cio:V2.0.0-beta.2 testgegevens bgmo addendum: verschil tussen versies
k (NICTIZ-9056: Small textual improvement) |
(NICTIZ-13820: Updated wiki file (included proper references)) |
||
Regel 4: | Regel 4: | ||
=Addenda voor inhoudelijke gegevens= | =Addenda voor inhoudelijke gegevens= | ||
− | <section begin=cio- | + | <section begin=cio-bgo-tst-0.2-minimaalBB /> |
==Scenario 0.2 - minimaal BB== | ==Scenario 0.2 - minimaal BB== | ||
− | === <span id="Pat02" title="Intern ID Pat02">Patient</span>=== | + | === <span id="Pat02" title="Intern ID = Pat02">Patient</span>=== |
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
− | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="5" | <span id="Pat02" title="Intern ID = Pat02"><span id="Pat02" title="Intern ID Pat02">Patient</span></span> | + | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="5" | <span id="_Pat02"><span id="Pat02" title="Intern ID = Pat02"><span id="Pat02" title="Intern ID = Pat02">Patient</span></span></span> |
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan="4" width="30%"| Gegevenselement | |colspan="4" width="30%"| Gegevenselement | ||
Regel 21: | Regel 21: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Voornamen | |colspan="3"|Voornamen | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Petra |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Initialen | |colspan="3"|Initialen | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|P |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Geslachtsnaam | |colspan="4"|Geslachtsnaam | ||
Regel 31: | Regel 31: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Achternaam | |colspan="2"|Achternaam | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|XXX_Drijkoningen |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Identificatienummer | |colspan="4"|Identificatienummer | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|999900523 (in identificerend systeem: BSN) |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Geboortedatum | |colspan="4"|Geboortedatum | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|25 okt 1963 |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Geslacht | |colspan="4"|Geslacht | ||
− | |style="background-color: white;"|Vrouw (code = 'F' in codeSystem 'HL7 AdministrativeGender') | + | |style="background-color: white;"|Vrouw (code = 'F' in codeSystem '<span title="2.16.840.1.113883.5.1">HL7 AdministrativeGender</span>') |
|} | |} | ||
=== Geneesmiddelovergevoeligheid - IBUPROFEN=== | === Geneesmiddelovergevoeligheid - IBUPROFEN=== | ||
Regel 53: | Regel 53: | ||
|colspan="5"|Bewaking besluit | |colspan="5"|Bewaking besluit | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="12"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Besluit type | |colspan="3"|Besluit type | ||
− | |style="background-color: white;"|Started (qualifier value) (code = '385652002' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|Started (qualifier value) (code = '385652002' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Besluit datum tijd | ||
+ | |style="background-color: white;"|T - 30 dagen om 09:10:54 uur | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Besluit ingangs datum tijd | |colspan="3"|Besluit ingangs datum tijd | ||
Regel 73: | Regel 76: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Zorgverlener | |colspan="2"|Zorgverlener | ||
− | |style="background-color: white;"|zv-Peter-van-Pulver | + | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Registratie gegevens | |colspan="3"|Registratie gegevens | ||
− | |style="background-color: white;"|RegGeg-pat02-BB-01 | + | |style="background-color: white;"|Zie [[#RegGeg-pat02-BB-01|Registratie gegevens: RegGeg-pat02-BB-01]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Toelichting | |colspan="3"|Toelichting | ||
Regel 102: | Regel 105: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Zorgverlener | |colspan="3"|Zorgverlener | ||
− | |style="background-color: white;"|zv-Peter-van-Pulver | + | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Registratie datum tijd | |colspan="4"|Registratie datum tijd | ||
Regel 135: | Regel 138: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Zorgaanbieder | |colspan="4"|Zorgaanbieder | ||
− | |style="background-color: white;"|za-Huisartsenpraktijk-Pulver-en-Partners | + | |style="background-color: white;"|Zie [[#za-Huisartsenpraktijk-Pulver-en-Partners|Zorgaanbieder: za-Huisartsenpraktijk-Pulver-en-Partners]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|<span id="za-Huisartsenpraktijk-Pulver-en-Partners" title="Intern ID = za-Huisartsenpraktijk-Pulver-en-Partners">Zorgaanbieder za-Huisartsenpraktijk-Pulver-en-Partners</span> | |colspan="6"|<span id="za-Huisartsenpraktijk-Pulver-en-Partners" title="Intern ID = za-Huisartsenpraktijk-Pulver-en-Partners">Zorgaanbieder za-Huisartsenpraktijk-Pulver-en-Partners</span> | ||
Regel 164: | Regel 167: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Adres soort | |colspan="3"|Adres soort | ||
− | |style="background-color: white;"|Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') | + | |style="background-color: white;"|Werkadres (code = 'WP' in codeSystem '<span title="2.16.840.1.113883.5.1119">HL7 AddressUse</span>') |
− | |}<section end=cio- | + | |}<section end=cio-bgo-tst-0.2-minimaalBB /> |
− | <section begin=cio- | + | <section begin=cio-bgo-tst-0.3-maximaalBB /> |
==Scenario 0.3 - maximaal BB, O, R== | ==Scenario 0.3 - maximaal BB, O, R== | ||
− | === <span id="Pat03" title="Intern ID Pat03">Patient</span>=== | + | === <span id="Pat03" title="Intern ID = Pat03">Patient</span>=== |
{| class="wikitable" width="85%" | {| class="wikitable" width="85%" | ||
− | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="5" | <span id="Pat03" title="Intern ID = Pat03"><span id="Pat03" title="Intern ID Pat03">Patient</span></span> | + | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="5" | <span id="_Pat03"><span id="Pat03" title="Intern ID = Pat03"><span id="Pat03" title="Intern ID = Pat03">Patient</span></span></span> |
|-style="background-color: #1F497D;; color: white; text-align:left;" | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
|colspan="4" width="30%"| Gegevenselement | |colspan="4" width="30%"| Gegevenselement | ||
Regel 183: | Regel 186: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Voornamen | |colspan="3"|Voornamen | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|Erwin |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Initialen | |colspan="3"|Initialen | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|E |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Geslachtsnaam | |colspan="4"|Geslachtsnaam | ||
Regel 193: | Regel 196: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Achternaam | |colspan="2"|Achternaam | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|XXX_Dubbeld |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Identificatienummer | |colspan="4"|Identificatienummer | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|999900535 (in identificerend systeem: BSN) |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Geboortedatum | |colspan="4"|Geboortedatum | ||
− | |style="background-color: white;"| | + | |style="background-color: white;"|26 okt 1963 |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Geslacht | |colspan="4"|Geslacht | ||
− | |style="background-color: white;"|Man (code = 'M' in codeSystem 'HL7 AdministrativeGender') | + | |style="background-color: white;"|Man (code = 'M' in codeSystem '<span title="2.16.840.1.113883.5.1">HL7 AdministrativeGender</span>') |
|} | |} | ||
=== Geneesmiddelovergevoeligheid - PENICILLINES=== | === Geneesmiddelovergevoeligheid - PENICILLINES=== | ||
Regel 215: | Regel 218: | ||
|colspan="5"|Bewaking besluit | |colspan="5"|Bewaking besluit | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="12"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Besluit type | |colspan="3"|Besluit type | ||
− | |style="background-color: white;"|Started (qualifier value) (code = '385652002' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|Started (qualifier value) (code = '385652002' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Besluit datum tijd | ||
+ | |style="background-color: white;"|T - 108 dagen om 11:15:46 uur | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Besluit ingangs datum tijd | |colspan="3"|Besluit ingangs datum tijd | ||
Regel 235: | Regel 241: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Zorgverlener | |colspan="2"|Zorgverlener | ||
− | |style="background-color: white;"|zv-Peter-van-Pulver | + | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Registratie gegevens | |colspan="3"|Registratie gegevens | ||
− | |style="background-color: white;"|RegGegevens-pat03-BB-01 | + | |style="background-color: white;"|Zie [[#RegGegevens-pat03-BB-01|Registratie gegevens: RegGegevens-pat03-BB-01]] |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Toelichting | ||
+ | |style="background-color: white;"|Patiënt heeft aangegeven in het verleden allergische reacties te hebben gehad na gebruik penicilline. | ||
|} | |} | ||
=== Geneesmiddelovergevoeligheid - PENICILLINES=== | === Geneesmiddelovergevoeligheid - PENICILLINES=== | ||
Regel 251: | Regel 260: | ||
|colspan="5"|Bewaking besluit | |colspan="5"|Bewaking besluit | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="15"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Besluit type | |colspan="3"|Besluit type | ||
− | |style="background-color: white;"|Discontinued (qualifier value) (code = '410546004' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|Discontinued (qualifier value) (code = '410546004' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Besluit datum tijd | ||
+ | |style="background-color: white;"|T - 50 dagen om 14:23:05 uur | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Besluit ingangs datum tijd | |colspan="3"|Besluit ingangs datum tijd | ||
Regel 271: | Regel 283: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Zorgverlener | |colspan="2"|Zorgverlener | ||
− | |style="background-color: white;"|zv-Peter-van-Pulver | + | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Relatie bewaking besluit | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Identificatie | ||
+ | |style="background-color: white;"|pat03-BB-01 | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Registratie gegevens | |colspan="3"|Registratie gegevens | ||
− | |style="background-color: white;"|RegGegevens-pat03-BB-02 | + | |style="background-color: white;"|Zie [[#RegGegevens-pat03-BB-02|Registratie gegevens: RegGegevens-pat03-BB-02]] |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Toelichting | ||
+ | |style="background-color: white;"|Bewaking op volledige groep penicillines stopgezet, omdat patiënt wel goed reageert op flucloxacilline. | ||
|} | |} | ||
