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Samenvatting Perinatale Zorgen Deel 2 ABC-Handelingen
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Samenvatting van het vak Perinatale Zorgen Deel 2 ABC-handelingen
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Perinatale zorgen deel 2: ABC-HandelingInhoudsopgave
1 Diabeteszorg...................................................................................................................................3
1.1 Definities......................................................................................................................................3
1.2 Symptomen..................................................................................................................................5
1.3 Bloedglucosemeting.....................................................................................................................5
1.3.1 Zelfcontrole...........................................................................................................................6
1.3.2 Mogelijke meetmomenten...................................................................................................6
1.3.3 Aandachtspunten..................................................................................................................6
1.3.4 Capillaire BA..........................................................................................................................7
1.4 Toedienen van insuline.................................................................................................................8
1.5 Complicaties...............................................................................................................................10
1.5.1 Hypoglycemie......................................................................................................................10
1.5.2 Hyperglycemie....................................................................................................................11
1.6 Materialen toediening................................................................................................................11
2 De inspuitingen.............................................................................................................................12
2.1 Definitie......................................................................................................................................12
2.2 Redenen......................................................................................................................................12
2.3 Benodigdheden voor de inspuiting.............................................................................................12
2.3.1 Spuit....................................................................................................................................12
2.3.2 Naald...................................................................................................................................13
2.3.3 In te spuiten vloeistof.........................................................................................................14
2.4 7 Rights of medication................................................................................................................15
2.5 Soorten inspuitingen...................................................................................................................15
2.5.1 Subcutaan...........................................................................................................................15
2.5.2 Intramusculair.....................................................................................................................16
2.5.3 Intraveneus.........................................................................................................................17
2.5.4 Intracutaan..........................................................................................................................17
2.6 Mogelijke reacties......................................................................................................................18
2.6.1 Anafylaxie............................................................................................................................18
2.6.2 Syncope...............................................................................................................................18
3 De venapunctie.............................................................................................................................19
3.1 Samenstelling van het bloed.......................................................................................................19
3.2 Vormen van bloedafname..........................................................................................................20
3.2.1 Doel.....................................................................................................................................20
3.2.2 Capillaire bloedafname.......................................................................................................21
3.2.3 Veneuze bloedafname........................................................................................................21
3.2.4 Arteriële bloedafname........................................................................................................21
3.3 De veneuze bloedafname...........................................................................................................21
4 Zorgen in verband met IV-infuus..................................................................................................25
4.1 Definitie......................................................................................................................................25
4.2 Materiaal....................................................................................................................................25
4.2.1 Infusiereciptiënten..............................................................................................................25
4.2.2 Soorten infusieleidingen.....................................................................................................26
4.2.3 Schakelkranen.....................................................................................................................27
4.2.4 Punctiemateriaal.................................................................................................................27
1
, 4.2.5 Infuussystemen...................................................................................................................27
4.2.6 Infuusregelaars (manueel of elektronisch)..........................................................................28
4.3 Klaarmaken IV-infuus.................................................................................................................28
4.3.1 Voorbereiding.....................................................................................................................28
4.3.2 Uitvoering: in de verpleegruimte........................................................................................29
4.3.3 Uitvoering: assistentie bij plaatsen.....................................................................................29
4.3.4 Nazorg.................................................................................................................................30
4.4 Regelen druppelsnelheid............................................................................................................30
4.5 Veranderen van infuusrecipiënt..................................................................................................30
4.5.1 Voorbereiding.....................................................................................................................30
4.5.2 Uitvoering...........................................................................................................................30
4.5.3 Nazorg.................................................................................................................................30
4.5.4 Verwijderen van lucht uit leiding........................................................................................30
4.6 Observeren IV-infuus..................................................................................................................32
4.7 Verwijderen IV-infuus.................................................................................................................32
5 Decubitus......................................................................................................................................33
5.1 Definitie......................................................................................................................................33
5.2 Classificatie.................................................................................................................................33
5.3 Oorzaken....................................................................................................................................34
5.3.1 Verticale druk: drukpunten.................................................................................................34
5.3.2 Schuifkracht........................................................................................................................34
5.3.3 Druk en schuifkracht...........................................................................................................34
5.4 Weefseltolerantie.......................................................................................................................34
5.4.1 Weefseldruk voor druk.......................................................................................................34
5.4.2 Weefseltolerantie voor verandering in 0 2-concentratie......................................................35
5.5 Preventie....................................................................................................................................35
5.5.1 Positionering.......................................................................................................................35
5.5.2 Wisselhouding.....................................................................................................................35
5.5.3 Drukverdelende middelen..................................................................................................36
2
,1 Diabeteszorg
1.1 Definities
Diabetes is chronisch/ niet-geneesbaar. (Zwangerschapsdiabetes kan wel worden opgelost
soms.
Het is een ziekte waarbij het bloedsuikergehalte is verhoogd tekort aan insuline of
ongevoeligheid/onvoldoende werkzaamheid insuline.
Suiker glucose lichaamsdelen. Cellen hebben nood aan glucose voor energie.
Insuline regelt de opname van glucose: sleutelhormoon; insuline bindt aan receptoren en
zorgt ervoor dat de cel opengaat en dan gaat glucose binnenin de cel:
Hormoon in bètacellen in pancreas
Binden aan receptoren zodat glucose van de bloedbaan in de cel wordt opgenomen
Normaalwaarde: 70-110 mg/dl
Hyperglycemie: >180 mg/dl
Hypoglycemie: <60 mg/dl
Suikergehalte in het bloed is verhoogd.
Lichaam stuurt trigger naar B-cellen zorgen
ervoor dat insuline vrijkomt insuline minder
suiker in het bloed dalen van
bloedsuikerspiegel (BBS)
3
, Verbruiken van veel suiker bv bij het sporten.
Verschillende vormen van insuline:
1. Diabetes mellitus type 1 (DM1): komt minder vaak voor.
Onvoldoende/geen insuline (geen functionerende B-cellen)
Oorzaken:
Genetisch/erfelijk
Auto-immuunziekte: het lichaam valt u eigen cellen aan T-
cellen.
Omgevingsfactoren: bv aanbieden van borstvoeding of te vroeg
aanbieden van gluten (vanaf 4-6 maand) of geven van koemelk.
Vaak op jonge leeftijd (vaak <40 jaar) wordt dit vastgesteld
10% vd diabetespatiënten
0,4% vd totale bevolking
Insuline subcutaan/ dieet
2. Latent auto-immune diabetes in adults (LADA): lijkt op type 1
Traag evoluerend
Auto-immune diabetes
Meestal diagnose >30 jaar
Dieet/vermageren/bewegen/orale medicatie
Evt. Insuline (niet vanaf het begin verschil met type 1)
3. Diabetes mellitus type 2 (DM2): grootste groep
Productie insuline daalt (wel nog functionerende B-cellen)
Productie glucagon (alfacellen) blijft bestaan: glucosevrijzetting in bloed is
dus hyperglycemie
Ongevoeligheid weefsels/insuline resistentie
Langzaam verloop
>40 jaar, ouderen vaak door overgewicht; toename jonger leeftijd:
overgewicht en lichaamsbeweging
Tabletten per os/dieet
Vaker een hyper dan een hypo
4. Maturity-onset diabetes of the young (MODY)
Insuline niet steeds nodig
Oorzaak = mutatie van het gen
Familiaal (50% overervingskans)
Diagnose meestal <25 jaar
4
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