Samenvatting MK-FO-1-S25 Zorg verlenen aan een pasgeborene met een laag- en midden complexe
zorgvraag
Oktober 2025
Amstel Academie
1
,1 Antenatale diagnostiek & klinische genetica...................................................................................................6
1.1 Meiose:.....................................................................................................................................................6
1.2 Chromosomen..........................................................................................................................................6
1.3 Autosomale overerving.............................................................................................................................7
1.4 Chromosomale overerving.......................................................................................................................7
1.5 Mitochondriële overerving.......................................................................................................................9
1.6 Chromosoomafwijkingen........................................................................................................................10
1.7 Numerieke chromosoomafwijkingen......................................................................................................10
1.8 Structurele chromosoomafwijkingen......................................................................................................11
1.9 Terminologie aangeboren afwijkingen...................................................................................................12
1.10 Prenatale afwijkingen...........................................................................................................................12
1.11 NIPT Niet-invasieve Prenatale Test.......................................................................................................13
1.12 Confined placental mosaïcism (CPM)...................................................................................................14
1.13 Structureel echoscopisch onderzoek (SEO)..........................................................................................14
1.14 GUO I Targeted screening hoog risico groep........................................................................................15
2 Pasgeborene met gezondheidsproblemen....................................................................................................16
2.1 Transitiefase van intra- naar extra-uterien.............................................................................................16
2.2 Postnatale Ontwikkeling en Onrijpheid..................................................................................................16
2.3 Foetale Circulatie (voor de geboorte).....................................................................................................17
2.4 Neonatale Circulatie (na de geboorte)....................................................................................................18
2.5 Postpartum Saturatieprofiel...................................................................................................................18
2.6 Fysiologie Postpartum............................................................................................................................18
2.7 Neonatale Definities: Termijn en Gewicht..............................................................................................19
2.8 Serotiniteit (> 42 weken)........................................................................................................................19
2.9 Macrosomie............................................................................................................................................20
2.10 Problemen Gerelateerd aan Transitie...................................................................................................21
2.11 Problemen Gerelateerd aan Onrijpheid van Systemen.........................................................................21
2.12 Geboortetrauma...................................................................................................................................22
2.13 Congenitale Afwijkingen.......................................................................................................................22
2.14 Chronische Hypoxie..............................................................................................................................22
2.15 Prematuriteit........................................................................................................................................22
2.16 Neonatale Beoordeling Postpartum: APGAR- score..............................................................................23
2.17 Perinatale Asfyxie.................................................................................................................................23
2.18 Oorzaken van Asfyxie............................................................................................................................24
2.19 Thompsonscore....................................................................................................................................24
2.20 Postnatale Behandeling Asfyxie............................................................................................................24
2
, 2.21 Postneonatale Behandeling..................................................................................................................24
2.22 Whole Body Cooling..............................................................................................................................24
2.23 Schedel Neonaat: Fontanellen en Naden..............................................................................................25
2.24 Complicaties postpartum......................................................................................................................25
2.25 Alarmsypmtomen schedel neonaat......................................................................................................27
2.26 Macrocefalie.........................................................................................................................................27
2.27 Microcefalie..........................................................................................................................................27
2.28 Vitamine D & K Suppletie......................................................................................................................28
2.29 Geboortetrauma:..................................................................................................................................28
2.30 Pijn bij Neonaten..................................................................................................................................28
2.31 Meetinstrumenten: COMFORTneo Schaal............................................................................................29
2.32 Hyperinsulinisme..................................................................................................................................29
2.33 Polycytemie..........................................................................................................................................30
2.34 Wet Lung..............................................................................................................................................30
2.35 Respiratoir Distress Syndroom (NRDS/IRDS).........................................................................................31
2.36 Apneus en Hypopneus..........................................................................................................................33
2.37 Persisterende Pulmonale Hypertensie van de Neonaat (PPHN)...........................................................33
3 Hyperbilirubinemie, hypoglykemie en neonatale infectiesilirubine..............................................................34
3.1 HbF.........................................................................................................................................................34
3.2 De bilirubine stofwisseling......................................................................................................................35
3.3 Hyperbilirubinemie.................................................................................................................................35
3.4 Screening................................................................................................................................................37
3.5 Bloedroepen...........................................................................................................................................38
3.6 Neonatale hypoglykemie........................................................................................................................39
3.7 Streefwaarden en interventiegrenzen bij alle pasgeborenen.................................................................40
3.8 Symptomen............................................................................................................................................40
3.9 Risicofactoren.........................................................................................................................................40
3.10 Glucose controles > 35 weken..............................................................................................................41
3.11 Glucose controles < 35 weken..............................................................................................................41
3.12 Therapie................................................................................................................................................41
3.13 Transmissie...........................................................................................................................................42
3.14 Congenitale infecties............................................................................................................................42
3.15 Symptomen..........................................................................................................................................43
3.16 Bacteriële infecties...............................................................................................................................43
3.17 Virale infecties......................................................................................................................................44
