SAMENVATTING TDC 3
3 VDK
Axelle Pieri
,INHOUDSTAFEL
H1: METEN & SCHATTEN E-BEHOEFTE ...................................................... 1
BEPALING VAN DE INDIVIDUELE BEHOEFTE ........................................................... 1
SCHATTEN VS METEN .............................................................................. 1
WANNEER WE TOCH SCHATTEN, WAT KIEZEN WE DAN? ............................................ 7
VOORBEELD UIT DE PRAKTIJK .......................................................................... 7
H2: MALNUTRITIE ................................................................................... 8
DEFINITIES EN BEGRIPPEN ............................................................................. 8
PROBLEEM / GEVOLGEN ............................................................................... 17
RISICOGROEPEN ........................................................................................ 18
SCREENEN/ DIAGNOSE & ERNST ..................................................................... 19
MULTIDISCIPLINAIRE BEHANDELING/OPVOLGING ................................................... 25
AANVULLENDE INFORMATIE ........................................................................... 28
DECUBITUS – DOORLIGWONDEN ..................................................................... 30
H3: KLINISCHE VOEDING ...................................................................... 33
ALGEMEEN .............................................................................................. 33
INDELING ............................................................................................... 34
ENTERALE VOEDING PER OS .......................................................................... 34
ENTERALE VOEDING VIA SONDE ...................................................................... 36
PARENTERALE VOEDING OF PN (PARENTERALE NUTRITIE) ........................................ 50
H4: ONCOLOGIE ..................................................................................... 59
WAT IS KANKER? ...................................................................................... 59
PREVENTIE – SCREENEN .............................................................................. 60
DIAGNOSE .............................................................................................. 61
BEHANDELING .......................................................................................... 63
Cancer-related malnutrition ................................................................. 63
Anorexia-cachexiesyndroom ................................................................ 65
Cachexie ........................................................................................... 65
Sarcopenie ........................................................................................ 66
Nutritional care in cancer (Screening & Diagnose) ................................... 67
DIEETBEHANDELING ................................................................................... 68
Praktische adviezen ............................................................................ 69
Klinische voeding ............................................................................... 70
SPECIFIEKE ADVIEZEN ................................................................................. 71
Chemotherapie – Cytostatica ............................................................... 71
Radiotherapie – “Bestraling” ................................................................ 72
Smaak- en geurveranderingen ............................................................. 72
Misselijkheid en braken ....................................................................... 73
Droge mond – Xerostomie ................................................................... 73
Mucositis ........................................................................................... 74
Hinderlijke slijmvorming ...................................................................... 74
KIEMARME VOEDING ................................................................................... 75
FYSIEKE ACTIVITEIT ................................................................................... 76
PALLIATIEVE ZORG – PALLIATIEVE VOEDING........................................................ 77
Terminale fase ................................................................................... 78
DIGITALE LESSEN ...................................................................................... 78
, Deel 1 – Oncologie - Klachten en complicaties tijdens de behandeling........ 79
Deel 2 – Oncologie - Diëten en voedingssupplementen in de oncologie ...... 80
H5: NEFROLOGIE ................................................................................... 81
FUNCTIES VAN DE NIER................................................................................ 81
PATHOFYSOLOGIE VAN DE NIER ...................................................................... 81
DIABETES MELLITUS & NEFROLOGISCHE AANDOENINGEN ......................................... 83
LABO BIJ NEFROLOGISCHE PROBLEMEN .............................................................. 83
INSCHATTING RISICO OP PROGRESSIE/VERWIKKELINGEN BIJ CNI ............................... 85
BASISDIËTEN BIJ NEFROLOGISCHE AANDOENINGEN................................................ 87
MALNUTRITIE BIJ NEFROLOGISCHE AANDOENINGEN ............................................... 87
NUTRITIONAL ASSESSMENT .......................................................................... 88
ACUTE NIERINSUFFICIËNTIE .......................................................................... 89
CHRONISCHE NIERINSUFFICIËNTIE (CNI) .......................................................... 89
ZORGTRAJECT CNI .................................................................................... 91
TERMINALE NIERINSUFFICIËNTIE ..................................................................... 92
NIERFUNCTIEVERVANGENDE THERAPIE .............................................................. 92
