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Kennislijn Chronisch Zieken OP3 Samenvatting
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De studiezustersKennislijn onderwijsperiode 3
Chronisch zieken
1
,Inhoud
Anatomie, fysiologie & pathologie.........................................................................................................4
Blok 1..................................................................................................................................................4
Astma & COPD................................................................................................................................4
Ademhaling.....................................................................................................................................8
Ziekte van Crohn & Colitis ulcerosa..............................................................................................10
Proactive Nursing..........................................................................................................................18
Blok 2................................................................................................................................................21
Chirurgie.......................................................................................................................................21
Acute buik.....................................................................................................................................29
Spijsvertering/digestivus..............................................................................................................30
Peritonitis/ileus............................................................................................................................35
Acute buik/ appendicitis/ cholelithiasis/ cholecystitis..................................................................40
Blok 3................................................................................................................................................44
Reumatische afwijkingen..............................................................................................................44
Endocrinologie/ Hormonenstelsel................................................................................................47
Obesitas........................................................................................................................................56
Verpleegkunde.....................................................................................................................................60
Zelfmanagement..................................................................................................................................60
Aspecten van zelfmanagement........................................................................................................61
Verpleegkundige perspectieven op zelfmanagementondersteuning...............................................62
Het generiek model zelfmanagement..............................................................................................63
Pilotenmodel....................................................................................................................................63
De 4 centrale elementen van zelfmanagement................................................................................64
Verpleegkundige ondersteuning bij zelfmanagement en eigen regie..................................................66
Het 5A-model...................................................................................................................................66
4 perspectieven................................................................................................................................71
Zelfmanagementinterventies: ontwikkeling, evaluatie en implementatie...........................................71
Het raamwerk van de Medical Research Council (MRC) ..................................................................73
Intervention mapping ......................................................................................................................74
Zelfmanagementondersteuning bij Diabetes Mellitus..........................................................................75
Klinisch redeneren en verpleegkundige classificaties...........................................................................80
Het verpleegkundig proces...............................................................................................................81
Classificatiesystemen............................................................................................................................85
Opbouw ICF-model...........................................................................................................................86
2
,Overzicht van het verpleegkundig proces.............................................................................................90
Kritisch denken.....................................................................................................................................91
Kritisch denken: diagnostische begrippen............................................................................................94
Zingeving..............................................................................................................................................96
Zin werkt! Movisie, kennis en advies voor maatschappelijke ontwikkeling..........................................98
Zingeving, zingevingsbehoeften, zinvol leven en levensvragen............................................................99
Gezondheidsbevordering, gedragsverandering en preventie.............................................................101
Preventie........................................................................................................................................102
De stappenreeks van gedragsverandering......................................................................................104
Stages of change-model.................................................................................................................104
Health counseling-model................................................................................................................105
Intervention mapping.....................................................................................................................105
Verlieskunde.......................................................................................................................................106
Culturele diversiteit............................................................................................................................110
Culturele diversiteit in de gezondheidszorg.......................................................................................110
Begrippen culturele diversiteit...........................................................................................................112
Diversiteit...........................................................................................................................................113
Subjectivisme......................................................................................................................................113
Diversiteit, betekenisverlening en communicatie..............................................................................114
Levensbeschouwing, religie en geloven.............................................................................................116
Dwang en drang in de zorg.................................................................................................................117
Wet zorg en dwang.............................................................................................................................119
Ethiek: Beslissen over behandeling en zorg........................................................................................119
Zelfbeschikking: grenzen en consequenties...................................................................................125
Ethiek: Bemoeizorg in beeld...............................................................................................................131
Recht: wet- en regelgeving zorgvragers chronische aandoening........................................................133
Somatoforme stoornissen..................................................................................................................134
Psychiatrie, somatische aandoeningen, somatisch-symptoomstoornis en verwante stoornissen.....138
Modelrichtlijn WGBO.........................................................................................................................147
3
, Anatomie, fysiologie & pathologie
Blok 1
Astma & COPD
Astma COPD
Symptomen Aanvallen van benauwdheid, Hoesten, slijm, benauwdheid.
piepen en hoesten.
Oorzaken Van buitenaf; pollen, Chronische ontsteking van de
huisstofmijt, parfum, kou kleine luchtwegen. Roken is
hierbij de belangrijkste oorzaak.
Klachten In aanvallen, buiten de Door langdurige ontsteking gaat
aanvallen om zijn er het longweefsel kapot; hierdoor
nauwelijks klachten. ontstaat longemfyseem.
Patiënten hebben vooral last
van het uitademen. Er blijft veel
lucht in de longen achter.
Hierdoor wordt de patiënt
kortademig en kan er hartfalen
ontstaan.
Patiënten zijn ook vatbaarder
voor luchtweginfecties zoals
pneumonie. Deze ontsteking
kan een verergering geven van
de COPD klachten. Dit wordt
ook wel exacerbatie genoemd.
Leeftijd Vanaf jongere leeftijd Ontstaat op oudere leeftijd.
Histamine
aanmaak
Allergische reactie Mestcellen Zwelling wand van
Afweersysteem bronchus en
(door bv katten, worden Bronchoconstrictie
maakt IgE aan bronchioli, extra Piepen, hoesten,
pollen, huisstofmijt) geactiveerd (vernauwing van de
slijmproductie, benauwdheid
Leukotriënen luchtwegen)
verkramping glad
aanmaak
spierweefsel
Astma
Niet-allergische
Overgevoeligheid Verkramping glad
reactie (door bv kou,
cholinerge receptoren spierweefsel
rook, inspanning)
4
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