
Prognose.............................................................................................................................................................24
Diagnostiek.........................................................................................................................................................25
Behandeling........................................................................................................................................................26
Medicamenteuze therapie............................................................................................................................26
Onderhoudsbehandeling...............................................................................................................................26

Hartinfarct................................................................................................................................................... 27
Pathofysiologie...................................................................................................................................................27
............................................................................................................................................................................27
Diagnostiek.........................................................................................................................................................28
Behandeling........................................................................................................................................................28
Algemene behandeling..................................................................................................................................28
Complicaties.......................................................................................................................................................29
Maatregelen bij verdenking hartinfarct.............................................................................................................29

Postmyocardinfarctsyndroom (syndroom van Dressler)................................................................................29

Shock........................................................................................................................................................... 30
Herkennen vitaal bedreigde patiënt..................................................................................................................30
Vroege herkenning........................................................................................................................................30
Sepsis.............................................................................................................................................................30
Screeningsinstrumenten................................................................................................................................30
Shock algemeen.................................................................................................................................................30
Definitie.........................................................................................................................................................30
Verschillende fases........................................................................................................................................31
Soorten shock.....................................................................................................................................................32
Hypovolemische shock..................................................................................................................................32
Behandeling...................................................................................................................................................33
Obstructieve shock........................................................................................................................................33
Cardiogene shock..........................................................................................................................................34
Distributieve shock.......................................................................................................................................35

Inleiding ritme............................................................................................................................................. 38

3

, Ritmestrook........................................................................................................................................................38
Normaalwaarden van een sinusritme................................................................................................................38
ECG.....................................................................................................................................................................39
Het maken van een correct en leesbaar ECG.....................................................................................................40
Plaatsen van de borstafleidingen:.................................................................................................................40

Driehoek van Einthoven............................................................................................................................... 41

Beoordeling van het ECG.............................................................................................................................. 42
ST-segment.........................................................................................................................................................42
ST-elevatie.....................................................................................................................................................42
ST-depressie...................................................................................................................................................42

Het geleidingssysteem................................................................................................................................. 43

Actiepotentiaal............................................................................................................................................ 44

Ecg-papier, QRS-complex en bepalen van de frequentie...............................................................................45
Frequentie van een regelmatig ritme.................................................................................................................45
Frequentie van een onregelmatig ritme............................................................................................................45

Bloedstolling................................................................................................................................................ 46
Primaire homestase...........................................................................................................................................46
Secundaire hemostase.......................................................................................................................................47
Stollingsfactoren................................................................................................................................................48
Fibrinolytisch systeem........................................................................................................................................48
Verhoogde bloedingsneiging.........................................................................................................................48
Bloedingsstoornissen.....................................................................................................................................48
Oorzaken van een veranderde stolling...............................................................................................................49
Trombose.......................................................................................................................................................49
Post trombotisch syndroom..........................................................................................................................49
DIS (Diffusie intravasale stolling)...................................................................................................................49
Symptomen veranderde stolling........................................................................................................................49
Bloedtransfusie...................................................................................................................................................50
Bloedproducten.............................................................................................................................................50
Plasmaproducten...........................................................................................................................................50
Verhoogde stollingsneiging (vorming van trombose)........................................................................................50
Trias van Virchow...........................................................................................................................................51
Behandeling trombose met anticoagulantia.................................................................................................51
Preventie van trombose................................................................................................................................51
Laboratoriumonderzoek.....................................................................................................................................52
Activated partial thromboplastin time (aPTT)...............................................................................................52
Prothrombinetijd (PT)....................................................................................................................................52
International Normalized Ratio (INR)............................................................................................................52
Trombocyten (bloedplaatjes)........................................................................................................................52
Fibrinogeen....................................................................................................................................................52
D-Dimeer........................................................................................................................................................53
Bewaking en verpleegkundige observaties...................................................................................................53

Bloedtransfusie............................................................................................................................................ 54

4

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