=== Geneesmiddelovergevoeligheid - PENICILLINES=== | === Geneesmiddelovergevoeligheid - PENICILLINES=== | ||
Regel 287: | Regel 309: | ||
|colspan="5"|Bewaking besluit | |colspan="5"|Bewaking besluit | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="15"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Besluit type | |colspan="3"|Besluit type | ||
− | |style="background-color: white;"|Started (qualifier value) (code = '385652002' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|Started (qualifier value) (code = '385652002' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Besluit datum tijd | ||
+ | |style="background-color: white;"|T - 50 dagen om 14:25:30 uur | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Besluit ingangs datum tijd | |colspan="3"|Besluit ingangs datum tijd | ||
Regel 300: | Regel 325: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Overgevoeligheid | |colspan="2"|Overgevoeligheid | ||
− | |style="background-color: white;"|pat03-overgevoeligheid-01 | + | |style="background-color: white;"|Zie [[#pat03-overgevoeligheid-01|Overgevoeligheid: pat03-overgevoeligheid-01]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Te bewaken stof | |colspan="4"|Te bewaken stof | ||
Regel 317: | Regel 342: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Zorgverlener | |colspan="2"|Zorgverlener | ||
− | |style="background-color: white;"|zv-Peter-van-Pulver | + | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Registratie gegevens | |colspan="3"|Registratie gegevens | ||
− | |style="background-color: white;"|RegGegevens-pat03-BB-03 | + | |style="background-color: white;"|Zie [[#RegGegevens-pat03-BB-03|Registratie gegevens: RegGegevens-pat03-BB-03]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|<span id="pat03-overgevoeligheid-01" title="Intern ID = pat03-overgevoeligheid-01">Overgevoeligheid pat03-overgevoeligheid-01</span> | |colspan="5"|<span id="pat03-overgevoeligheid-01" title="Intern ID = pat03-overgevoeligheid-01">Overgevoeligheid pat03-overgevoeligheid-01</span> | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="22"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Aandoening begin datum tijd | |colspan="3"|Aandoening begin datum tijd | ||
Regel 330: | Regel 355: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Aandoening ernst | |colspan="3"|Aandoening ernst | ||
− | |style="background-color: white;"|Matig (code = '6736007' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|Matig (code = '6736007' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Aandoening aanwezigheid | |colspan="3"|Aandoening aanwezigheid | ||
− | |style="background-color: white;"|Known present (qualifier value) (code = '410515003' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|Known present (qualifier value) (code = '410515003' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Aandoening status datum | |colspan="3"|Aandoening status datum | ||
Regel 346: | Regel 371: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Wijze van vaststellen | |colspan="3"|Wijze van vaststellen | ||
− | |style="background-color: white;"|History and physical examination with evaluation and management of patient (procedure) (code = '14736009' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|History and physical examination with evaluation and management of patient (procedure) (code = '14736009' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Zekerheid status | |colspan="3"|Zekerheid status | ||
− | |style="background-color: white;"|Confirmed present (qualifier value) (code = '410605003' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|Confirmed present (qualifier value) (code = '410605003' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Overgevoeligheid categorie | |colspan="3"|Overgevoeligheid categorie | ||
− | |style="background-color: white;"|geneesmiddelen (code = '419511003' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|geneesmiddelen (code = '419511003' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Verwacht risico bij blootstelling | |colspan="3"|Verwacht risico bij blootstelling | ||
− | |style="background-color: white;"|Severe (severity modifier) (qualifier value) (code = '24484000' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|Severe (severity modifier) (qualifier value) (code = '24484000' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Diagnose | |colspan="4"|Diagnose | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="3"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Diagnose naam | |colspan="2"|Diagnose naam | ||
|style="background-color: white;"|overgevoeligheid voor meerdere geneesmiddelen (aandoening) (code = '735458004' in codeSystem 'SNOMED Clinical Terms') | |style="background-color: white;"|overgevoeligheid voor meerdere geneesmiddelen (aandoening) (code = '735458004' in codeSystem 'SNOMED Clinical Terms') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Nadere specificatie diagnose naam | ||
+ | |style="background-color: white;"|Overgevoeligheid voor penicillines | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Diagnostisch inzicht datum | |colspan="3"|Diagnostisch inzicht datum | ||
Regel 372: | Regel 400: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Zorgverlener | |colspan="2"|Zorgverlener | ||
− | |style="background-color: white;"|zv-Peter-van-Pulver | + | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Registratie gegevens | |colspan="3"|Registratie gegevens | ||
− | |style="background-color: white;"|RegGegevens-pat03-overg-01 | + | |style="background-color: white;"|Zie [[#RegGegevens-pat03-overg-01|Registratie gegevens: RegGegevens-pat03-overg-01]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Toelichting | |colspan="3"|Toelichting | ||
Regel 391: | Regel 419: | ||
|colspan="5"|Bewaking besluit | |colspan="5"|Bewaking besluit | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="15"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Besluit type | |colspan="3"|Besluit type | ||
− | |style="background-color: white;"|Started (qualifier value) (code = '385652002' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|Started (qualifier value) (code = '385652002' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Besluit datum tijd | ||
+ | |style="background-color: white;"|T - 730 dagen om 09:57:02 uur | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Besluit ingangs datum tijd | |colspan="3"|Besluit ingangs datum tijd | ||
Regel 404: | Regel 435: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Reactie | |colspan="2"|Reactie | ||
− | |style="background-color: white;"|pat03-reactie-01 | + | |style="background-color: white;"|Zie [[#pat03-reactie-01|Reactie: pat03-reactie-01]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Te bewaken stof | |colspan="4"|Te bewaken stof | ||
Regel 418: | Regel 449: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Zorgverlener | |colspan="2"|Zorgverlener | ||
− | |style="background-color: white;"|zv-Peter-van-Pulver | + | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Registratie gegevens | |colspan="3"|Registratie gegevens | ||
− | |style="background-color: white;"|RegGegevens-pat03-BB-04 | + | |style="background-color: white;"|Zie [[#RegGegevens-pat03-BB-04|Registratie gegevens: RegGegevens-pat03-BB-04]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Toelichting | |colspan="3"|Toelichting | ||
Regel 428: | Regel 459: | ||
|colspan="5"|<span id="pat03-reactie-01" title="Intern ID = pat03-reactie-01">Reactie pat03-reactie-01</span> | |colspan="5"|<span id="pat03-reactie-01" title="Intern ID = pat03-reactie-01">Reactie pat03-reactie-01</span> | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="26"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Aandoening begin datum tijd | |colspan="3"|Aandoening begin datum tijd | ||
Regel 434: | Regel 465: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Aandoening ernst | |colspan="3"|Aandoening ernst | ||
− | |style="background-color: white;"|Ernstig (code = '24484000' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|Ernstig (code = '24484000' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Aandoening aanwezigheid | |colspan="3"|Aandoening aanwezigheid | ||
− | |style="background-color: white;"|Known present (qualifier value) (code = '410515003' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|Known present (qualifier value) (code = '410515003' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Aandoening status datum | |colspan="3"|Aandoening status datum | ||
Regel 447: | Regel 478: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Veroorzakende stof | |colspan="2"|Veroorzakende stof | ||
− | |style="background-color: white;"|NORVASC TABLET 5MG (code = ' | + | |style="background-color: white;"|NORVASC TABLET 5MG (code = '642916' in codeSystem 'G-Standaard HPK') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Wijze van blootstelling | |colspan="3"|Wijze van blootstelling | ||
Regel 454: | Regel 485: | ||
|colspan="3"|Blootstelling datum tijd | |colspan="3"|Blootstelling datum tijd | ||
|style="background-color: white;"|T - 732 dagen | |style="background-color: white;"|T - 732 dagen | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Latentietijd reactie | ||
+ | |style="background-color: white;"|12 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Tijdsduur reactie | ||
+ | |style="background-color: white;"|2 dagen | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Wijze van vaststellen | |colspan="3"|Wijze van vaststellen | ||
− | |style="background-color: white;"|History taking (procedure) (code = '84100007' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|History taking (procedure) (code = '84100007' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Zekerheid status | |colspan="3"|Zekerheid status | ||
− | |style="background-color: white;"|Suspected (qualifier value) (code = '415684004' in codeSystem 'SNOMED CT') | + | |style="background-color: white;"|Suspected (qualifier value) (code = '415684004' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Reactie verschijnsel | |colspan="3"|Reactie verschijnsel | ||
|style="background-color: white;"|Invaliderende hoofdpijn bij gebruik amlodipine | |style="background-color: white;"|Invaliderende hoofdpijn bij gebruik amlodipine | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Reactie verschijnsel | ||
+ | |style="background-color: white;"|Visusklachten | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Diagnose | |colspan="4"|Diagnose | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="3"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Diagnose naam | |colspan="2"|Diagnose naam | ||
|style="background-color: white;"|overgevoeligheidsreactie (aandoening) (code = '421961002' in codeSystem 'SNOMED Clinical Terms') | |style="background-color: white;"|overgevoeligheidsreactie (aandoening) (code = '421961002' in codeSystem 'SNOMED Clinical Terms') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Nadere specificatie diagnose naam | ||
