Inhoud
1. Visie op zorgverlening aan kinderen............................................................................................................................6
2. Profiel zorgverleners voor kinderen............................................................................................................................6
3. Zorg voor het kind.......................................................................................................................................................6
3.1 Intramurale zorg....................................................................................................................................................6
3.2 Extramurale zorg...................................................................................................................................................9
1. Groei............................................................................................................................................................................ 9
1.1 Factoren die de groei beïnvloeden........................................................................................................................9
1.2 Groeipatroon.......................................................................................................................................................10
1.3 Evolutie van gewicht – lengte- hoofdomtrek.......................................................................................................11
1.4 De lichaamsverhoudingen...................................................................................................................................11
1.5 De skeletleeftijd...................................................................................................................................................11
2. Slaap.......................................................................................................................................................................... 12
2.1 Wiegendood........................................................................................................................................................13
2.2 Beïnvloedende factoren wiegendood..................................................................................................................14
2.3 Polysomnografie..................................................................................................................................................15
2.4 Soorten apneus....................................................................................................................................................17
2.5 Monitoring...........................................................................................................................................................18
2.6 Preventie wiegendood.........................................................................................................................................20
3. De Tandontwikkeling.................................................................................................................................................20
4. Het haar..................................................................................................................................................................... 22
5. Zindelijkheid..............................................................................................................................................................24
6. Het spel..................................................................................................................................................................... 25
7. Lichaamstaal..............................................................................................................................................................28
8. Het huilen.................................................................................................................................................................. 28
8.1 Betekenis.............................................................................................................................................................28
8.2 Breath holding spells...........................................................................................................................................29
8.3 Excessief huilen...................................................................................................................................................29
9. Registratie van de ontwikkeling.................................................................................................................................31
9.1 Van Wiechen.......................................................................................................................................................31
9.2 Denver Delevopment Screening Test..................................................................................................................32
10. Preventie en ongevallen..........................................................................................................................................33
1. Borstvoeding.............................................................................................................................................................35
2. Kunstvoeding of Kunstmelk.......................................................................................................................................38
3. Vaste voeding............................................................................................................................................................44
3.1 Eten met een lepel...............................................................................................................................................44
Pagina 1 van 126
, 3.2 Starten met groente-of fruitpap..........................................................................................................................45
3.3 Baby led weaning.................................................................................................................................................47
4. Voedingsproblemen..................................................................................................................................................47
4.1 Bij zuigelingen......................................................................................................................................................47
4.2 Bij peuters en kleuters.........................................................................................................................................48
5. Vitaminesupplementen.............................................................................................................................................49
5.1 Vitamine D...........................................................................................................................................................49
5.2 Vitamine K...........................................................................................................................................................49
5.3 Ijzer...................................................................................................................................................................... 49
1. Definitie en elementen..............................................................................................................................................49
2. Interventies............................................................................................................................................................... 50
3. Observatie van de communicatie tussen ouder en kind............................................................................................51
4. Ouderparticipatie en rooming-in...............................................................................................................................52
5. Communicatie tussen zorgverlener en kind..............................................................................................................54
1. Het ABCDE bij het kind..............................................................................................................................................56
1.1 Airway bij kinderen (A)........................................................................................................................................56
1.2 Breathing (B)........................................................................................................................................................58
1.3 Circulation (C ).....................................................................................................................................................61
1.4 Disability (D)........................................................................................................................................................64
1.5 Exposure/ Environment (E ).................................................................................................................................64
2. Groei.......................................................................................................................................................................... 65
2.1 Gewicht............................................................................................................................................................... 66
2.2 Lengte.................................................................................................................................................................. 67
2.3 hoofdomtrek........................................................................................................................................................68
3. Zintuigelijke functies..................................................................................................................................................69
3.1 De ogen............................................................................................................................................................... 69
3.1.1 Observaties...................................................................................................................................................69
3.1.2 Visus.............................................................................................................................................................70
3.1.3 Afwijkingen van het oog...............................................................................................................................71
3.1.4 Toedienen van oogdruppels en – zalf...........................................................................................................74
3.2 Het gehoor...........................................................................................................................................................74
4. Vitale functies............................................................................................................................................................75
4.1 Ademhaling..........................................................................................................................................................76
4.2 Hartfrequentie.....................................................................................................................................................78
4.3 Lichaamstemperatuur.........................................................................................................................................78
4.3.1 Koorts...........................................................................................................................................................78
4.4 Bloeddruk meten.................................................................................................................................................80
4.5 Bewustzijn controleren........................................................................................................................................81
Pagina 2 van 126
, 4.6 Diurese volgen.....................................................................................................................................................81