NIERTRANSPLANTATIE ................................................................................. 98
KLINISCHE/MEDISCHE VOEDINGEN ................................................................ 101
FOSFAATBINDERS – CHELATOREN ................................................................. 102
JICHT – PURINE & URINEZUUR..................................................................... 103
UROLITHIASIS – NIERSTENEN ...................................................................... 106
H6: VOEDSELINTOLERANTIE EN -ALLERGIE ......................................... 109
BEGRIPPEN............................................................................................ 109
DIAGNOSE ............................................................................................ 114
DIEET- EN VOEDINGSMAATREGELEN ............................................................... 116
Allergieën ........................................................................................ 116
Intoleranties .................................................................................... 118
MIGRAINE ............................................................................................. 122
Migraine en voeding ......................................................................... 122
ADHD – AANDACHTSTOORNIS MET HYPERACTIVITEIT .......................................... 123
ADHD en voeding ............................................................................. 123
Restrictie – Eliminatie dieet ............................................................... 123
H7: FODMAP ........................................................................................ 124
PRIKKELBARE DARMSYNDROOM (PDS) ............................................................ 124
LAAG FODMAP DIEET .............................................................................. 125
WANNEER IS EEN VM FODMAP- RIJK OF ARM? ................................................. 129
H9: MCT- EN KETOGEEN DIEET ............................................................ 136
MCT-DIEET ........................................................................................... 136
MCT-vetten VS LCT-vetten ................................................................ 136
Vetbeperkt dieet .............................................................................. 136
Chyluslekkage in thorax of abdomen ................................................... 137
Dieet en dieetadvies ......................................................................... 138
Beschikbare producten ...................................................................... 139
KETOGEEN DIEET & EPILEPSIE ...................................................................... 139
Epilepsie ......................................................................................... 139
Behandeling van epilepsie ................................................................. 139
Ketogeen dieet – Ketose ................................................................... 140
, Klassiek ketogeen dieet ..................................................................... 141
Ketogeen dieet met MCT-vetten ......................................................... 142
H9: PSYCHIATRIE EN AFHANKELIJKHEID ............................................ 143
VOEDINGSGERELATEERDE PSYCHIATRISCHE AANDOENINGEN ................................... 143
ANDERE PSYCHIATRISCHE AANDOENINGEN ....................................................... 144
INTERACTIE VOEDING – MEDICATIE ................................................................ 145
DRUG- EN ALCOHOLAFHANKELIJKHEID ............................................................ 148
Druggebruik en methadon ................................................................. 148
ALCOHOLAFHANKELIJKHEID ......................................................................... 149
AANDACHTSPUNTEN PRAKTIJK ...................................................................... 150
H10: VOEDINGSZORG BIJ SPECIFIEKE AANDOENINGEN...................... 151
ALS – AMYOTROFISCHE LATERAAL SCLEROSE ................................................... 151
Wat is ALS? ..................................................................................... 151
MS – MULTIPLE SCLEROSE ......................................................................... 152
REUMATOÏDE ARTRITIS (RA) ...................................................................... 154
Wat is RA? ...................................................................................... 154
Reumatoïde cachectische obesitas ...................................................... 155
RA VS Vetzuren................................................................................ 155
Dieetbehandelingsdoelen ................................................................... 155
Dieetadvies ..................................................................................... 156
BRANDWONDEN ...................................................................................... 156
Voedingsgerelateerde complicaties ..................................................... 157
Dieet- en voedingsadviezen ............................................................... 158
HIV/AIDS ........................................................................................... 159
Wat is HIV – AIDS? .......................................................................... 159
Ziektegerelateerde voedingsproblemen ............................................... 160
Dieet- en voedingsadvies .................................................................. 161
ZIEKTE VAN PARKINSON ............................................................................ 161
Pathologie ....................................................................................... 161
Levodopa ........................................................................................ 162
Voedingsproblemen .......................................................................... 163
Bijvoeding ....................................................................................... 163