+ | |style="background-color: white;"|Overgevoeligheidsreactie op amlodipine | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Diagnostisch inzicht datum | |colspan="3"|Diagnostisch inzicht datum | ||
Regel 479: | Regel 522: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="2"|Zorgverlener | |colspan="2"|Zorgverlener | ||
− | |style="background-color: white;"|zv-Peter-van-Pulver | + | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Registratie gegevens | |colspan="3"|Registratie gegevens | ||
− | |style="background-color: white;"|RegGegevens-pat03-reactie-01 | + | |style="background-color: white;"|Zie [[#RegGegevens-pat03-reactie-01|Registratie gegevens: RegGegevens-pat03-reactie-01]] |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Toelichting | ||
+ | |style="background-color: white;"|Toelichtingsveld bij reactie | ||
|} | |} | ||
=== Bouwstenen=== | === Bouwstenen=== | ||
Regel 495: | Regel 541: | ||
|colspan="6"|<span id="RegGegevens-pat03-BB-01" title="Intern ID = RegGegevens-pat03-BB-01">Registratie gegevens RegGegevens-pat03-BB-01</span> | |colspan="6"|<span id="RegGegevens-pat03-BB-01" title="Intern ID = RegGegevens-pat03-BB-01">Registratie gegevens RegGegevens-pat03-BB-01</span> | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="9"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Identificatienummer | |colspan="4"|Identificatienummer | ||
Regel 505: | Regel 551: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Zorgverlener | |colspan="3"|Zorgverlener | ||
− | |style="background-color: white;"|zv-Peter-van-Pulver | + | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Registratie datum tijd | ||
+ | |style="background-color: white;"|T - 108 dagen om 11:15:46 uur | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="5"|Informatiebron | |colspan="5"|Informatiebron | ||
Regel 512: | Regel 561: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Patient | |colspan="3"|Patient | ||
− | |style="background-color: white;"|Pat03 | + | |style="background-color: white;"|Zie [[#Pat03|Patient: Pat03]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|<span id="RegGegevens-pat03-BB-02" title="Intern ID = RegGegevens-pat03-BB-02">Registratie gegevens RegGegevens-pat03-BB-02</span> | |colspan="6"|<span id="RegGegevens-pat03-BB-02" title="Intern ID = RegGegevens-pat03-BB-02">Registratie gegevens RegGegevens-pat03-BB-02</span> | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
− | |rowspan=" | + | |rowspan="6"| |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Identificatienummer | |colspan="4"|Identificatienummer | ||
Regel 526: | Regel 575: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Zorgverlener | |colspan="3"|Zorgverlener | ||
− | |style="background-color: white;"|zv-Peter-van-Pulver | + | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Registratie datum tijd | ||
+ | |style="background-color: white;"|T - 50 dagen om 14:23:05 uur | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|<span id="RegGegevens-pat03-BB-03" title="Intern ID = RegGegevens-pat03-BB-03">Registratie gegevens RegGegevens-pat03-BB-03</span> | |colspan="6"|<span id="RegGegevens-pat03-BB-03" title="Intern ID = RegGegevens-pat03-BB-03">Registratie gegevens RegGegevens-pat03-BB-03</span> | ||
Regel 540: | Regel 592: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Zorgverlener | |colspan="3"|Zorgverlener | ||
− | |style="background-color: white;"|zv-Peter-van-Pulver | + | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Registratie datum tijd | |colspan="4"|Registratie datum tijd | ||
Regel 557: | Regel 609: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Zorgverlener | |colspan="3"|Zorgverlener | ||
− | |style="background-color: white;"|zv-Peter-van-Pulver | + | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Registratie datum tijd | |colspan="4"|Registratie datum tijd | ||
Regel 567: | Regel 619: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Patient | |colspan="3"|Patient | ||
− | |style="background-color: white;"|Pat03 | + | |style="background-color: white;"|Zie [[#Pat03|Patient: Pat03]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|<span id="RegGegevens-pat03-overg-01" title="Intern ID = RegGegevens-pat03-overg-01">Registratie gegevens RegGegevens-pat03-overg-01</span> | |colspan="6"|<span id="RegGegevens-pat03-overg-01" title="Intern ID = RegGegevens-pat03-overg-01">Registratie gegevens RegGegevens-pat03-overg-01</span> | ||
Regel 581: | Regel 633: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Zorgverlener | |colspan="3"|Zorgverlener | ||
− | |style="background-color: white;"|zv-Peter-van-Pulver | + | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Registratie datum tijd | |colspan="4"|Registratie datum tijd | ||
Regel 598: | Regel 650: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Zorgverlener | |colspan="3"|Zorgverlener | ||
− | |style="background-color: white;"|zv-Peter-van-Pulver | + | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] |
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Registratie datum tijd | |colspan="4"|Registratie datum tijd | ||
Regel 631: | Regel 683: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="4"|Zorgaanbieder | |colspan="4"|Zorgaanbieder | ||
− | |style="background-color: white;"|za-Huisartsenpraktijk-Pulver-en-Partners | + | |style="background-color: white;"|Zie [[#za-Huisartsenpraktijk-Pulver-en-Partners|Zorgaanbieder: za-Huisartsenpraktijk-Pulver-en-Partners]] |
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|<span id="za-Huisartsenpraktijk-Pulver-en-Partners" title="Intern ID = za-Huisartsenpraktijk-Pulver-en-Partners">Zorgaanbieder za-Huisartsenpraktijk-Pulver-en-Partners</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="10"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Zorgaanbieder identificatienummer | ||
+ | |style="background-color: white;"|00001111 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.205) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Organisatie naam | ||
+ | |style="background-color: white;"|Huisartsenpraktijk Pulver & Partners | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Adresgegevens | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="6"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Straat | ||
+ | |style="background-color: white;"|Dorpstraat | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Huisnummer | ||
+ | |style="background-color: white;"|1 | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Postcode | ||
+ | |style="background-color: white;"|1234AA | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Woonplaats | ||
+ | |style="background-color: white;"|Ons Dorp | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Adres soort | ||
+ | |style="background-color: white;"|Werkadres (code = 'WP' in codeSystem '<span title="2.16.840.1.113883.5.1119">HL7 AddressUse</span>') | ||
+ | |}<section end=cio-bgo-tst-0.3-maximaalBB /> | ||
+ | <section begin=cio-bgo-tst-0.4-relatiesBB /> | ||
+ | ==Scenario 0.4 - relaties BB, O, R== | ||
+ | |||
+ | === <span id="Pat04" title="Intern ID = Pat04">Patient</span>=== | ||
+ | |||
+ | {| class="wikitable" width="85%" | ||
+ | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="5" | <span id="_Pat04"><span id="Pat04" title="Intern ID = Pat04"><span id="Pat04" title="Intern ID = Pat04">Patient</span></span></span> | ||
+ | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
+ | |colspan="4" width="30%"| Gegevenselement | ||
+ | || Waarde | ||
+ | |||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Naamgegevens | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="6"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Voornamen | ||
+ | |style="background-color: white;"|Willem | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Initialen | ||
+ | |style="background-color: white;"|W | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Geslachtsnaam | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Achternaam | ||
+ | |style="background-color: white;"|XXX_Zwaan | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Identificatienummer | ||
+ | |style="background-color: white;"|999901199 (in identificerend systeem: BSN) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Geboortedatum | ||
+ | |style="background-color: white;"|30 nov 1985 | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Geslacht | ||
+ | |style="background-color: white;"|Man (code = 'M' in codeSystem '<span title="2.16.840.1.113883.5.1">HL7 AdministrativeGender</span>') | ||
+ | |} | ||
+ | === Geneesmiddelovergevoeligheid - PENICILLINES=== | ||
+ | |||
+ | {| class="wikitable" width="85%" | ||
+ | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="5" | Geneesmiddelovergevoeligheid - PENICILLINES | ||
+ | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
+ | |colspan="4" width="30%"| Gegevenselement | ||
+ | || Waarde | ||
+ | |||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Bewaking besluit | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="15"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Besluit type | ||
+ | |style="background-color: white;"|Started (qualifier value) (code = '385652002' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Besluit datum tijd | ||
+ | |style="background-color: white;"|T - 60 dagen om 11:15:46 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Besluit ingangs datum tijd | ||
+ | |style="background-color: white;"|T - 60 dagen om 11:15:46 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Besluit grond | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Overgevoeligheid | ||
+ | |style="background-color: white;"|Zie [[#pat04-overgevoeligheid-01|Overgevoeligheid: pat04-overgevoeligheid-01]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Te bewaken stof | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Onveilige stof | ||
+ | |style="background-color: white;"|PENICILLINES (code = '35' in codeSystem 'G-Standaard Ongewenste medicatiegroepen') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Beslisser | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Registratie gegevens | ||
+ | |style="background-color: white;"|Zie [[#RegGegevens-pat04-BB-01|Registratie gegevens: RegGegevens-pat04-BB-01]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Toelichting | ||
+ | |style="background-color: white;"|Uit voorzorg breed bewaken | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|<span id="pat04-overgevoeligheid-01" title="Intern ID = pat04-overgevoeligheid-01">Overgevoeligheid pat04-overgevoeligheid-01</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="22"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening begin datum tijd | ||
+ | |style="background-color: white;"|T - 65 dagen om 18:00 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening ernst | ||