5. Pijn............................................................................................................................................................................. 81
5.1 Pijnbeleving.........................................................................................................................................................82
5.2 Uitingen van pijn..................................................................................................................................................83
5.3 Pijninstrumenten.................................................................................................................................................84
5.4 Pijnbestrijding......................................................................................................................................................87
1. Kindvriendelijke omgeving........................................................................................................................................92
2. Positionering..............................................................................................................................................................92
3. Vertrouwensrelatie opbouwen en communicatie.....................................................................................................93
3.1 Vertrouwensrelatie opbouwen met het kind......................................................................................................93
3.2 Communicatie met kind voor en tijdens procedure............................................................................................93
4. Niet-farmacologische pijn- en/of angst reducerende interventies............................................................................95
1. Algemene kinderziekten............................................................................................................................................96
1.1 Tetanus................................................................................................................................................................97
1.2 Pertussis..............................................................................................................................................................97
1.3 Mazelen...............................................................................................................................................................97
1.4 Bof zie mindmaps................................................................................................................................................97
1.5 Rode hond...........................................................................................................................................................97
1.6 Erythema infectiosum..........................................................................................................................................97
1.7 Exanthenum subitum..........................................................................................................................................97
1.8 Varicella...............................................................................................................................................................97
2. Gastro-enteritis.........................................................................................................................................................99
2.1 Stomatitis.............................................................................................................................................................99
2.2 Gastro- Oesofagale reflux en – ziekte..................................................................................................................99
2.3 Obstipatie............................................................................................................................................................99
2.4 Gastro-enteritis...................................................................................................................................................99
2.5 Enterobius vermicularis zie mindmaps................................................................................................................99
2.6 Koemelkeiwitallergie...........................................................................................................................................99
2.7 Coeliakie..............................................................................................................................................................99
2.8 Voedingsintolleratie of – overgevoeligheid.........................................................................................................99
2.9 Maagsonde plaatsen, maagtubage, maagspoeling en sondevoeding................................................................102
3. Ademhalingsstelsel en NKO.....................................................................................................................................103
3.1 Rhinitis...............................................................................................................................................................104
3.2 Adenoïditis.........................................................................................................................................................104
3.3 Acute faryngitis..................................................................................................................................................104
3.4 Tonsillitis............................................................................................................................................................104
3.5 Acute epiglottis..................................................................................................................................................104
3.6 Laryngitis subglottica.........................................................................................................................................104
Pagina 3 van 126
, 3.7 Bronchitis...........................................................................................................................................................104
3.8 Acute bronchiolitis.............................................................................................................................................104
3.9 Pneumonie zie mindmaps.................................................................................................................................104
3.10 Astma..............................................................................................................................................................104
3.11 Otitis externa...................................................................................................................................................104
3.12 Cerumprop......................................................................................................................................................104
3.13 Trommelvliesperforatie...................................................................................................................................104
3.14 Myringitis.........................................................................................................................................................104
3.15 Acute otitis media............................................................................................................................................104
3.16 Sereuze otitis media........................................................................................................................................104
3.17 Toedienen van oordruppels.............................................................................................................................105
3.18 Zweettest zie pag. 197 tot en met 201............................................................................................................105
4. Afname RSV-staal....................................................................................................................................................105
4.1 Zuurstof- & aerosoltoediening...........................................................................................................................105
4.1.1 Zuurstoftoediening.....................................................................................................................................105
4.1.2 Aerosoltherapie..........................................................................................................................................107
5. Urologie................................................................................................................................................................... 111
5.1 Urineweginfecties..............................................................................................................................................111
5.2 afname urinestaal..............................................................................................................................................111
6. groei en puberteit....................................................................................................................................................112
6.1 Te klein gestalte.................................................................................................................................................112
6.1.1 Familiaal klein gestalte...............................................................................................................................112
6.1.2 Groeihormoondeficiëntie...........................................................................................................................112
6.1.3 Syndroom van Turner.................................................................................................................................112
6.1.4 Hypothyreoïdie...........................................................................................................................................112
6.1.5 Achondroplasie...........................................................................................................................................112
6.2 Te groot gestalte zie mindmaps.........................................................................................................................112
6.2.1 Constitutioneel groot gestalte....................................................................................................................112
6.2.2 Syndroom van Marfan................................................................................................................................112
6.2.3 Syndroom van Klinefelter...........................................................................................................................112
6.3 Afwijkingen van de pubertaire ontwikkeling.....................................................................................................112
6.3.1 Pubertas praecox........................................................................................................................................112
6.3.2 Constitutioneel vertraagde pubertaire ontwikkeling..................................................................................112
6.3.3 Pubertas Tarda............................................................................................................................................112
7. Pre- en postoperatieve zorgen................................................................................................................................112
7.1 Algemeen...........................................................................................................................................................112
7.1.1 Voorbereiden, voorlichten..........................................................................................................................112
7.1.2 Informed consent.......................................................................................................................................114
Pagina 4 van 126