3 VDK
Axelle Pieri
,INHOUDSTAFEL
H1: METEN & SCHATTEN E-BEHOEFTE ...................................................... 1
BEPALING VAN DE INDIVIDUELE BEHOEFTE ........................................................... 1
SCHATTEN VS METEN .............................................................................. 1
WANNEER WE TOCH SCHATTEN, WAT KIEZEN WE DAN? ............................................ 7
VOORBEELD UIT DE PRAKTIJK .......................................................................... 7
H2: MALNUTRITIE ................................................................................... 8
DEFINITIES EN BEGRIPPEN ............................................................................. 8
PROBLEEM / GEVOLGEN ............................................................................... 17
RISICOGROEPEN ........................................................................................ 18
SCREENEN/ DIAGNOSE & ERNST ..................................................................... 19
MULTIDISCIPLINAIRE BEHANDELING/OPVOLGING ................................................... 25
AANVULLENDE INFORMATIE ........................................................................... 28
DECUBITUS – DOORLIGWONDEN ..................................................................... 30
H3: KLINISCHE VOEDING ...................................................................... 33
ALGEMEEN .............................................................................................. 33
INDELING ............................................................................................... 34
ENTERALE VOEDING PER OS .......................................................................... 34
ENTERALE VOEDING VIA SONDE ...................................................................... 36
PARENTERALE VOEDING OF PN (PARENTERALE NUTRITIE) ........................................ 50
H4: ONCOLOGIE ..................................................................................... 59
WAT IS KANKER? ...................................................................................... 59
PREVENTIE – SCREENEN .............................................................................. 60
DIAGNOSE .............................................................................................. 61
BEHANDELING .......................................................................................... 63
Cancer-related malnutrition ................................................................. 63
Anorexia-cachexiesyndroom ................................................................ 65
Cachexie ........................................................................................... 65
Sarcopenie ........................................................................................ 66
Nutritional care in cancer (Screening & Diagnose) ................................... 67
DIEETBEHANDELING ................................................................................... 68
Praktische adviezen ............................................................................ 69
Klinische voeding ............................................................................... 70
SPECIFIEKE ADVIEZEN ................................................................................. 71
Chemotherapie – Cytostatica ............................................................... 71
Radiotherapie – “Bestraling” ................................................................ 72
Smaak- en geurveranderingen ............................................................. 72
Misselijkheid en braken ....................................................................... 73
Droge mond – Xerostomie ................................................................... 73
Mucositis ........................................................................................... 74
Hinderlijke slijmvorming ...................................................................... 74
KIEMARME VOEDING ................................................................................... 75
FYSIEKE ACTIVITEIT ................................................................................... 76
PALLIATIEVE ZORG – PALLIATIEVE VOEDING........................................................ 77
Terminale fase ................................................................................... 78
DIGITALE LESSEN ...................................................................................... 78
, Deel 1 – Oncologie - Klachten en complicaties tijdens de behandeling........ 79
Deel 2 – Oncologie - Diëten en voedingssupplementen in de oncologie ...... 80
H5: NEFROLOGIE ................................................................................... 81
FUNCTIES VAN DE NIER................................................................................ 81
PATHOFYSOLOGIE VAN DE NIER ...................................................................... 81
DIABETES MELLITUS & NEFROLOGISCHE AANDOENINGEN ......................................... 83
LABO BIJ NEFROLOGISCHE PROBLEMEN .............................................................. 83
INSCHATTING RISICO OP PROGRESSIE/VERWIKKELINGEN BIJ CNI ............................... 85
BASISDIËTEN BIJ NEFROLOGISCHE AANDOENINGEN................................................ 87
MALNUTRITIE BIJ NEFROLOGISCHE AANDOENINGEN ............................................... 87
NUTRITIONAL ASSESSMENT .......................................................................... 88
ACUTE NIERINSUFFICIËNTIE .......................................................................... 89
CHRONISCHE NIERINSUFFICIËNTIE (CNI) .......................................................... 89
ZORGTRAJECT CNI .................................................................................... 91
TERMINALE NIERINSUFFICIËNTIE ..................................................................... 92
NIERFUNCTIEVERVANGENDE THERAPIE .............................................................. 92