+ | |style="background-color: white;"|Matig (code = '6736007' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening aanwezigheid | ||
+ | |style="background-color: white;"|Known present (qualifier value) (code = '410515003' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening status datum | ||
+ | |style="background-color: white;"|T - 60 dagen om 11:15:46 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Agens | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Stof | ||
+ | |style="background-color: white;"|FLUCLOXACILLINE (code = '40991' in codeSystem 'G-Standaard generieke namen') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Wijze van vaststellen | ||
+ | |style="background-color: white;"|History taking (procedure) (code = '84100007' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zekerheid status | ||
+ | |style="background-color: white;"|Suspected (qualifier value) (code = '415684004' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Overgevoeligheid categorie | ||
+ | |style="background-color: white;"|geneesmiddelen (code = '419511003' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Verwacht risico bij blootstelling | ||
+ | |style="background-color: white;"|Mild (qualifier value) (code = '255604002' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Diagnose | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="3"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Diagnose naam | ||
+ | |style="background-color: white;"|overgevoeligheid voor meerdere geneesmiddelen (aandoening) (code = '735458004' in codeSystem 'SNOMED Clinical Terms') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Nadere specificatie diagnose naam | ||
+ | |style="background-color: white;"|overgevoeligheid voor Flucloxacilline | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Diagnostisch inzicht datum | ||
+ | |style="background-color: white;"|T - 60 dagen om 11:15:46 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Diagnose steller | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Registratie gegevens | ||
+ | |style="background-color: white;"|Zie [[#RegGegevens-pat04-overg-01|Registratie gegevens: RegGegevens-pat04-overg-01]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Toelichting | ||
+ | |style="background-color: white;"|mogelijk sprake van overgevoeligheid op meerdere geneesmiddelen | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|<span id="pat04-reactie-01" title="Intern ID = pat04-reactie-01">Reactie pat04-reactie-01</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="27"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening begin datum tijd | ||
+ | |style="background-color: white;"|T - 65 dagen om 18:00 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening ernst | ||
+ | |style="background-color: white;"|Matig (code = '6736007' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening aanwezigheid | ||
+ | |style="background-color: white;"|Known present (qualifier value) (code = '410515003' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening status datum | ||
+ | |style="background-color: white;"|T - 60 dagen om 11:15:46 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Veroorzaker | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Veroorzakende stof | ||
+ | |style="background-color: white;"|FLUCLOXACILLINE (code = '40991' in codeSystem 'G-Standaard generieke namen') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Wijze van blootstelling | ||
+ | |style="background-color: white;"|ORAAL (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Blootstelling datum tijd | ||
+ | |style="background-color: white;"|T - 65 dagen om 10:00 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Latentietijd reactie | ||
+ | |style="background-color: white;"|8 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Tijdsduur reactie | ||
+ | |style="background-color: white;"|2 dagen | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Wijze van vaststellen | ||
+ | |style="background-color: white;"|History taking (procedure) (code = '84100007' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zekerheid status | ||
+ | |style="background-color: white;"|Suspected (qualifier value) (code = '415684004' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Reactie verschijnsel | ||
+ | |style="background-color: white;"|huiduitslag, gegeneraliseerd | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Diagnose | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="3"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Diagnose naam | ||
+ | |style="background-color: white;"|ongewenste reactie (aandoening) (code = '281647001' in codeSystem 'SNOMED Clinical Terms') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Nadere specificatie diagnose naam | ||
+ | |style="background-color: white;"|ongewenste reactie op flucloxacilline | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Diagnostisch inzicht datum | ||
+ | |style="background-color: white;"|T - 60 dagen om 11:15:46 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Diagnose steller | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Relatie overgevoeligheid | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Identificatie | ||
+ | |style="background-color: white;"|pat04-overgevoeligheid-01 | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Registratie gegevens | ||
+ | |style="background-color: white;"|Zie [[#RegGegevens-pat04-reactie-01|Registratie gegevens: RegGegevens-pat04-reactie-01]] | ||
+ | |} | ||
+ | === Geneesmiddelovergevoeligheid - PENICILLINES=== | ||
+ | |||
+ | {| class="wikitable" width="85%" | ||
+ | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="5" | Geneesmiddelovergevoeligheid - PENICILLINES | ||
+ | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
+ | |colspan="4" width="30%"| Gegevenselement | ||
+ | || Waarde | ||
+ | |||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Bewaking besluit | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="18"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Besluit type | ||
+ | |style="background-color: white;"|Discontinued (qualifier value) (code = '410546004' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Besluit datum tijd | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Besluit ingangs datum tijd | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Besluit grond | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Overgevoeligheid | ||
+ | |style="background-color: white;"|Zie [[#pat04-overgevoeligheid-02|Overgevoeligheid: pat04-overgevoeligheid-02]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Te bewaken stof | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Onveilige stof | ||
+ | |style="background-color: white;"|PENICILLINES (code = '35' in codeSystem 'G-Standaard Ongewenste medicatiegroepen') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Beslisser | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Relatie bewaking besluit | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Identificatie | ||
+ | |style="background-color: white;"|pat04-BB-01 | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Registratie gegevens | ||
+ | |style="background-color: white;"|Zie [[#RegGegevens-pat04-BB-02|Registratie gegevens: RegGegevens-pat04-BB-02]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Toelichting | ||
+ | |style="background-color: white;"|de te bewaken stof moet aangepast worden | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|<span id="pat04-overgevoeligheid-02" title="Intern ID = pat04-overgevoeligheid-02">Overgevoeligheid pat04-overgevoeligheid-02</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="25"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening begin datum tijd | ||
+ | |style="background-color: white;"|T - 65 dagen om 18:00 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening ernst | ||
+ | |style="background-color: white;"|Matig (code = '6736007' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening aanwezigheid | ||
+ | |style="background-color: white;"|Known absent (qualifier value) (code = '410516002' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening status datum | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Agens | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Stof | ||
+ | |style="background-color: white;"|FLUCLOXACILLINE (code = '40991' in codeSystem '<span title="2.16.840.1.113883.2.4.4.1.750">G-Standaard SNK</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Wijze van vaststellen | ||
+ | |style="background-color: white;"|History taking (procedure) (code = '84100007' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zekerheid status | ||
+ | |style="background-color: white;"|Suspected (qualifier value) (code = '415684004' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Overgevoeligheid categorie | ||
+ | |style="background-color: white;"|geneesmiddelen (code = '419511003' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Verwacht risico bij blootstelling | ||
+ | |style="background-color: white;"|Mild (qualifier value) (code = '255604002' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Diagnose | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="3"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Diagnose naam | ||
+ | |style="background-color: white;"|overgevoeligheid voor meerdere geneesmiddelen (aandoening) (code = '735458004' in codeSystem 'SNOMED Clinical Terms') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Nadere specificatie diagnose naam | ||
+ | |style="background-color: white;"|overgevoeligheid voor Flucloxacilline | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Diagnostisch inzicht datum | ||
+ | |style="background-color: white;"|T - 60 dagen om 11:15:46 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Diagnose steller | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Relatie overgevoeligheid | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Identificatie | ||
+ | |style="background-color: white;"|pat04-overgevoeligheid-01 | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Registratie gegevens | ||
+ | |style="background-color: white;"|Zie [[#RegGegevens-pat04-overg-02|Registratie gegevens: RegGegevens-pat04-overg-02]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Toelichting | ||
+ | |style="background-color: white;"|mogelijk sprake van overgevoeligheid op meerdere geneesmiddelen | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|<span id="pat04-reactie-02" title="Intern ID = pat04-reactie-02">Reactie pat04-reactie-02</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="29"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening begin datum tijd | ||
+ | |style="background-color: white;"|T - 65 dagen om 18:00 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening ernst | ||
+ | |style="background-color: white;"|Matig (code = '6736007' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening aanwezigheid | ||