3.18 Sepsis....................................................................................................................................................44
3
, 4 Verpleegkundige zorg van de zieke pasgeborene..........................................................................................45
4.1 Gewichtsverlies bij Pasgeborenen..........................................................................................................45
4.2 Urinatie bij pasgeborenen......................................................................................................................45
4.3 Herkennen van een Zieke Zuigeling: Systematische Beoordeling...........................................................45
4.4 Normale Parametrie bij Zuigelingen (0-12 maanden).............................................................................46
4.5 Pylorushypertrofie..................................................................................................................................46
4.6 Veelvoorkomende Opnameredenen bij Zuigelingen..............................................................................46
4.7 De zuigeling met koorts..........................................................................................................................47
4.8 Voeding en Vloeistoffen bij Zuigelingen..................................................................................................47
4.9 Aandachtspunten bij de Zorg voor een Zieke Zuigeling..........................................................................48
4.10 Fototherapie bij Hyperbilirubinemie: Specifieke Zorginterventies.......................................................48
4.11 Thermoregulatie: Mechanismen van Warmteverlies............................................................................49
5 Fysiologie van de zwangerschap – Embryo en placenta................................................................................50
5.1 Functies van de Placenta........................................................................................................................50
5.2 Structuur van de Placenta.......................................................................................................................51
5.3 Foetale Circulatie....................................................................................................................................51
5.4 Maternale Circulatie...............................................................................................................................52
5.5 Vliezen (Foetale Membranen)................................................................................................................52
5.6 Vruchtwater............................................................................................................................................53
5.7 Navelstreng.............................................................................................................................................53
5.8 Geboorte placenta..................................................................................................................................53
5.9 Bijzondere placenta’s..............................................................................................................................54
5.10 De menstruele cyclus............................................................................................................................54
5.11 Bevruchting...........................................................................................................................................56
5.12 Vroege embryonale ontwikkeling.........................................................................................................56
5.13 Nidatie..................................................................................................................................................57
5.14 Gastrulatie en neurulatie......................................................................................................................57
5.15 Neurulatie.............................................................................................................................................57
5.16 Vorming van placenta, vliezen, vruchtwater en navelstreng................................................................57
5.17 Placentaire circulatie............................................................................................................................58
5.18 Placentaire-maternale uitwisseling:......................................................................................................58
5.19 Functie van de placenta........................................................................................................................59
5.20 Amnion.................................................................................................................................................59
5.21 Vruchtwater..........................................................................................................................................59
6 Fysiologie van de pasgeborene......................................................................................................................60
6.1 Foetale circulatie....................................................................................................................................60
4
zorgvraag
Oktober 2025
Amstel Academie
1
,1 Antenatale diagnostiek & klinische genetica...................................................................................................6
1.1 Meiose:.....................................................................................................................................................6
1.2 Chromosomen..........................................................................................................................................6
1.3 Autosomale overerving.............................................................................................................................7
1.4 Chromosomale overerving.......................................................................................................................7
1.5 Mitochondriële overerving.......................................................................................................................9
1.6 Chromosoomafwijkingen........................................................................................................................10
1.7 Numerieke chromosoomafwijkingen......................................................................................................10
1.8 Structurele chromosoomafwijkingen......................................................................................................11
1.9 Terminologie aangeboren afwijkingen...................................................................................................12
1.10 Prenatale afwijkingen...........................................................................................................................12
1.11 NIPT Niet-invasieve Prenatale Test.......................................................................................................13
1.12 Confined placental mosaïcism (CPM)...................................................................................................14
1.13 Structureel echoscopisch onderzoek (SEO)..........................................................................................14
1.14 GUO I Targeted screening hoog risico groep........................................................................................15
2 Pasgeborene met gezondheidsproblemen....................................................................................................16
2.1 Transitiefase van intra- naar extra-uterien.............................................................................................16
2.2 Postnatale Ontwikkeling en Onrijpheid..................................................................................................16
2.3 Foetale Circulatie (voor de geboorte).....................................................................................................17
2.4 Neonatale Circulatie (na de geboorte)....................................................................................................18
2.5 Postpartum Saturatieprofiel...................................................................................................................18
2.6 Fysiologie Postpartum............................................................................................................................18
2.7 Neonatale Definities: Termijn en Gewicht..............................................................................................19
2.8 Serotiniteit (> 42 weken)........................................................................................................................19
2.9 Macrosomie............................................................................................................................................20
2.10 Problemen Gerelateerd aan Transitie...................................................................................................21
2.11 Problemen Gerelateerd aan Onrijpheid van Systemen.........................................................................21
2.12 Geboortetrauma...................................................................................................................................22
2.13 Congenitale Afwijkingen.......................................................................................................................22
2.14 Chronische Hypoxie..............................................................................................................................22
2.15 Prematuriteit........................................................................................................................................22
2.16 Neonatale Beoordeling Postpartum: APGAR- score..............................................................................23
2.17 Perinatale Asfyxie.................................................................................................................................23
2.18 Oorzaken van Asfyxie............................................................................................................................24
2.19 Thompsonscore....................................................................................................................................24
2.20 Postnatale Behandeling Asfyxie............................................................................................................24
2