NIERTRANSPLANTATIE ................................................................................. 98
KLINISCHE/MEDISCHE VOEDINGEN ................................................................ 101
FOSFAATBINDERS – CHELATOREN ................................................................. 102
JICHT – PURINE & URINEZUUR..................................................................... 103
UROLITHIASIS – NIERSTENEN ...................................................................... 106
H6: VOEDSELINTOLERANTIE EN -ALLERGIE ......................................... 109
BEGRIPPEN............................................................................................ 109
DIAGNOSE ............................................................................................ 114
DIEET- EN VOEDINGSMAATREGELEN ............................................................... 116
Allergieën ........................................................................................ 116
Intoleranties .................................................................................... 118
MIGRAINE ............................................................................................. 122
Migraine en voeding ......................................................................... 122
ADHD – AANDACHTSTOORNIS MET HYPERACTIVITEIT .......................................... 123
ADHD en voeding ............................................................................. 123
Restrictie – Eliminatie dieet ............................................................... 123
H7: FODMAP ........................................................................................ 124
PRIKKELBARE DARMSYNDROOM (PDS) ............................................................ 124
LAAG FODMAP DIEET .............................................................................. 125
WANNEER IS EEN VM FODMAP- RIJK OF ARM? ................................................. 129
H9: MCT- EN KETOGEEN DIEET ............................................................ 136
MCT-DIEET ........................................................................................... 136
MCT-vetten VS LCT-vetten ................................................................ 136
Vetbeperkt dieet .............................................................................. 136
Chyluslekkage in thorax of abdomen ................................................... 137
Dieet en dieetadvies ......................................................................... 138
Beschikbare producten ...................................................................... 139
KETOGEEN DIEET & EPILEPSIE ...................................................................... 139
Epilepsie ......................................................................................... 139
Behandeling van epilepsie ................................................................. 139
Ketogeen dieet – Ketose ................................................................... 140
, Klassiek ketogeen dieet ..................................................................... 141
Ketogeen dieet met MCT-vetten ......................................................... 142
H9: PSYCHIATRIE EN AFHANKELIJKHEID ............................................ 143
VOEDINGSGERELATEERDE PSYCHIATRISCHE AANDOENINGEN ................................... 143
ANDERE PSYCHIATRISCHE AANDOENINGEN ....................................................... 144
INTERACTIE VOEDING – MEDICATIE ................................................................ 145
DRUG- EN ALCOHOLAFHANKELIJKHEID ............................................................ 148
Druggebruik en methadon ................................................................. 148
ALCOHOLAFHANKELIJKHEID ......................................................................... 149
AANDACHTSPUNTEN PRAKTIJK ...................................................................... 150
H10: VOEDINGSZORG BIJ SPECIFIEKE AANDOENINGEN...................... 151
ALS – AMYOTROFISCHE LATERAAL SCLEROSE ................................................... 151
Wat is ALS? ..................................................................................... 151
MS – MULTIPLE SCLEROSE ......................................................................... 152
REUMATOÏDE ARTRITIS (RA) ...................................................................... 154
Wat is RA? ...................................................................................... 154
Reumatoïde cachectische obesitas ...................................................... 155
RA VS Vetzuren................................................................................ 155
Dieetbehandelingsdoelen ................................................................... 155
Dieetadvies ..................................................................................... 156
BRANDWONDEN ...................................................................................... 156
Voedingsgerelateerde complicaties ..................................................... 157
Dieet- en voedingsadviezen ............................................................... 158
HIV/AIDS ........................................................................................... 159
Wat is HIV – AIDS? .......................................................................... 159
Ziektegerelateerde voedingsproblemen ............................................... 160
Dieet- en voedingsadvies .................................................................. 161
ZIEKTE VAN PARKINSON ............................................................................ 161
Pathologie ....................................................................................... 161
Levodopa ........................................................................................ 162
Voedingsproblemen .......................................................................... 163
Bijvoeding ....................................................................................... 163