+ | |style="background-color: white;"|Known absent (qualifier value) (code = '410516002' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening status datum | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Veroorzaker | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Veroorzakende stof | ||
+ | |style="background-color: white;"|FLUCLOXACILLINE (code = '40991' in codeSystem 'G-Standaard generieke namen') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Wijze van blootstelling | ||
+ | |style="background-color: white;"|ORAAL (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Blootstelling datum tijd | ||
+ | |style="background-color: white;"|T - 65 dagen om 10:00 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Latentietijd reactie | ||
+ | |style="background-color: white;"|8 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Tijdsduur reactie | ||
+ | |style="background-color: white;"|2 dagen | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Wijze van vaststellen | ||
+ | |style="background-color: white;"|History taking (procedure) (code = '84100007' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zekerheid status | ||
+ | |style="background-color: white;"|Suspected (qualifier value) (code = '415684004' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Reactie verschijnsel | ||
+ | |style="background-color: white;"|huiduitslag, gegeneraliseerd | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Diagnose | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Diagnose naam | ||
+ | |style="background-color: white;"|ongewenste reactie (aandoening) (code = '281647001' in codeSystem 'SNOMED Clinical Terms') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Diagnostisch inzicht datum | ||
+ | |style="background-color: white;"|T - 60 dagen om 11:15:46 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Diagnose steller | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Relatie overgevoeligheid | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Identificatie | ||
+ | |style="background-color: white;"|pat04-overgevoeligheid-02 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.3) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Relatie reactie | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Identificatie | ||
+ | |style="background-color: white;"|pat04-reactie-01 | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Registratie gegevens | ||
+ | |style="background-color: white;"|Zie [[#RegGegevens-pat04-reactie-02|Registratie gegevens: RegGegevens-pat04-reactie-02]] | ||
+ | |} | ||
+ | === Geneesmiddelovergevoeligheid - PENICILLINES=== | ||
+ | |||
+ | {| class="wikitable" width="85%" | ||
+ | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="5" | Geneesmiddelovergevoeligheid - PENICILLINES | ||
+ | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
+ | |colspan="4" width="30%"| Gegevenselement | ||
+ | || Waarde | ||
+ | |||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Bewaking besluit | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="19"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Besluit type | ||
+ | |style="background-color: white;"|Started (qualifier value) (code = '385652002' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Besluit datum tijd | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Besluit ingangs datum tijd | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Besluit grond | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Overgevoeligheid | ||
+ | |style="background-color: white;"|Zie [[#pat04-overgevoeligheid-03|Overgevoeligheid: pat04-overgevoeligheid-03]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Te bewaken stof | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="4"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Onveilige stof | ||
+ | |style="background-color: white;"|PENICILLINES (code = '35' in codeSystem 'G-Standaard Ongewenste medicatiegroepen') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Veilig binnen onveilige groep | ||
+ | |style="background-color: white;"|FENOXYMETHYLPENICILLINE (code = '1051555' in codeSystem 'G Standaard HPK') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Veilig binnen onveilige groep | ||
+ | |style="background-color: white;"|BENZYLPENICILLINE VOOR INFUSIE (code = '2477696' in codeSystem 'G Standaard HPK') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Beslisser | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Relatie bewaking besluit | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Identificatie | ||
+ | |style="background-color: white;"|pat04-BB-02 | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Registratie gegevens | ||
+ | |style="background-color: white;"|Zie [[#RegGegevens-pat04-BB-03|Registratie gegevens: RegGegevens-pat04-BB-03]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|<span id="pat04-overgevoeligheid-03" title="Intern ID = pat04-overgevoeligheid-03">Overgevoeligheid pat04-overgevoeligheid-03</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="25"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening begin datum tijd | ||
+ | |style="background-color: white;"|T - 65 dagen om 18:00 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening ernst | ||
+ | |style="background-color: white;"|Matig (code = '6736007' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening aanwezigheid | ||
+ | |style="background-color: white;"|Known present (qualifier value) (code = '410515003' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening status datum | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Agens | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Stof | ||
+ | |style="background-color: white;"|PENICILLINES (code = '35' in codeSystem 'G-Standaard Ongewenste medicatiegroepen') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Wijze van vaststellen | ||
+ | |style="background-color: white;"|History and physical examination with evaluation and management of patient (procedure) (code = '14736009' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zekerheid status | ||
+ | |style="background-color: white;"|Confirmed present (qualifier value) (code = '410605003' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Overgevoeligheid categorie | ||
+ | |style="background-color: white;"|geneesmiddelen (code = '419511003' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Verwacht risico bij blootstelling | ||
+ | |style="background-color: white;"|Mild (qualifier value) (code = '255604002' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Diagnose | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="3"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Diagnose naam | ||
+ | |style="background-color: white;"|overgevoeligheid voor meerdere geneesmiddelen (aandoening) (code = '735458004' in codeSystem 'SNOMED Clinical Terms') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Nadere specificatie diagnose naam | ||
+ | |style="background-color: white;"|Overgevoeligheid voor penicillines | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Diagnostisch inzicht datum | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Diagnose steller | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Relatie overgevoeligheid | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Identificatie | ||
+ | |style="background-color: white;"|pat04-overgevoeligheid-02 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.3) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Registratie gegevens | ||
+ | |style="background-color: white;"|Zie [[#RegGegevens-pat04-overg-03|Registratie gegevens: RegGegevens-pat04-overg-03]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Toelichting | ||
+ | |style="background-color: white;"|Vastgesteld middels huidpriktest. | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|<span id="pat04-reactie-03" title="Intern ID = pat04-reactie-03">Reactie pat04-reactie-03</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="30"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening begin datum tijd | ||
+ | |style="background-color: white;"|T - 65 dagen om 18:00 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening ernst | ||
+ | |style="background-color: white;"|Matig (code = '6736007' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening aanwezigheid | ||
+ | |style="background-color: white;"|Known present (qualifier value) (code = '410515003' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Aandoening status datum | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Veroorzaker | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Veroorzakende stof | ||
+ | |style="background-color: white;"|FLUCLOXACILLINE (code = '40991' in codeSystem 'G-Standaard generieke namen') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Wijze van blootstelling | ||
+ | |style="background-color: white;"|ORAAL (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Blootstelling datum tijd | ||
+ | |style="background-color: white;"|T - 65 dagen om 10:00 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Latentietijd reactie | ||
+ | |style="background-color: white;"|8 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Tijdsduur reactie | ||
+ | |style="background-color: white;"|2 dagen | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Wijze van vaststellen | ||
+ | |style="background-color: white;"|History taking (procedure) (code = '84100007' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zekerheid status | ||
+ | |style="background-color: white;"|Confirmed present (qualifier value) (code = '410605003' in codeSystem '<span title="2.16.840.1.113883.6.96">SNOMED CT</span>') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Reactie verschijnsel | ||
+ | |style="background-color: white;"|huiduitslag, gegeneraliseerd | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Diagnose | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="3"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Diagnose naam | ||
+ | |style="background-color: white;"|ongewenste reactie (aandoening) (code = '281647001' in codeSystem 'SNOMED Clinical Terms') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Nadere specificatie diagnose naam | ||
+ | |style="background-color: white;"|ongewenste reactie op flucloxacilline | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Diagnostisch inzicht datum | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Diagnose steller | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Relatie overgevoeligheid | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Identificatie | ||
+ | |style="background-color: white;"|pat04-overgevoeligheid-03 | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Relatie reactie | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Identificatie | ||
