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  3. Hogeschool Gent (HoGent)
  4.  
  5. Bachelor Voedings En Dieetkunde
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  7. Evidence based 3

Summary

Samenvatting Evidence based 3 theorie
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  • Course
  • Evidence based 3
  • Institution
  • Hogeschool Gent (HoGent)

Dit is een samenvatting van alle theorie van evidence based 3: de slides en de notities uit de lessen. Een heel semester samengevat in 107 pagina's met tussentitels en foto's.

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Document information

  • December 29, 2023
  • 107
  • 2023/2024
  • Summary

Subjects

  • evidence based
  • diëtetische diagnose
  • dieet

Written for

  • Hogeschool Gent (HoGent)
  • Bachelor Voedings En Dieetkunde
  • Evidence based 3
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EBD3: hoorcolleges, theorie
Inhoudsopgave
1. Ondervoeding, malnutritie ................................................................................................................................................ 4
1.1 Ondervoeding/malnutritie................................................................................................................................................ 4
1.1.1 Definitie .................................................................................................................................................................. 4
1.1.2 Diagnostische criteria ............................................................................................................................................. 4
1.1.3 Oorzaken ................................................................................................................................................................. 5
1.1.4 Risicogroepen ......................................................................................................................................................... 5
1.1.5 Ondervoedingssyndromen ..................................................................................................................................... 7
1.1.6 Uitingsvormen ........................................................................................................................................................ 8
1.1.7 En wat met ondervoeding bij kinderen…? .............................................................................................................. 9
1.1.8 Ondervoeding: gevolgen ....................................................................................................................................... 10
1.2 Diëtetisch onderzoek ...................................................................................................................................................... 10
1.2.1 Nutritional assessment ......................................................................................................................................... 11
1.2.2 Bepalen voedingstoestand ................................................................................................................................... 15
1.3 Diëtetische diagnose ...................................................................................................................................................... 17
1.4 Dieetbehandeling van de ondervoede patiënt ............................................................................................................... 17
1.4.1 Voedingsbehoefte ................................................................................................................................................. 17
1.4.2 Refeedingsyndroom .............................................................................................................................................. 19
1.5 Nutritional support ......................................................................................................................................................... 21
1.5.1 Voorwaarden ........................................................................................................................................................ 21
1.5.2 Beslissingsboom .................................................................................................................................................... 21
1.5.3 Voedingsinterventies bij volwassenen ................................................................................................................. 21
1.2 Kauw-en slikproblemen .................................................................................................................................................. 26
1.2.1 Inleiding: de slikact .......................................................................................................................................................... 26
1.2.2 Paramedische gegevens .................................................................................................................................................. 27
1.2.3 Diëtetische gegevens ....................................................................................................................................................... 29
1.2.4 Dieetbehandelingplan ..................................................................................................................................................... 30
1.2.5 Eerste hulp bij verslikken ................................................................................................................................................. 34
1.2.6 Praktisch: Parki’s kookatelier; Yves Meersman ism de Vlaamse Parkinson Liga ............................................................. 34

2. Longaandoeningen ........................................................................................................................................................... 36
2.1 Voeding bij COPD-patiënten; rol van diëtiste bij longrevalidatie ................................................................................... 36
Anatomie van de longen + wat is COPD? ................................................................................................................................. 36
Longrevalidatie ......................................................................................................................................................................... 37
Rookstop ................................................................................................................................................................................... 39
Voedingstoestand bij COPD-patiënten ..................................................................................................................................... 40
Voedingsadvies + aandachtspunten als diëtiste – comorbiditeiten ......................................................................................... 41
Long covid – rol van diëtiste ..................................................................................................................................................... 43

3. Decubitus en brandwonden.............................................................................................................................................. 45
3.1 Decubitus ........................................................................................................................................................................ 45
Wat is decubitus? ..................................................................................................................................................................... 45
Wat zijn de gevolgen van decubitus ......................................................................................................................................... 45
Behandeldoelen ........................................................................................................................................................................ 45
Taken van de diëtist: nutritional assessment ........................................................................................................................... 46
Taken van de diëtist: diëtetische diagnose .............................................................................................................................. 50
Taken van de diëtist: nutritional support ................................................................................................................................. 50
3.2 Brandwonden ................................................................................................................................................................. 51
Wat zijn brandwonden? ........................................................................................................................................................... 51
Wanneer ziekenhuisopname .................................................................................................................................................... 51

1

, Behandeldoelen ........................................................................................................................................................................ 51
Taken van de diëtist: nutritional assessment ........................................................................................................................... 52
Normopstelling ......................................................................................................................................................................... 53
Taken van diëtist....................................................................................................................................................................... 54

4. Neurologische aandoeningen ........................................................................................................................................... 56
4.1 Acute aandoeningen: stroke........................................................................................................................................... 56
4.2 Ziekte van Parkinson ...................................................................................................................................................... 56
4.3 De ziekte van Huntington ............................................................................................................................................... 57
4.4 Multiple sclerose ............................................................................................................................................................ 57
4.5 Amyotrofische laterale sclerose (ALS) ............................................................................................................................ 57
4.6 Dementie ........................................................................................................................................................................ 57

