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samenvatting VMV4: wondzorg
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samenvatting VMV 4 :wondzorg 2e jaar in 2de semester, vives brugge 2022. volledig samengevat
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Bachelor verpleegkunde OLF 2VMV 4:
Wondzorg
VMV 4: wondzorg 1
,Bachelor verpleegkunde OLF 2
Inhoudsopgave
1. inleiding .................................................................................................................................................... 6
2. soorten wondgenezing ............................................................................................................................. 6
2.1. primaire wondgenezing ............................................................................................................................................ 6
2.2. Secundaire wondgenezing ........................................................................................................................................ 6
2.3. Tertiaire wondgenezing ............................................................................................................................................ 6
3. Care cycle als wondbehandelingsconcept ................................................................................................ 7
3.1. Langdurige wondheling............................................................................................................................................. 7
3.2. Wound bed preparation ........................................................................................................................................... 7
3.3. TIME ............................................................................................................................................................................. 7
3.4. Care cycle ................................................................................................................................................................... 8
4. Doelen van wondzorg .............................................................................................................................. 9
4.1. Algemene wondbehandeling .................................................................................................................................... 9
4.2. Aandachtspunten bij wondverzorging..................................................................................................................... 9
4.3. Complicaties bij wondverzorging ......................................................................................................................... 10
Adhesie of verklevingen .................................................................................................................................................. 10
Keloïd .................................................................................................................................................................................. 10
Contracturen ...................................................................................................................................................................... 10
Wondbreuk of hernia ...................................................................................................................................................... 10
Wonddehiscentie .............................................................................................................................................................. 10
5. wondinfecties.......................................................................................................................................... 10
5.1. Infectiepreventie ...................................................................................................................................................... 10
5.2. Infectie bij chirurgische wonden ............................................................................................................................ 11
Besmetting .......................................................................................................................................................................... 11
Kolonisatie .......................................................................................................................................................................... 11
Kritische kolonisatie .......................................................................................................................................................... 11
Infectie ................................................................................................................................................................................ 11
6. Peilen en uitduwen van de wonde ......................................................................................................... 11
6.1. Doelstelling .............................................................................................................................................................. 11
6.2. Verpleegkundige aandachtspunten ...................................................................................................................... 12
7. Wondspoeling ......................................................................................................................................... 12
Water of een zoutoplossing .................................................................................................................................................. 13
Antiseptische spoelvloeistoffen .............................................................................................................................................. 13
7.1. Verpleegkundige aandachtspunten bij wondspoeling........................................................................................ 13
NaCl 0,9% ......................................................................................................................................................................... 14
Woundcleanser ................................................................................................................................................................. 14
Polyvidone jodium ............................................................................................................................................................ 14
Hacdil of HAC ................................................................................................................................................................... 14
Carrel .................................................................................................................................................................................. 14
waterstofperoxide............................................................................................................................................................ 14
VMV 4: wondzorg 2
,Bachelor verpleegkunde OLF 2
8. afnemen van een wondcultuur ............................................................................................................... 14
8.1. begrippen ................................................................................................................................................................. 14
8.2. Verantwoordelijke M-O ......................................................................................................................................... 14
8.3. Randvoorwaarden................................................................................................................................................... 15
8.4. Verpleegkundige aandachtspunten ...................................................................................................................... 15
8.5. Prkatische toepassing ............................................................................................................................................. 15
9. Verzorging van de wonden met drainage .............................................................................................. 15
9.1. Begrippen ................................................................................................................................................................. 16
9.2. Gesloten drainagesystemen ................................................................................................................................... 16
9.2.1. Redons of vacuümdrain ................................................................................................................................... 16
9.2.2. Harmonicadrain ................................................................................................................................................ 17
9.2.3. Buik- of wondbeddrains .................................................................................................................................. 17
9.3. Open drainagesystemen ........................................................................................................................................ 17
Penrose drain..................................................................................................................................................................... 17
Golfdrain of lamel ........................................................................................................................................................... 17
Hydrofiel gaas .................................................................................................................................................................. 17
9.4. Verpleegkundige aandachtspunten bij verzorgen van een wonde met een drain ......................................... 17
9.5. Verpleegproblemen bij wonden met een drain ................................................................................................... 18
Irritatie en infectie ............................................................................................................................................................ 18
slechte drainage ............................................................................................................................................................... 18
Overmatig verlies v. bloed, vocht en vitale stiffen .................................................................................................... 18
Optreden van fistel na verwijderen van de drain ..................................................................................................... 18
9.6. praktische toepassing ............................................................................................................................................. 18