+ | |style="background-color: white;"|pat04-reactie-02 | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Registratie gegevens | ||
+ | |style="background-color: white;"|Zie [[#RegGegevens-pat04-reactie-03|Registratie gegevens: RegGegevens-pat04-reactie-03]] | ||
+ | |} | ||
+ | === Bouwstenen=== | ||
+ | |||
+ | {| class="wikitable" width="85%" | ||
+ | |style="background-color: #1F497D;; color: white; font-weight: bold; text-align:center;" colspan="6" | Bouwstenen | ||
+ | |-style="background-color: #1F497D;; color: white; text-align:left;" | ||
+ | |colspan="5" width="30%"| Gegevenselement | ||
+ | || Waarde | ||
+ | |||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|<span id="RegGegevens-pat04-BB-01" title="Intern ID = RegGegevens-pat04-BB-01">Registratie gegevens RegGegevens-pat04-BB-01</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="9"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Identificatienummer | ||
+ | |style="background-color: white;"|pat04-BB-01 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.754) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Auteur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Registratie datum tijd | ||
+ | |style="background-color: white;"|T - 60 dagen om 11:15:46 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Informatiebron | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|<span id="RegGegevens-pat04-BB-02" title="Intern ID = RegGegevens-pat04-BB-02">Registratie gegevens RegGegevens-pat04-BB-02</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="6"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Identificatienummer | ||
+ | |style="background-color: white;"|pat04-BB-02 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.754) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Auteur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Registratie datum tijd | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|<span id="RegGegevens-pat04-BB-03" title="Intern ID = RegGegevens-pat04-BB-03">Registratie gegevens RegGegevens-pat04-BB-03</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="6"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Identificatienummer | ||
+ | |style="background-color: white;"|pat04-BB-03 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.754) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Auteur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Registratie datum tijd | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|<span id="RegGegevens-pat04-overg-03" title="Intern ID = RegGegevens-pat04-overg-03">Registratie gegevens RegGegevens-pat04-overg-03</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="6"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Identificatienummer | ||
+ | |style="background-color: white;"|pat04-overgevoeligheid-03 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.3) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Auteur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Registratie datum tijd | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|<span id="RegGegevens-pat04-reactie-03" title="Intern ID = RegGegevens-pat04-reactie-03">Registratie gegevens RegGegevens-pat04-reactie-03</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="6"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Identificatienummer | ||
+ | |style="background-color: white;"|pat04-reactie-03 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.4) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Auteur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Registratie datum tijd | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|<span id="RegGegevens-pat04-overg-01" title="Intern ID = RegGegevens-pat04-overg-01">Registratie gegevens RegGegevens-pat04-overg-01</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="6"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Identificatienummer | ||
+ | |style="background-color: white;"|pat04-overgevoeligheid-01 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.3) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Auteur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Registratie datum tijd | ||
+ | |style="background-color: white;"|T - 60 dagen om 11:15:46 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|<span id="RegGegevens-pat04-reactie-01" title="Intern ID = RegGegevens-pat04-reactie-01">Registratie gegevens RegGegevens-pat04-reactie-01</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="6"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Identificatienummer | ||
+ | |style="background-color: white;"|pat04-reactie-01 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.4) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Auteur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Registratie datum tijd | ||
+ | |style="background-color: white;"|T - 60 dagen om 11:15:46 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|<span id="RegGegevens-pat04-overg-02" title="Intern ID = RegGegevens-pat04-overg-02">Registratie gegevens RegGegevens-pat04-overg-02</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="6"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Identificatienummer | ||
+ | |style="background-color: white;"|pat04-overgevoeligheid-02 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.3) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Auteur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Registratie datum tijd | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|<span id="RegGegevens-pat04-reactie-02" title="Intern ID = RegGegevens-pat04-reactie-02">Registratie gegevens RegGegevens-pat04-reactie-02</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="6"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Identificatienummer | ||
+ | |style="background-color: white;"|pat04-reactie-02 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.4) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Auteur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="2"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Zorgverlener | ||
+ | |style="background-color: white;"|Zie [[#zv-Peter-van-Pulver|Zorgverlener: zv-Peter-van-Pulver]] | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Registratie datum tijd | ||
+ | |style="background-color: white;"|T - 10 dagen om 15:55:30 uur | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="6"|<span id="zv-Peter-van-Pulver" title="Intern ID = zv-Peter-van-Pulver">Zorgverlener zv-Peter-van-Pulver</span> | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="11"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Zorgverlener identificatienummer | ||
+ | |style="background-color: white;"|000001111 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.139) | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="5"|Naamgegevens | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="6"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="3"|Voornamen | ||
+ | |style="background-color: white;"|Peter | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Geslachtsnaam | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |rowspan="3"| | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Voorvoegsels | ||
+ | |style="background-color: white;"|van | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="2"|Achternaam | ||
+ | |style="background-color: white;"|Pulver | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Specialisme | ||
+ | |style="background-color: white;"|Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | ||
+ | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
+ | |colspan="4"|Zorgaanbieder | ||
+ | |style="background-color: white;"|Zie [[#za-Huisartsenpraktijk-Pulver-en-Partners|Zorgaanbieder: za-Huisartsenpraktijk-Pulver-en-Partners]] | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="6"|<span id="za-Huisartsenpraktijk-Pulver-en-Partners" title="Intern ID = za-Huisartsenpraktijk-Pulver-en-Partners">Zorgaanbieder za-Huisartsenpraktijk-Pulver-en-Partners</span> | |colspan="6"|<span id="za-Huisartsenpraktijk-Pulver-en-Partners" title="Intern ID = za-Huisartsenpraktijk-Pulver-en-Partners">Zorgaanbieder za-Huisartsenpraktijk-Pulver-en-Partners</span> | ||
Regel 660: | Regel 1.572: | ||
|-style="vertical-align:top; background-color: #E3E3E3;;" | |-style="vertical-align:top; background-color: #E3E3E3;;" | ||
|colspan="3"|Adres soort | |colspan="3"|Adres soort | ||
− | |style="background-color: white;"|Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') | + | |style="background-color: white;"|Werkadres (code = 'WP' in codeSystem '<span title="2.16.840.1.113883.5.1119">HL7 AddressUse</span>') |
− | |}<section end=cio- | + | |}<section end=cio-bgo-tst-0.4-relatiesBB /> |
Huidige versie van 26 mrt 2024 om 17:10
Inhoud
1 Addenda voor inhoudelijke gegevens
1.1 Scenario 0.2 - minimaal BB
1.1.1 Patient
Patient | ||||
Gegevenselement | Waarde | |||
Naamgegevens | ||||
Voornamen | Petra | |||
Initialen | P | |||
Geslachtsnaam | ||||
Achternaam | XXX_Drijkoningen | |||
Identificatienummer | 999900523 (in identificerend systeem: BSN) | |||
Geboortedatum | 25 okt 1963 | |||
Geslacht | Vrouw (code = 'F' in codeSystem 'HL7 AdministrativeGender') |
1.1.2 Geneesmiddelovergevoeligheid - IBUPROFEN
Geneesmiddelovergevoeligheid - IBUPROFEN | ||||
Gegevenselement | Waarde | |||
Bewaking besluit | ||||
Besluit type | Started (qualifier value) (code = '385652002' in codeSystem 'SNOMED CT') | |||
Besluit datum tijd | T - 30 dagen om 09:10:54 uur | |||
Besluit ingangs datum tijd | T - 30 dagen om 09:10:54 uur | |||
Te bewaken stof | ||||
Onveilige stof | IBUPROFEN (code = '1155' in codeSystem 'G-Standaard generieke namen (bestand 750)') | |||
Beslisser | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Registratie gegevens | Zie Registratie gegevens: RegGeg-pat02-BB-01 | |||
Toelichting | zwelling van lippen en tong na gebruik van ibuprofen tabletten |
1.1.3 Bouwstenen
Bouwstenen | |||||
Gegevenselement | Waarde | ||||
Registratie gegevens RegGeg-pat02-BB-01 | |||||
Identificatienummer | pat02-BB-01 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.754) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 30 dagen om 09:10:54 uur | ||||
Zorgverlener zv-Peter-van-Pulver | |||||
Zorgverlener identificatienummer | 000001111 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.139) | ||||
Naamgegevens | |||||
Voornamen | Peter | ||||
Geslachtsnaam | |||||
Voorvoegsels | van | ||||
Achternaam | Pulver | ||||
Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | ||||
Zorgaanbieder | Zie Zorgaanbieder: za-Huisartsenpraktijk-Pulver-en-Partners | ||||
Zorgaanbieder za-Huisartsenpraktijk-Pulver-en-Partners | |||||
Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.205) | ||||
Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
Adresgegevens | |||||
Straat | Dorpstraat | ||||
Huisnummer | 1 | ||||
Postcode | 1234AA | ||||
Woonplaats | Ons Dorp | ||||