1. Visie op zorgverlening aan kinderen............................................................................................................................6
2. Profiel zorgverleners voor kinderen............................................................................................................................6
3. Zorg voor het kind.......................................................................................................................................................6
3.1 Intramurale zorg....................................................................................................................................................6
3.2 Extramurale zorg...................................................................................................................................................9
1. Groei............................................................................................................................................................................ 9
1.1 Factoren die de groei beïnvloeden........................................................................................................................9
1.2 Groeipatroon.......................................................................................................................................................10
1.3 Evolutie van gewicht – lengte- hoofdomtrek.......................................................................................................11
1.4 De lichaamsverhoudingen...................................................................................................................................11
1.5 De skeletleeftijd...................................................................................................................................................11
2. Slaap.......................................................................................................................................................................... 12
2.1 Wiegendood........................................................................................................................................................13
2.2 Beïnvloedende factoren wiegendood..................................................................................................................14
2.3 Polysomnografie..................................................................................................................................................15
2.4 Soorten apneus....................................................................................................................................................17
2.5 Monitoring...........................................................................................................................................................18
2.6 Preventie wiegendood.........................................................................................................................................20
3. De Tandontwikkeling.................................................................................................................................................20
4. Het haar..................................................................................................................................................................... 22
5. Zindelijkheid..............................................................................................................................................................24
6. Het spel..................................................................................................................................................................... 25
7. Lichaamstaal..............................................................................................................................................................28
8. Het huilen.................................................................................................................................................................. 28
8.1 Betekenis.............................................................................................................................................................28
8.2 Breath holding spells...........................................................................................................................................29
8.3 Excessief huilen...................................................................................................................................................29
9. Registratie van de ontwikkeling.................................................................................................................................31
9.1 Van Wiechen.......................................................................................................................................................31
9.2 Denver Delevopment Screening Test..................................................................................................................32
10. Preventie en ongevallen..........................................................................................................................................33
1. Borstvoeding.............................................................................................................................................................35
2. Kunstvoeding of Kunstmelk.......................................................................................................................................38
3. Vaste voeding............................................................................................................................................................44
3.1 Eten met een lepel...............................................................................................................................................44
Pagina 1 van 126
, 3.2 Starten met groente-of fruitpap..........................................................................................................................45
3.3 Baby led weaning.................................................................................................................................................47
4. Voedingsproblemen..................................................................................................................................................47
4.1 Bij zuigelingen......................................................................................................................................................47
4.2 Bij peuters en kleuters.........................................................................................................................................48
5. Vitaminesupplementen.............................................................................................................................................49
5.1 Vitamine D...........................................................................................................................................................49
5.2 Vitamine K...........................................................................................................................................................49
5.3 Ijzer...................................................................................................................................................................... 49
1. Definitie en elementen..............................................................................................................................................49
2. Interventies............................................................................................................................................................... 50
3. Observatie van de communicatie tussen ouder en kind............................................................................................51
4. Ouderparticipatie en rooming-in...............................................................................................................................52
5. Communicatie tussen zorgverlener en kind..............................................................................................................54
1. Het ABCDE bij het kind..............................................................................................................................................56
1.1 Airway bij kinderen (A)........................................................................................................................................56
1.2 Breathing (B)........................................................................................................................................................58
1.3 Circulation (C ).....................................................................................................................................................61
1.4 Disability (D)........................................................................................................................................................64
1.5 Exposure/ Environment (E ).................................................................................................................................64
2. Groei.......................................................................................................................................................................... 65
2.1 Gewicht............................................................................................................................................................... 66
2.2 Lengte.................................................................................................................................................................. 67
2.3 hoofdomtrek........................................................................................................................................................68
3. Zintuigelijke functies..................................................................................................................................................69
3.1 De ogen............................................................................................................................................................... 69
3.1.1 Observaties...................................................................................................................................................69
3.1.2 Visus.............................................................................................................................................................70
3.1.3 Afwijkingen van het oog...............................................................................................................................71
3.1.4 Toedienen van oogdruppels en – zalf...........................................................................................................74
3.2 Het gehoor...........................................................................................................................................................74
4. Vitale functies............................................................................................................................................................75
4.1 Ademhaling..........................................................................................................................................................76
4.2 Hartfrequentie.....................................................................................................................................................78
4.3 Lichaamstemperatuur.........................................................................................................................................78
4.3.1 Koorts...........................................................................................................................................................78
4.4 Bloeddruk meten.................................................................................................................................................80
4.5 Bewustzijn controleren........................................................................................................................................81
Pagina 2 van 126
, 4.6 Diurese volgen.....................................................................................................................................................81