, 2.21 Postneonatale Behandeling..................................................................................................................24
2.22 Whole Body Cooling..............................................................................................................................24
2.23 Schedel Neonaat: Fontanellen en Naden..............................................................................................25
2.24 Complicaties postpartum......................................................................................................................25
2.25 Alarmsypmtomen schedel neonaat......................................................................................................27
2.26 Macrocefalie.........................................................................................................................................27
2.27 Microcefalie..........................................................................................................................................27
2.28 Vitamine D & K Suppletie......................................................................................................................28
2.29 Geboortetrauma:..................................................................................................................................28
2.30 Pijn bij Neonaten..................................................................................................................................28
2.31 Meetinstrumenten: COMFORTneo Schaal............................................................................................29
2.32 Hyperinsulinisme..................................................................................................................................29
2.33 Polycytemie..........................................................................................................................................30
2.34 Wet Lung..............................................................................................................................................30
2.35 Respiratoir Distress Syndroom (NRDS/IRDS).........................................................................................31
2.36 Apneus en Hypopneus..........................................................................................................................33
2.37 Persisterende Pulmonale Hypertensie van de Neonaat (PPHN)...........................................................33
3 Hyperbilirubinemie, hypoglykemie en neonatale infectiesilirubine..............................................................34
3.1 HbF.........................................................................................................................................................34
3.2 De bilirubine stofwisseling......................................................................................................................35
3.3 Hyperbilirubinemie.................................................................................................................................35
3.4 Screening................................................................................................................................................37
3.5 Bloedroepen...........................................................................................................................................38
3.6 Neonatale hypoglykemie........................................................................................................................39
3.7 Streefwaarden en interventiegrenzen bij alle pasgeborenen.................................................................40
3.8 Symptomen............................................................................................................................................40
3.9 Risicofactoren.........................................................................................................................................40
3.10 Glucose controles > 35 weken..............................................................................................................41
3.11 Glucose controles < 35 weken..............................................................................................................41
3.12 Therapie................................................................................................................................................41
3.13 Transmissie...........................................................................................................................................42
3.14 Congenitale infecties............................................................................................................................42
3.15 Symptomen..........................................................................................................................................43
3.16 Bacteriële infecties...............................................................................................................................43
3.17 Virale infecties......................................................................................................................................44
3.18 Sepsis....................................................................................................................................................44
3
, 4 Verpleegkundige zorg van de zieke pasgeborene..........................................................................................45
4.1 Gewichtsverlies bij Pasgeborenen..........................................................................................................45
4.2 Urinatie bij pasgeborenen......................................................................................................................45
4.3 Herkennen van een Zieke Zuigeling: Systematische Beoordeling...........................................................45
4.4 Normale Parametrie bij Zuigelingen (0-12 maanden).............................................................................46
4.5 Pylorushypertrofie..................................................................................................................................46
4.6 Veelvoorkomende Opnameredenen bij Zuigelingen..............................................................................46
4.7 De zuigeling met koorts..........................................................................................................................47
4.8 Voeding en Vloeistoffen bij Zuigelingen..................................................................................................47
4.9 Aandachtspunten bij de Zorg voor een Zieke Zuigeling..........................................................................48
4.10 Fototherapie bij Hyperbilirubinemie: Specifieke Zorginterventies.......................................................48
4.11 Thermoregulatie: Mechanismen van Warmteverlies............................................................................49
5 Fysiologie van de zwangerschap – Embryo en placenta................................................................................50
5.1 Functies van de Placenta........................................................................................................................50
5.2 Structuur van de Placenta.......................................................................................................................51
5.3 Foetale Circulatie....................................................................................................................................51
5.4 Maternale Circulatie...............................................................................................................................52
5.5 Vliezen (Foetale Membranen)................................................................................................................52
5.6 Vruchtwater............................................................................................................................................53
5.7 Navelstreng.............................................................................................................................................53
5.8 Geboorte placenta..................................................................................................................................53
5.9 Bijzondere placenta’s..............................................................................................................................54
5.10 De menstruele cyclus............................................................................................................................54
5.11 Bevruchting...........................................................................................................................................56
5.12 Vroege embryonale ontwikkeling.........................................................................................................56
5.13 Nidatie..................................................................................................................................................57
5.14 Gastrulatie en neurulatie......................................................................................................................57
5.15 Neurulatie.............................................................................................................................................57
5.16 Vorming van placenta, vliezen, vruchtwater en navelstreng................................................................57
5.17 Placentaire circulatie............................................................................................................................58
5.18 Placentaire-maternale uitwisseling:......................................................................................................58
5.19 Functie van de placenta........................................................................................................................59
5.20 Amnion.................................................................................................................................................59
5.21 Vruchtwater..........................................................................................................................................59
6 Fysiologie van de pasgeborene......................................................................................................................60
6.1 Foetale circulatie....................................................................................................................................60
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