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Samenvatting Minor Complexe zorg 2023/2024
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Minor:Complexe zorg kennistoets 2023/2024
HAN Verpleegkunde.
,Inhoudsopgave
Klinische redeneren...................................................................................................................................... 4
Redeneerhulpen voor het inschatten van een vitaal bedreigde patiënt.............................................................4
Respiratie..................................................................................................................................................... 6
Anatomie van de longen en luchtwegen.............................................................................................................6
Fysiologie van de longen en luchtwegen.............................................................................................................6
Pathologieën van de longen en luchtwegen.......................................................................................................7
Verpleegkundige zorg bij een pneumonie...........................................................................................................7
Hoe kunnen pneumonie ingedeeld worden........................................................................................................8
Welke mensen zijn kwetsbaar voor een pneumonie...........................................................................................9
Beginnende pneumonie herkennen...................................................................................................................10
Diagnostiek en therapie bij een pneumonie......................................................................................................10
Potentiële complicaties bij een pneumonie.......................................................................................................11
Zuur/base evenwicht – inleiding beademing................................................................................................ 12
Analyseren van bloedgas-analyse.....................................................................................................................12
Basis princicipes zuurstoftherapie en beademing.............................................................................................12
Gevolgen voor Verpleegkundig Handelen na Beademing van de Patiënt........................................................13
Circulatie:................................................................................................................................................... 14
Anatomie van het hart......................................................................................................................................14
Fysiologie van het hart......................................................................................................................................14
Pathologie van het hart.....................................................................................................................................15
Beschrijf de elektrofysiologie van het hart........................................................................................................16
Cardiac output...................................................................................................................................................17
Hartminuutvolume............................................................................................................................................18
welke factoren zijn van invloed op cardiac output...........................................................................................18
Gevolgen van cardiologische pathologie voor de patiënt.................................................................................19
Shock.......................................................................................................................................................... 20
Hoe ontstaat een shock.....................................................................................................................................20
Basisprincipes en werkingsmechanisme van alle vormen van shock................................................................21
Verschillende shocks oorzaak en symptomen...................................................................................................22
Verpleegkundige observatiepunten bij een shock.............................................................................................23
Interventiecardiologie................................................................................................................................. 24
Procedure hartkatheterisatie............................................................................................................................24
Complicaties hartkatheterisatie........................................................................................................................26
Crew resource management........................................................................................................................ 27
15 kernpunten CRM...........................................................................................................................................27
,Advanced life support................................................................................................................................. 27
Functie algoritme van de ALS............................................................................................................................27
Potentieel reversibele oorzaken van circulatiestilstand....................................................................................28
Behandeling van schokbare en niet schokbare ritmen.....................................................................................29
Medicatie toegediend tijdens ALS procedure....................................................................................................30
Neurologie.................................................................................................................................................. 31
Basisprincipes anatomie centraal zenuwstelsel................................................................................................31
Basisprincipes fysiologie centraal zenuwstelsel................................................................................................32
Pathologie centraal zenuwstelsel......................................................................................................................32
Pathologie perifeer zenuwstelsel......................................................................................................................33
Neurologische controles bij een patiënten als onderdeel van de ABCDE-methode..........................................34
Aandachtpunten afnemen AVPU en EMV.........................................................................................................35
Implicaties van afwijkende pupilcontrole, AVPU en EMV bij neurologische patiënten....................................36
Exposure & Environment............................................................................................................................. 37
Observaties en symptomen die vallen onder Exposure & Environment (E) uit de ABCDE-methodiek..............37
Complicaties van een gestoorde lichaamstemperatuur...................................................................................38
Interventies bij een hypo- hyperthermie...........................................................................................................39
Vochthuishouding....................................................................................................................................... 40
Basisprincipes vochthuishouding......................................................................................................................40
Belang van vochtbalans bij ernstig zieke patiënt..............................................................................................41
Functies en basisprincipes van mineralen natrium en kalium..........................................................................41
Afwijkingen m.b.t. natrium (hypo- en hypernatriemie)....................................................................................42
Afwijkingen t.a.v. kalium (hypo- en hyperkaliemie)..........................................................................................43
Pijn............................................................................................................................................................. 44
Farmacologische en niet farmacologische interventies bij pijn........................................................................44
Verschillende pijn schalen.................................................................................................................................45
Beïnvloedende factoren van pijn zijn................................................................................................................46
Antibiotica en Antibiotic Stewardship Programma (ASP)..............................................................................47
Mechanismen van resistentie bij BRMO...........................................................................................................47
Belangrijke maatregelen die resistentie tegen antibiotica beperken/vertragen..............................................48
Belangrijkste groepen antibiotica met indicatie...............................................................................................49
Belangrijke aspecten bij het bepalen van het soort antibiotica........................................................................50
Belangrijkste onderdelen van ASP.....................................................................................................................51
Verpleegkundige rol binnen het ASP.................................................................................................................52
Procedurele sedatie en analgesie (PSA)....................................................................................................... 52
Basisbegrippen van sedatie...............................................................................................................................52
, Belangrijkste aandachtpunten m.b.t. gesedeerde patiënten...........................................................................53
Oncologie................................................................................................................................................... 54
Darmkanker.......................................................................................................................................................54
Pathologie.....................................................................................................................................................54
Diagnostiek...................................................................................................................................................54
Symptomen...................................................................................................................................................55
Behandeling..................................................................................................................................................55
Borstkanker.......................................................................................................................................................55
Pathologie.....................................................................................................................................................55
Diagnostiek...................................................................................................................................................55
Symptomen...................................................................................................................................................56
Behandeling..................................................................................................................................................56
Longkanker........................................................................................................................................................56
Pathologie.....................................................................................................................................................56
Diagnostiek...................................................................................................................................................56
Symptomen...................................................................................................................................................57
Behandeling..................................................................................................................................................57
Multipel myeloom kanker.................................................................................................................................57
Pathologie.....................................................................................................................................................57
Diagnostiek...................................................................................................................................................57
Symptomen...................................................................................................................................................58
Behandeling..................................................................................................................................................58
De immuun gecompromitteerde patiënt..................................................................................................... 58
Meest voorkomende oorzaken van afweerstoornissen....................................................................................58
Belangrijkste risico’s en complicaties bij een patiënt met een gestoorde afweer............................................59
Belangrijkste aspecten in de zorg bij immuun gecompromitteerde patiënt.....................................................60
Bloed en stolling......................................................................................................................................... 61
Fysiologie van bloedstolling..............................................................................................................................61
Stollingsstoornissen...........................................................................................................................................62
Oorzaken, complicaties en interventies bij stollingsproblemen........................................................................63
Geneesmiddelen die de stolling beïnvloeden....................................................................................................64
Indicatie en contra indicatie bij infusievloeistoffen en bloedproducten...........................................................65
Complicaties bij toedienen van bloedproducten...............................................................................................66
Complicatie van massale bloedtransfusie bij acuut ernstige bloedverlies........................................................67
Klinische redeneren
Redeneerhulpen voor het inschatten van een vitaal bedreigde patiënt.
- Een veelgebruikte redeneerhulp is de ABCDE-methodiek (Airway,
Breathing, Circulation, Disability, Exposure), die helpt bij de
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