5. Oncologie en immunodeficiëntie ...................................................................................................................................... 59
5.1 Oncologie........................................................................................................................................................................ 59
5.1.1 Inleiding ................................................................................................................................................................ 59
5.1.2 Diëtetisch onderzoek ............................................................................................................................................ 59
5.1.3 Diëtetische diagnose............................................................................................................................................. 62
5.1.4 Dieetbehandeling ................................................................................................................................................. 62
5.1.5 Voeding ter preventie van kanker ........................................................................................................................ 69
5.2 Immunodeficiëntie.......................................................................................................................................................... 72
5.2.1 Definitie ................................................................................................................................................................ 72
5.2.2 Infectiepreventieprogramma ............................................................................................................................... 73
5.2.3 Voedingsbeleid ..................................................................................................................................................... 73
5.2.4 Hygiënemaatregelen............................................................................................................................................. 74

6. Nierlijden – nefrologie ...................................................................................................................................................... 75
6.1 Inleiding .......................................................................................................................................................................... 75
6.1.1 De nieren: voorkennis ........................................................................................................................................... 75
6.1.2 Functies ................................................................................................................................................................. 75
6.2 Diëtetisch onderzoek: symptomen en klachten .............................................................................................................. 76
6.2.1 Oorzaken ............................................................................................................................................................... 76
6.2.2 complicaties .......................................................................................................................................................... 76
6.2.3 Soorten nieraandoeningen ................................................................................................................................... 77
6.2.4 Classificatie NI ....................................................................................................................................................... 77
6.3 Diëtetische diagnose en dieetbehandeling bij de verschillende nieraandoeningen ....................................................... 79
6.3.1 Preterminale nierinsufficiëntie ............................................................................................................................. 82
6.3.2 Terminale nierinsufficiëntie .................................................................................................................................. 91
6.4 Diabetische nefropathie ................................................................................................................................................. 98
Definitie .................................................................................................................................................................................... 98
Doel........................................................................................................................................................................................... 99
Dieettherapie ............................................................................................................................................................................ 99

7. Leverlijden ...................................................................................................................................................................... 100
Inleiding ...................................................................................................................................................................................... 100
7.1 Diëtetisch onderzoek .................................................................................................................................................... 100
7.1.1 Functies ............................................................................................................................................................... 100
7.1.2 Classificatie ......................................................................................................................................................... 101
7.2 Medische en diëtetische diagnose ................................................................................................................................ 101
7.2.1 Medische diagnose ............................................................................................................................................. 101
7.2.2 Biochemische parameters .................................................................................................................................. 102
7.2.3 Complicaties ....................................................................................................................................................... 103
7.2.4 Diëtetische diagnose........................................................................................................................................... 104

2

,7.3 (Dieet)behandeling bij leveraandoeningen .................................................................................................................. 105
7.3.1 Medicatie ............................................................................................................................................................ 105
7.3.2 Dieettherapie ...................................................................................................................................................... 105
7.3.3 Dieettherapie bij complicaties ............................................................................................................................ 107
7.4 Voedingsadvies bij cholestatische aandoeningen ........................................................................................................ 107




3

, 1. Ondervoeding, malnutritie
1.1 Ondervoeding/malnutritie
− Ondervoeding: culturele verschillen vb. india
o Bepaalde landen: ondervoeding komt zeer frequent voor
o Overkoepelend over alle tijden en alle locaties
1.1.1 Definitie
− Evolutie van…
= Toestand waarbij het lichaam over onvoldoende nutriënten beschikt (depletie)
− Naar…
= Toestand waarbij een tekort of disbalans van energie, eiwit en andere voedingsstoffen leidt tot meetbare,
nadelige effecten op lichaamssamenstelling, functioneren en klinische resultaten (ESPEN)
o ESPEN = European society for clinical nutrition and metabolism
− OF…
= Een aandoening die wordt veroorzaakt door een verminderde inname of opname van voeding met als gevolg
een veranderde lichaamssamenstelling (verminderde vetvrije massa) en lichaamscelmassa. Dit resulteert in een
afname van het fysiek en mentaal functioneren en een slechtere klinische uitkomst van ziekte (Sobotka, L.2012)
− Vb. laag albuminegehalte (levercirrose): vochtophoping (ascites)
o Kan 4-5 L vocht in de buik zitten
▪ Verminderde eetlust
▪ Verminderde opname
▪ Is een vicieuze cirkel
1.1.2 Diagnostische criteria




− Verhouding spier-vetmassa: niet enkel BMI!
− Lage BMI (<18,5): rekening houden met het totaalbeeld
o Letten op evolutie
o Kijken naar de mensen
− Recent onverwacht ongewenst gewichtsverlies
o Veranderde morfologie
o Vragen aan de patiënt of aan familie
− Algemene ligduur: verkort; evolutie thuis verder in kaart kunnen brengen en in de gaten kunnen houden →
hulp van de familie inschakelen OF zorghulp indien er geen familie is




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