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Onderbouwde reflectie leerjaar 3 HBO-V

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Dit document is geschreven als aanleiding van mijn stage binnen het MUMC in Maastricht. in dit document word de zorg rondom een CEA operatie beschreven en voorzien van een onderbouwing.

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  • May 15, 2024
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  • 2023/2024
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Meten, Interpreteren,
Handelen Auteur: Merijn Bekema 1939130
Hogeschool Zuyd
Docent begeleider: Sebastiaan van
den Hoek
Zorg rondom een CEA operatie Praktijk begeleider: Nancy Tonigold
21-5-2023


Merijn Bekema

,Voorwoord



Dit document is geschreven als onderdeel van mijn stage binnen het MUMC+ voor mijn opleiding tot
HBO verpleegkundige. De afdeling waar de stage plaatsvond is afdeling B4, dit is een verpleegafdeling
waar patiënten van de maag-darm-lever- én vaat- chirurgie worden opgenomen voor of na een operatie.
De opdracht was om aan de hand van een casus uit de praktijk een onderbouwde reflectie te schrijven
waarin ik mijn competenties als verpleegkundige kan ontwikkelen en bewijzen. Tijdens de stage op de
afdeling B4 heb ik kennis gemaakt met diverse casussen en heb ik voor deze opdracht uiteindelijk
gekozen voor de “zorg rondom een CEA operatie” Om te komen tot de eindconclusie is er gebruik
gemaakt van theoretisch (bronnen)onderzoek dat vervolgens getoetst is aan de praktijk.

,Inhoud
Inleiding.....................................................................................................................................................................5
Leeswijzer..............................................................................................................................................................7
Hoofdstuk 1. Voorbereiden van zorg.........................................................................................................................8
Anamnese..............................................................................................................................................................8
Diagnoses...............................................................................................................................................................9
Doelen................................................................................................................................................................. 10
Resultaat 1.......................................................................................................................................................10
Resultaat 2.......................................................................................................................................................10
Interventies..........................................................................................................................................................11
Interventie 1....................................................................................................................................................11
Interventie 2....................................................................................................................................................11
Hoofdstuk 2. Uitvoeren van zorg.............................................................................................................................12
Theorie.................................................................................................................................................................12
Interventie 1....................................................................................................................................................12
Interventie 2....................................................................................................................................................13
Streef systole...................................................................................................................................................15
Praktijk.................................................................................................................................................................15
Interventie 1........................................................................................................................................................15
Interventie 2........................................................................................................................................................16
Hoofdstuk 3. Evalueren van zorg.............................................................................................................................17
Hoofdstuk 4. Nabeschouwing..................................................................................................................................18
Conclusie.............................................................................................................................................................18
Aanbevelingen....................................................................................................................................................18
Literatuurlijst...........................................................................................................................................................19
Reflectieverslag........................................................................................................................................................20
Bijlagen.................................................................................................................................................................... 23
Bijlage 1 “hypothetische diagnoses”....................................................................................................................23
Bijlage 2 “Meten en registreren van pijn bij volwassenen op verpleegafdeling (Versie 5)”.................................24
Gerelateerde documenten:.....................................................................................................................................24
WANNEER?..........................................................................................................................................................25
WIE?..................................................................................................................................................................... 25
HOE?.................................................................................................................................................................... 25
Vraag................................................................................................................................................................25
Handel naar bevinden......................................................................................................................................25
Stroomschema.........................................................................................................................................................27
Geldigheid........................................................................................................................................................28
Fouten..............................................................................................................................................................28

, Auteursrechten voorbehouden.......................................................................................................................28
Bijlage 3 ”Vitaal bedreigde patiënt, herkennen d.m.v. Early Warning score (MEWS) en inzet Spoed interventie
team”................................................................................................................................................................... 29
Samenvatting / Doel................................................................................................................................................29
Uitvoerenden en verantwoordelijken (evt. bevoegdheden)....................................................................................29
Benodigde middelen................................................................................................................................................29
Indicaties................................................................................................................................................................. 30
Contra-indicaties......................................................................................................................................................30
Werkwijze................................................................................................................................................................30
Reguliere controle MEWS....................................................................................................................................30
Beleid bij MEWS ≤ 2.........................................................................................................................................31
Beleid bij MEWS 3............................................................................................................................................31
Beleid bij MEWS 4, 5........................................................................................................................................31
Beleid bij MEWS ≥ 6: oproepprocedure Spoed Interventie Team.....................................................................31
Stroomschema.....................................................................................................................................................33
Uitkomst SIT interventie......................................................................................................................................33
Reanimatie oproep tijdens een SIT oproep..........................................................................................................34
Sit-koffer..............................................................................................................................................................34
Procedure bij specifiëke patientengroepen.........................................................................................................35
Transport functieafdeling....................................................................................................................................36
CIV verpleegkundige............................................................................................................................................36
Rapportage / registratie...........................................................................................................................................37
Bijlagen.................................................................................................................................................................... 37
Zakkaartje............................................................................................................................................................37
SBARR.................................................................................................................................................................. 38
Bronvermeldingen...................................................................................................................................................38
Bijlage 4 “zorg rondom Carotis operatie (vernauwing of afsluiting): verpleegkundige”......................................39
Opnamedag (1 dag voor operatie):..........................................................................................................................40
Bijlage 5: ADVIESBEOORDELING ONDERBOUWDE REFLECTIE PRAKTIJK................................................................1
Bijlage 6: stage beoordelingsformulier..................................................................................................................4

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