Werken aan gezondheid
Preventieplan
Naam:
Studentnummer:
School: Hanze hogeschool Groningen
Studie: HBO-Verpleegkunde
Studieonderdeel: 3
Cursuscode: HVVB18MWAG
Docent:
Stageplaats: Medisch centrum Leeuwarden, Cardiologie afdeling
Stagebegeleider:
,Inhoudsopgave
Werken aan gezondheid..........................................................................................................................................1
Preventieplan............................................................................................................................................................1
Inleiding....................................................................................................................................................................4
1. Module Werken aan gezondheid........................................................................................................................5
1.1 CanMED’s rollen...........................................................................................................................................5
2. Het model van Rosendal.....................................................................................................................................6
3. Vertrouwen opbouwen........................................................................................................................................7
3.1 Vertrouwen opbouwen in de praktijk.............................................................................................................7
4. Anamnese.............................................................................................................................................................8
4.1 Casus..............................................................................................................................................................8
4.2 Gezondheidspatronen van Gordon.................................................................................................................9
5. Oorzaken en gevolgen.......................................................................................................................................10
5.1 ASE-model....................................................................................................................................................11
5.2 Transtheoretisch model................................................................................................................................11
5.3 CHA2DS2-VASc score...................................................................................................................................12
6. Mogelijke diagnoses voorleggen.......................................................................................................................12
6.1 Mogelijke diagnoses voorleggen in de praktijk............................................................................................15
7. Zelfredzaamheid................................................................................................................................................15
7.1 Achterhalen...................................................................................................................................................16
7.2 Adviseren......................................................................................................................................................16
7.3 Afspreken......................................................................................................................................................16
7.4 Assisteren......................................................................................................................................................16
7.5 Arrangeren...................................................................................................................................................17
7.6 Draagkracht en draaglast analyse...............................................................................................................17
7.7 Draagkracht en draaglast van de familie.....................................................................................................17
8. Diagnose vastleggen...........................................................................................................................................18
9. Resultaat bepalen..............................................................................................................................................20
9.1 Risico op voedingstekort...............................................................................................................................21
9.2 Risico op vallen............................................................................................................................................21
9.3 Risico op therapieontrouw gedrag...............................................................................................................21
10. Interventies bepalen........................................................................................................................................21
10.1 Risico op voedingstekort.............................................................................................................................22
10.2 Risico op vallen..........................................................................................................................................22
10.3 Risico op therapieontrouw gedrag.............................................................................................................23
2
, 11. Toewijzen en/of doorverwijzen......................................................................................................................24
11.1 Fysiotherapie..............................................................................................................................................24
11.2 Diëtist.........................................................................................................................................................24
11.3 Revalidatiezorg...........................................................................................................................................24
11.4 Thuiszorg en huishoudelijke hulp...............................................................................................................24
11.5 Maaltijdvoorziening...................................................................................................................................25
11.6 Mevrouw haar familie................................................................................................................................25
12. Zorgplan opstellen...........................................................................................................................................26
13. Monitoren en evalueren..................................................................................................................................28
13.1 Evalueren in de praktijk.............................................................................................................................28
Literatuurlijst........................................................................................................................................................31
Bijlage A: Uitgebreide casus.................................................................................................................................33
Bijlage B: Complexiteit van de casus...................................................................................................................35
Conclusie............................................................................................................................................................36
Bijlage C: Zelfredzaamheidsradar......................................................................................................................37
3
Preventieplan
Naam:
Studentnummer:
School: Hanze hogeschool Groningen
Studie: HBO-Verpleegkunde
Studieonderdeel: 3
Cursuscode: HVVB18MWAG
Docent:
Stageplaats: Medisch centrum Leeuwarden, Cardiologie afdeling
Stagebegeleider:
,Inhoudsopgave
Werken aan gezondheid..........................................................................................................................................1
Preventieplan............................................................................................................................................................1
Inleiding....................................................................................................................................................................4
1. Module Werken aan gezondheid........................................................................................................................5
1.1 CanMED’s rollen...........................................................................................................................................5
2. Het model van Rosendal.....................................................................................................................................6
3. Vertrouwen opbouwen........................................................................................................................................7
3.1 Vertrouwen opbouwen in de praktijk.............................................................................................................7
4. Anamnese.............................................................................................................................................................8
4.1 Casus..............................................................................................................................................................8
4.2 Gezondheidspatronen van Gordon.................................................................................................................9
5. Oorzaken en gevolgen.......................................................................................................................................10
5.1 ASE-model....................................................................................................................................................11
5.2 Transtheoretisch model................................................................................................................................11
5.3 CHA2DS2-VASc score...................................................................................................................................12
6. Mogelijke diagnoses voorleggen.......................................................................................................................12
6.1 Mogelijke diagnoses voorleggen in de praktijk............................................................................................15
7. Zelfredzaamheid................................................................................................................................................15
7.1 Achterhalen...................................................................................................................................................16
7.2 Adviseren......................................................................................................................................................16
7.3 Afspreken......................................................................................................................................................16
7.4 Assisteren......................................................................................................................................................16
7.5 Arrangeren...................................................................................................................................................17
7.6 Draagkracht en draaglast analyse...............................................................................................................17
7.7 Draagkracht en draaglast van de familie.....................................................................................................17
8. Diagnose vastleggen...........................................................................................................................................18
9. Resultaat bepalen..............................................................................................................................................20
9.1 Risico op voedingstekort...............................................................................................................................21
9.2 Risico op vallen............................................................................................................................................21
9.3 Risico op therapieontrouw gedrag...............................................................................................................21
10. Interventies bepalen........................................................................................................................................21
10.1 Risico op voedingstekort.............................................................................................................................22
10.2 Risico op vallen..........................................................................................................................................22
10.3 Risico op therapieontrouw gedrag.............................................................................................................23
2
, 11. Toewijzen en/of doorverwijzen......................................................................................................................24
11.1 Fysiotherapie..............................................................................................................................................24
11.2 Diëtist.........................................................................................................................................................24
11.3 Revalidatiezorg...........................................................................................................................................24
11.4 Thuiszorg en huishoudelijke hulp...............................................................................................................24
11.5 Maaltijdvoorziening...................................................................................................................................25
11.6 Mevrouw haar familie................................................................................................................................25
12. Zorgplan opstellen...........................................................................................................................................26
13. Monitoren en evalueren..................................................................................................................................28
13.1 Evalueren in de praktijk.............................................................................................................................28
Literatuurlijst........................................................................................................................................................31
Bijlage A: Uitgebreide casus.................................................................................................................................33
Bijlage B: Complexiteit van de casus...................................................................................................................35
Conclusie............................................................................................................................................................36
Bijlage C: Zelfredzaamheidsradar......................................................................................................................37
3