10. wondverzogring met wieken ............................................................................................................. 18
10.1. doelstelling ............................................................................................................................................................... 18
10.2. verpleegkundige aandachtspunten ....................................................................................................................... 19
10.3. Praktische toepassing ............................................................................................................................................. 19
11. Debrideren .......................................................................................................................................... 19
Chirurgische debridement....................................................................................................................................................... 20
Enzymatisch debridement (soort zalf) .................................................................................................................................. 20
Autolytische debridement ....................................................................................................................................................... 20
Biologisch debridement .......................................................................................................................................................... 20
Necrotische wonde ........................................................................................................................................................... 20
Fibrineuze wonde.............................................................................................................................................................. 20
Granulerende wonde ....................................................................................................................................................... 20
12. Wonden veroorzaakt door vasculaire insufficiëntie ........................................................................... 20
12.1. Veneuze ulcera ........................................................................................................................................................ 21
12.1.1. Behandeling ................................................................................................................................................. 21
12.2. Arteriële ulcera (aterieel vaatlijden) .................................................................................................................... 21
Klinische symptomen ......................................................................................................................................................... 22
Beoordeling........................................................................................................................................................................ 22
Behandeling ....................................................................................................................................................................... 22
VMV 4: wondzorg 3
, Bachelor verpleegkunde OLF 2
12.3. Onderscheid veneuze en arteriële ulcera............................................................................................................. 22
12.4. Decubitus .................................................................................................................................................................. 23
12.4.1. Wondzorg bij decubituswonden .............................................................................................................. 24
12.5. Lymfatische ulcera................................................................................................................................................... 24
13. Skin tears ............................................................................................................................................ 25
13.1. Begrippen ................................................................................................................................................................. 25
13.2. Preventie................................................................................................................................................................... 25
13.3. Classificatie van skin tears..................................................................................................................................... 27
Type 1-skin tear zonder weefselverlies ....................................................................................................................... 27
Type 2- skin tear met gedeeltelijk weefselverlies ..................................................................................................... 27
Type 3 – skin tear met volledig weefselverlies .......................................................................................................... 27
13.4. Wondzorg bij skin tears ........................................................................................................................................ 27
13.4.1. Basiswondzorg bij skin tears ..................................................................................................................... 27
13.4.2. Vaak voorkomende fouten ....................................................................................................................... 27
13.4.3. Observeer en rapporteer ......................................................................................................................... 28
14. IAD ..................................................................................................................................................... 28
14.1. Begrippen ................................................................................................................................................................. 28
14.1.1. Oorzaken ..................................................................................................................................................... 28
14.1.2. Classificatie .................................................................................................................................................. 29
14.1.3. Complicaties ................................................................................................................................................. 31
14.1.4. Differential diagnose ................................................................................................................................. 31
14.1.5. Preventive ..................................................................................................................................................... 32
14.1.6. Behandeling ................................................................................................................................................. 32
15. Intertrigo ............................................................................................................................................. 32
15.1. Begrippen ................................................................................................................................................................. 32
15.2. Verschijningsvormen van intertrigo ...................................................................................................................... 33
Gewone droge intertrigo ................................................................................................................................................ 33
Intertrigo met natte huid .................................................................................................................................................. 33
Intertrigo met geïnfecteerde huid.................................................................................................................................. 33
15.3. Differentiaal diagnose ........................................................................................................................................... 33
15.4. preventie................................................................................................................................................................... 33
15.4.1. Dagelijkse huidzorg.................................................................................................................................... 34
15.4.2. Voorkom huid-op-huid contact ................................................................................................................. 34
15.4.3. Vaak voorkomende fouten ....................................................................................................................... 34
15.4.4. Houd huidplooien droog............................................................................................................................ 34
15.5. Behandeling ............................................................................................................................................................. 34
Gewone droge intertrigo ................................................................................................................................................ 34
Intertrigo met natte huid .................................................................................................................................................. 34
Intertrigo met geïnfecteerde huid.................................................................................................................................. 34
15.6. Zinkzalven ................................................................................................................................................................ 35
16. Diabetesvoet....................................................................................................................................... 35
16.1. Begrippen ................................................................................................................................................................. 35
16.2. Verpleegkundige interventies ................................................................................................................................ 36
16.2.1. Preventieve maatregelen .......................................................................................................................... 36
16.2.2. Educatie van de zorgontvanger............................................................................................................... 36
VMV 4: wondzorg 4
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