Adres soort | Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') |
1.2 Scenario 0.3 - maximaal BB, O, R
1.2.1 Patient
Patient | ||||
Gegevenselement | Waarde | |||
Naamgegevens | ||||
Voornamen | Erwin | |||
Initialen | E | |||
Geslachtsnaam | ||||
Achternaam | XXX_Dubbeld | |||
Identificatienummer | 999900535 (in identificerend systeem: BSN) | |||
Geboortedatum | 26 okt 1963 | |||
Geslacht | Man (code = 'M' in codeSystem 'HL7 AdministrativeGender') |
1.2.2 Geneesmiddelovergevoeligheid - PENICILLINES
Geneesmiddelovergevoeligheid - PENICILLINES | ||||
Gegevenselement | Waarde | |||
Bewaking besluit | ||||
Besluit type | Started (qualifier value) (code = '385652002' in codeSystem 'SNOMED CT') | |||
Besluit datum tijd | T - 108 dagen om 11:15:46 uur | |||
Besluit ingangs datum tijd | T - 108 dagen om 11:15:46 uur | |||
Te bewaken stof | ||||
Onveilige stof | PENICILLINES (code = '35' in codeSystem 'G-Standaard Ongewenste medicatiegroepen') | |||
Beslisser | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat03-BB-01 | |||
Toelichting | Patiënt heeft aangegeven in het verleden allergische reacties te hebben gehad na gebruik penicilline. |
1.2.3 Geneesmiddelovergevoeligheid - PENICILLINES
Geneesmiddelovergevoeligheid - PENICILLINES | ||||
Gegevenselement | Waarde | |||
Bewaking besluit | ||||
Besluit type | Discontinued (qualifier value) (code = '410546004' in codeSystem 'SNOMED CT') | |||
Besluit datum tijd | T - 50 dagen om 14:23:05 uur | |||
Besluit ingangs datum tijd | T - 50 dagen om 14:23:05 uur | |||
Te bewaken stof | ||||
Onveilige stof | PENICILLINES (code = '35' in codeSystem 'G-Standaard Ongewenste medicatiegroepen') | |||
Beslisser | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Relatie bewaking besluit | ||||
Identificatie | pat03-BB-01 | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat03-BB-02 | |||
Toelichting | Bewaking op volledige groep penicillines stopgezet, omdat patiënt wel goed reageert op flucloxacilline. |
1.2.4 Geneesmiddelovergevoeligheid - PENICILLINES
Geneesmiddelovergevoeligheid - PENICILLINES | ||||
Gegevenselement | Waarde | |||
Bewaking besluit | ||||
Besluit type | Started (qualifier value) (code = '385652002' in codeSystem 'SNOMED CT') | |||
Besluit datum tijd | T - 50 dagen om 14:25:30 uur | |||
Besluit ingangs datum tijd | T - 50 dagen om 14:25:30 uur | |||
Besluit grond | ||||
Overgevoeligheid | Zie Overgevoeligheid: pat03-overgevoeligheid-01 | |||
Te bewaken stof | ||||
Onveilige stof | PENICILLINES (code = '35' in codeSystem 'G-Standaard Ongewenste medicatiegroepen') | |||
Veilig binnen onveilige groep | FLUCLOXACILLINE (code = '40991' in codeSystem 'G-Standaard generieke namen (Bestand 750)') | |||
Beslisser | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat03-BB-03 | |||
Overgevoeligheid pat03-overgevoeligheid-01 | ||||
Aandoening begin datum tijd | T - 105 dagen | |||
Aandoening ernst | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||
Aandoening aanwezigheid | Known present (qualifier value) (code = '410515003' in codeSystem 'SNOMED CT') | |||
Aandoening status datum | T - 50 dagen | |||
Agens | ||||
Stof | PENICILLINES (code = '35' in codeSystem 'G-Standaard Ongewenste medicatiegroepen') | |||
Wijze van vaststellen | History and physical examination with evaluation and management of patient (procedure) (code = '14736009' in codeSystem 'SNOMED CT') | |||
Zekerheid status | Confirmed present (qualifier value) (code = '410605003' in codeSystem 'SNOMED CT') | |||
Overgevoeligheid categorie | geneesmiddelen (code = '419511003' in codeSystem 'SNOMED CT') | |||
Verwacht risico bij blootstelling | Severe (severity modifier) (qualifier value) (code = '24484000' in codeSystem 'SNOMED CT') | |||
Diagnose | ||||
Diagnose naam | overgevoeligheid voor meerdere geneesmiddelen (aandoening) (code = '735458004' in codeSystem 'SNOMED Clinical Terms') | |||
Nadere specificatie diagnose naam | Overgevoeligheid voor penicillines | |||
Diagnostisch inzicht datum | T - 50 dagen | |||
Diagnose steller | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat03-overg-01 | |||
Toelichting | Vastgesteld middels huidpriktest. Flucloxacilline wordt wel goed verdragen door patiënt. |
1.2.5 Geneesmiddelovergevoeligheid - AMLODIPINE
Geneesmiddelovergevoeligheid - AMLODIPINE | ||||
Gegevenselement | Waarde | |||
Bewaking besluit | ||||
Besluit type | Started (qualifier value) (code = '385652002' in codeSystem 'SNOMED CT') | |||
Besluit datum tijd | T - 730 dagen om 09:57:02 uur | |||
Besluit ingangs datum tijd | T - 730 dagen om 09:57:02 uur | |||
Besluit grond | ||||
Reactie | Zie Reactie: pat03-reactie-01 | |||
Te bewaken stof | ||||
Onveilige stof | AMLODIPINE (code = '62081' in codeSystem 'G-Standaard generieke namen (bestand 750)') | |||
Beslisser | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat03-BB-04 | |||
Toelichting | Invaliderende bijwerking bij amlodipine tablet gebruik i.h.k.v. angina pectoris | |||
Reactie pat03-reactie-01 | ||||
Aandoening begin datum tijd | T - 732 dagen | |||
Aandoening ernst | Ernstig (code = '24484000' in codeSystem 'SNOMED CT') | |||
Aandoening aanwezigheid | Known present (qualifier value) (code = '410515003' in codeSystem 'SNOMED CT') | |||
Aandoening status datum | T - 732 dagen | |||
Veroorzaker | ||||
Veroorzakende stof | NORVASC TABLET 5MG (code = '642916' in codeSystem 'G-Standaard HPK') | |||
Wijze van blootstelling | ORAAL (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | |||
Blootstelling datum tijd | T - 732 dagen | |||
Latentietijd reactie | 12 uur | |||
Tijdsduur reactie | 2 dagen | |||
Wijze van vaststellen | History taking (procedure) (code = '84100007' in codeSystem 'SNOMED CT') | |||
Zekerheid status | Suspected (qualifier value) (code = '415684004' in codeSystem 'SNOMED CT') | |||
Reactie verschijnsel | Invaliderende hoofdpijn bij gebruik amlodipine | |||
Reactie verschijnsel | Visusklachten | |||
Diagnose | ||||
Diagnose naam | overgevoeligheidsreactie (aandoening) (code = '421961002' in codeSystem 'SNOMED Clinical Terms') | |||
Nadere specificatie diagnose naam | Overgevoeligheidsreactie op amlodipine | |||
Diagnostisch inzicht datum | T - 732 dagen | |||
Diagnose steller | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat03-reactie-01 | |||
Toelichting | Toelichtingsveld bij reactie |
1.2.6 Bouwstenen
Bouwstenen | |||||
Gegevenselement | Waarde | ||||
Registratie gegevens RegGegevens-pat03-BB-01 | |||||
Identificatienummer | pat03-BB-01 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.754) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 108 dagen om 11:15:46 uur | ||||
Informatiebron | |||||
Patient | Zie Patient: Pat03 | ||||
Registratie gegevens RegGegevens-pat03-BB-02 | |||||
Identificatienummer | pat03-BB-02 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.754) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 50 dagen om 14:23:05 uur | ||||
Registratie gegevens RegGegevens-pat03-BB-03 | |||||
Identificatienummer | pat03-BB-03 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.754) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 50 dagen om 14:25:30 uur | ||||
Registratie gegevens RegGegevens-pat03-BB-04 | |||||
Identificatienummer | pat03-BB-04 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.754) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 730 dagen om 09:57:02 uur | ||||
Informatiebron | |||||
Patient | Zie Patient: Pat03 | ||||
Registratie gegevens RegGegevens-pat03-overg-01 | |||||
Identificatienummer | pat03-overgevoeligheid-01 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.3) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 50 dagen om 14:25:30 uur | ||||
Registratie gegevens RegGegevens-pat03-reactie-01 | |||||
Identificatienummer | pat03-reactie-01 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.4) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 730 dagen om 09:57:02 uur | ||||
Zorgverlener zv-Peter-van-Pulver | |||||
Zorgverlener identificatienummer | 000001111 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.139) | ||||
Naamgegevens | |||||
Voornamen | Peter | ||||
Geslachtsnaam | |||||
Voorvoegsels | van | ||||
Achternaam | Pulver | ||||
Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | ||||
Zorgaanbieder | Zie Zorgaanbieder: za-Huisartsenpraktijk-Pulver-en-Partners | ||||
Zorgaanbieder za-Huisartsenpraktijk-Pulver-en-Partners | |||||
Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.205) | ||||
Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
Adresgegevens | |||||
Straat | Dorpstraat | ||||
Huisnummer | 1 | ||||
Postcode | 1234AA | ||||
Woonplaats | Ons Dorp | ||||
Adres soort | Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') |
1.3 Scenario 0.4 - relaties BB, O, R
1.3.1 Patient
Patient | ||||
Gegevenselement | Waarde | |||
Naamgegevens | ||||
Voornamen | Willem | |||
Initialen | W | |||
Geslachtsnaam | ||||
Achternaam | XXX_Zwaan | |||
Identificatienummer | 999901199 (in identificerend systeem: BSN) | |||
Geboortedatum | 30 nov 1985 | |||
Geslacht | Man (code = 'M' in codeSystem 'HL7 AdministrativeGender') |
1.3.2 Geneesmiddelovergevoeligheid - PENICILLINES
Geneesmiddelovergevoeligheid - PENICILLINES | ||||
Gegevenselement | Waarde | |||
Bewaking besluit | ||||
Besluit type | Started (qualifier value) (code = '385652002' in codeSystem 'SNOMED CT') | |||
Besluit datum tijd | T - 60 dagen om 11:15:46 uur | |||
Besluit ingangs datum tijd | T - 60 dagen om 11:15:46 uur | |||
Besluit grond | ||||
Overgevoeligheid | Zie Overgevoeligheid: pat04-overgevoeligheid-01 | |||
Te bewaken stof | ||||
Onveilige stof | PENICILLINES (code = '35' in codeSystem 'G-Standaard Ongewenste medicatiegroepen') | |||
Beslisser | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat04-BB-01 | |||
Toelichting | Uit voorzorg breed bewaken | |||
Overgevoeligheid pat04-overgevoeligheid-01 | ||||
Aandoening begin datum tijd | T - 65 dagen om 18:00 uur | |||
Aandoening ernst | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||
Aandoening aanwezigheid | Known present (qualifier value) (code = '410515003' in codeSystem 'SNOMED CT') | |||
Aandoening status datum | T - 60 dagen om 11:15:46 uur | |||
Agens | ||||
Stof | FLUCLOXACILLINE (code = '40991' in codeSystem 'G-Standaard generieke namen') | |||
Wijze van vaststellen | History taking (procedure) (code = '84100007' in codeSystem 'SNOMED CT') | |||
Zekerheid status | Suspected (qualifier value) (code = '415684004' in codeSystem 'SNOMED CT') | |||
Overgevoeligheid categorie | geneesmiddelen (code = '419511003' in codeSystem 'SNOMED CT') | |||
Verwacht risico bij blootstelling | Mild (qualifier value) (code = '255604002' in codeSystem 'SNOMED CT') | |||
Diagnose | ||||
Diagnose naam | overgevoeligheid voor meerdere geneesmiddelen (aandoening) (code = '735458004' in codeSystem 'SNOMED Clinical Terms') | |||
Nadere specificatie diagnose naam | overgevoeligheid voor Flucloxacilline | |||
Diagnostisch inzicht datum | T - 60 dagen om 11:15:46 uur | |||