5. Pijn............................................................................................................................................................................. 81
5.1 Pijnbeleving.........................................................................................................................................................82
5.2 Uitingen van pijn..................................................................................................................................................83
5.3 Pijninstrumenten.................................................................................................................................................84
5.4 Pijnbestrijding......................................................................................................................................................87
1. Kindvriendelijke omgeving........................................................................................................................................92
2. Positionering..............................................................................................................................................................92
3. Vertrouwensrelatie opbouwen en communicatie.....................................................................................................93
3.1 Vertrouwensrelatie opbouwen met het kind......................................................................................................93
3.2 Communicatie met kind voor en tijdens procedure............................................................................................93
4. Niet-farmacologische pijn- en/of angst reducerende interventies............................................................................95
1. Algemene kinderziekten............................................................................................................................................96
1.1 Tetanus................................................................................................................................................................97
1.2 Pertussis..............................................................................................................................................................97
1.3 Mazelen...............................................................................................................................................................97
1.4 Bof zie mindmaps................................................................................................................................................97
1.5 Rode hond...........................................................................................................................................................97
1.6 Erythema infectiosum..........................................................................................................................................97
1.7 Exanthenum subitum..........................................................................................................................................97
1.8 Varicella...............................................................................................................................................................97
2. Gastro-enteritis.........................................................................................................................................................99
2.1 Stomatitis.............................................................................................................................................................99
2.2 Gastro- Oesofagale reflux en – ziekte..................................................................................................................99
2.3 Obstipatie............................................................................................................................................................99
2.4 Gastro-enteritis...................................................................................................................................................99
2.5 Enterobius vermicularis zie mindmaps................................................................................................................99
2.6 Koemelkeiwitallergie...........................................................................................................................................99
2.7 Coeliakie..............................................................................................................................................................99
2.8 Voedingsintolleratie of – overgevoeligheid.........................................................................................................99
2.9 Maagsonde plaatsen, maagtubage, maagspoeling en sondevoeding................................................................102
3. Ademhalingsstelsel en NKO.....................................................................................................................................103
3.1 Rhinitis...............................................................................................................................................................104
3.2 Adenoïditis.........................................................................................................................................................104
3.3 Acute faryngitis..................................................................................................................................................104
3.4 Tonsillitis............................................................................................................................................................104
3.5 Acute epiglottis..................................................................................................................................................104
3.6 Laryngitis subglottica.........................................................................................................................................104
Pagina 3 van 126
, 3.7 Bronchitis...........................................................................................................................................................104
3.8 Acute bronchiolitis.............................................................................................................................................104
3.9 Pneumonie zie mindmaps.................................................................................................................................104
3.10 Astma..............................................................................................................................................................104
3.11 Otitis externa...................................................................................................................................................104
3.12 Cerumprop......................................................................................................................................................104
3.13 Trommelvliesperforatie...................................................................................................................................104
3.14 Myringitis.........................................................................................................................................................104
3.15 Acute otitis media............................................................................................................................................104
3.16 Sereuze otitis media........................................................................................................................................104
3.17 Toedienen van oordruppels.............................................................................................................................105
3.18 Zweettest zie pag. 197 tot en met 201............................................................................................................105
4. Afname RSV-staal....................................................................................................................................................105
4.1 Zuurstof- & aerosoltoediening...........................................................................................................................105
4.1.1 Zuurstoftoediening.....................................................................................................................................105
4.1.2 Aerosoltherapie..........................................................................................................................................107
5. Urologie................................................................................................................................................................... 111
5.1 Urineweginfecties..............................................................................................................................................111
5.2 afname urinestaal..............................................................................................................................................111
6. groei en puberteit....................................................................................................................................................112
6.1 Te klein gestalte.................................................................................................................................................112
6.1.1 Familiaal klein gestalte...............................................................................................................................112
6.1.2 Groeihormoondeficiëntie...........................................................................................................................112
6.1.3 Syndroom van Turner.................................................................................................................................112
6.1.4 Hypothyreoïdie...........................................................................................................................................112
6.1.5 Achondroplasie...........................................................................................................................................112
6.2 Te groot gestalte zie mindmaps.........................................................................................................................112
6.2.1 Constitutioneel groot gestalte....................................................................................................................112
6.2.2 Syndroom van Marfan................................................................................................................................112
6.2.3 Syndroom van Klinefelter...........................................................................................................................112
6.3 Afwijkingen van de pubertaire ontwikkeling.....................................................................................................112
6.3.1 Pubertas praecox........................................................................................................................................112
6.3.2 Constitutioneel vertraagde pubertaire ontwikkeling..................................................................................112
6.3.3 Pubertas Tarda............................................................................................................................................112
7. Pre- en postoperatieve zorgen................................................................................................................................112
7.1 Algemeen...........................................................................................................................................................112
7.1.1 Voorbereiden, voorlichten..........................................................................................................................112
7.1.2 Informed consent.......................................................................................................................................114
Pagina 4 van 126