Diagnose steller | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat04-overg-01 | |||
Toelichting | mogelijk sprake van overgevoeligheid op meerdere geneesmiddelen | |||
Reactie pat04-reactie-01 | ||||
Aandoening begin datum tijd | T - 65 dagen om 18:00 uur | |||
Aandoening ernst | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||
Aandoening aanwezigheid | Known present (qualifier value) (code = '410515003' in codeSystem 'SNOMED CT') | |||
Aandoening status datum | T - 60 dagen om 11:15:46 uur | |||
Veroorzaker | ||||
Veroorzakende stof | FLUCLOXACILLINE (code = '40991' in codeSystem 'G-Standaard generieke namen') | |||
Wijze van blootstelling | ORAAL (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | |||
Blootstelling datum tijd | T - 65 dagen om 10:00 uur | |||
Latentietijd reactie | 8 uur | |||
Tijdsduur reactie | 2 dagen | |||
Wijze van vaststellen | History taking (procedure) (code = '84100007' in codeSystem 'SNOMED CT') | |||
Zekerheid status | Suspected (qualifier value) (code = '415684004' in codeSystem 'SNOMED CT') | |||
Reactie verschijnsel | huiduitslag, gegeneraliseerd | |||
Diagnose | ||||
Diagnose naam | ongewenste reactie (aandoening) (code = '281647001' in codeSystem 'SNOMED Clinical Terms') | |||
Nadere specificatie diagnose naam | ongewenste reactie op flucloxacilline | |||
Diagnostisch inzicht datum | T - 60 dagen om 11:15:46 uur | |||
Diagnose steller | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Relatie overgevoeligheid | ||||
Identificatie | pat04-overgevoeligheid-01 | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat04-reactie-01 |
1.3.3 Geneesmiddelovergevoeligheid - PENICILLINES
Geneesmiddelovergevoeligheid - PENICILLINES | ||||
Gegevenselement | Waarde | |||
Bewaking besluit | ||||
Besluit type | Discontinued (qualifier value) (code = '410546004' in codeSystem 'SNOMED CT') | |||
Besluit datum tijd | T - 10 dagen om 15:55:30 uur | |||
Besluit ingangs datum tijd | T - 10 dagen om 15:55:30 uur | |||
Besluit grond | ||||
Overgevoeligheid | Zie Overgevoeligheid: pat04-overgevoeligheid-02 | |||
Te bewaken stof | ||||
Onveilige stof | PENICILLINES (code = '35' in codeSystem 'G-Standaard Ongewenste medicatiegroepen') | |||
Beslisser | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Relatie bewaking besluit | ||||
Identificatie | pat04-BB-01 | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat04-BB-02 | |||
Toelichting | de te bewaken stof moet aangepast worden | |||
Overgevoeligheid pat04-overgevoeligheid-02 | ||||
Aandoening begin datum tijd | T - 65 dagen om 18:00 uur | |||
Aandoening ernst | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||
Aandoening aanwezigheid | Known absent (qualifier value) (code = '410516002' in codeSystem 'SNOMED CT') | |||
Aandoening status datum | T - 10 dagen om 15:55:30 uur | |||
Agens | ||||
Stof | FLUCLOXACILLINE (code = '40991' in codeSystem 'G-Standaard SNK') | |||
Wijze van vaststellen | History taking (procedure) (code = '84100007' in codeSystem 'SNOMED CT') | |||
Zekerheid status | Suspected (qualifier value) (code = '415684004' in codeSystem 'SNOMED CT') | |||
Overgevoeligheid categorie | geneesmiddelen (code = '419511003' in codeSystem 'SNOMED CT') | |||
Verwacht risico bij blootstelling | Mild (qualifier value) (code = '255604002' in codeSystem 'SNOMED CT') | |||
Diagnose | ||||
Diagnose naam | overgevoeligheid voor meerdere geneesmiddelen (aandoening) (code = '735458004' in codeSystem 'SNOMED Clinical Terms') | |||
Nadere specificatie diagnose naam | overgevoeligheid voor Flucloxacilline | |||
Diagnostisch inzicht datum | T - 60 dagen om 11:15:46 uur | |||
Diagnose steller | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Relatie overgevoeligheid | ||||
Identificatie | pat04-overgevoeligheid-01 | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat04-overg-02 | |||
Toelichting | mogelijk sprake van overgevoeligheid op meerdere geneesmiddelen | |||
Reactie pat04-reactie-02 | ||||
Aandoening begin datum tijd | T - 65 dagen om 18:00 uur | |||
Aandoening ernst | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||
Aandoening aanwezigheid | Known absent (qualifier value) (code = '410516002' in codeSystem 'SNOMED CT') | |||
Aandoening status datum | T - 10 dagen om 15:55:30 uur | |||
Veroorzaker | ||||
Veroorzakende stof | FLUCLOXACILLINE (code = '40991' in codeSystem 'G-Standaard generieke namen') | |||
Wijze van blootstelling | ORAAL (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | |||
Blootstelling datum tijd | T - 65 dagen om 10:00 uur | |||
Latentietijd reactie | 8 uur | |||
Tijdsduur reactie | 2 dagen | |||
Wijze van vaststellen | History taking (procedure) (code = '84100007' in codeSystem 'SNOMED CT') | |||
Zekerheid status | Suspected (qualifier value) (code = '415684004' in codeSystem 'SNOMED CT') | |||
Reactie verschijnsel | huiduitslag, gegeneraliseerd | |||
Diagnose | ||||
Diagnose naam | ongewenste reactie (aandoening) (code = '281647001' in codeSystem 'SNOMED Clinical Terms') | |||
Diagnostisch inzicht datum | T - 60 dagen om 11:15:46 uur | |||
Diagnose steller | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Relatie overgevoeligheid | ||||
Identificatie | pat04-overgevoeligheid-02 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.3) | |||
Relatie reactie | ||||
Identificatie | pat04-reactie-01 | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat04-reactie-02 |
1.3.4 Geneesmiddelovergevoeligheid - PENICILLINES
Geneesmiddelovergevoeligheid - PENICILLINES | ||||
Gegevenselement | Waarde | |||
Bewaking besluit | ||||
Besluit type | Started (qualifier value) (code = '385652002' in codeSystem 'SNOMED CT') | |||
Besluit datum tijd | T - 10 dagen om 15:55:30 uur | |||
Besluit ingangs datum tijd | T - 10 dagen om 15:55:30 uur | |||
Besluit grond | ||||
Overgevoeligheid | Zie Overgevoeligheid: pat04-overgevoeligheid-03 | |||
Te bewaken stof | ||||
Onveilige stof | PENICILLINES (code = '35' in codeSystem 'G-Standaard Ongewenste medicatiegroepen') | |||
Veilig binnen onveilige groep | FENOXYMETHYLPENICILLINE (code = '1051555' in codeSystem 'G Standaard HPK') | |||
Veilig binnen onveilige groep | BENZYLPENICILLINE VOOR INFUSIE (code = '2477696' in codeSystem 'G Standaard HPK') | |||
Beslisser | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Relatie bewaking besluit | ||||
Identificatie | pat04-BB-02 | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat04-BB-03 | |||
Overgevoeligheid pat04-overgevoeligheid-03 | ||||
Aandoening begin datum tijd | T - 65 dagen om 18:00 uur | |||
Aandoening ernst | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||
Aandoening aanwezigheid | Known present (qualifier value) (code = '410515003' in codeSystem 'SNOMED CT') | |||
Aandoening status datum | T - 10 dagen om 15:55:30 uur | |||
Agens | ||||
Stof | PENICILLINES (code = '35' in codeSystem 'G-Standaard Ongewenste medicatiegroepen') | |||
Wijze van vaststellen | History and physical examination with evaluation and management of patient (procedure) (code = '14736009' in codeSystem 'SNOMED CT') | |||
Zekerheid status | Confirmed present (qualifier value) (code = '410605003' in codeSystem 'SNOMED CT') | |||
Overgevoeligheid categorie | geneesmiddelen (code = '419511003' in codeSystem 'SNOMED CT') | |||
Verwacht risico bij blootstelling | Mild (qualifier value) (code = '255604002' in codeSystem 'SNOMED CT') | |||
Diagnose | ||||
Diagnose naam | overgevoeligheid voor meerdere geneesmiddelen (aandoening) (code = '735458004' in codeSystem 'SNOMED Clinical Terms') | |||
Nadere specificatie diagnose naam | Overgevoeligheid voor penicillines | |||
Diagnostisch inzicht datum | T - 10 dagen om 15:55:30 uur | |||
Diagnose steller | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Relatie overgevoeligheid | ||||
Identificatie | pat04-overgevoeligheid-02 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.3) | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat04-overg-03 | |||
Toelichting | Vastgesteld middels huidpriktest. | |||
Reactie pat04-reactie-03 | ||||
Aandoening begin datum tijd | T - 65 dagen om 18:00 uur | |||
Aandoening ernst | Matig (code = '6736007' in codeSystem 'SNOMED CT') | |||
Aandoening aanwezigheid | Known present (qualifier value) (code = '410515003' in codeSystem 'SNOMED CT') | |||
Aandoening status datum | T - 10 dagen om 15:55:30 uur | |||
Veroorzaker | ||||
Veroorzakende stof | FLUCLOXACILLINE (code = '40991' in codeSystem 'G-Standaard generieke namen') | |||
Wijze van blootstelling | ORAAL (code = '9' in codeSystem 'G-Standaard Toedieningswegen (tabel 7)') | |||
Blootstelling datum tijd | T - 65 dagen om 10:00 uur | |||
Latentietijd reactie | 8 uur | |||
Tijdsduur reactie | 2 dagen | |||
Wijze van vaststellen | History taking (procedure) (code = '84100007' in codeSystem 'SNOMED CT') | |||
Zekerheid status | Confirmed present (qualifier value) (code = '410605003' in codeSystem 'SNOMED CT') | |||
Reactie verschijnsel | huiduitslag, gegeneraliseerd | |||
Diagnose | ||||
Diagnose naam | ongewenste reactie (aandoening) (code = '281647001' in codeSystem 'SNOMED Clinical Terms') | |||
Nadere specificatie diagnose naam | ongewenste reactie op flucloxacilline | |||
Diagnostisch inzicht datum | T - 10 dagen om 15:55:30 uur | |||
Diagnose steller | ||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | |||
Relatie overgevoeligheid | ||||
Identificatie | pat04-overgevoeligheid-03 | |||
Relatie reactie | ||||
Identificatie | pat04-reactie-02 | |||
Registratie gegevens | Zie Registratie gegevens: RegGegevens-pat04-reactie-03 |
1.3.5 Bouwstenen
Bouwstenen | |||||
Gegevenselement | Waarde | ||||
Registratie gegevens RegGegevens-pat04-BB-01 | |||||
Identificatienummer | pat04-BB-01 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.754) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 60 dagen om 11:15:46 uur | ||||
Informatiebron | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie gegevens RegGegevens-pat04-BB-02 | |||||
Identificatienummer | pat04-BB-02 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.754) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 10 dagen om 15:55:30 uur | ||||
Registratie gegevens RegGegevens-pat04-BB-03 | |||||
Identificatienummer | pat04-BB-03 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.754) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 10 dagen om 15:55:30 uur | ||||
Registratie gegevens RegGegevens-pat04-overg-03 | |||||
Identificatienummer | pat04-overgevoeligheid-03 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.3) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 10 dagen om 15:55:30 uur | ||||
Registratie gegevens RegGegevens-pat04-reactie-03 | |||||
Identificatienummer | pat04-reactie-03 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.4) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 10 dagen om 15:55:30 uur | ||||
Registratie gegevens RegGegevens-pat04-overg-01 | |||||
Identificatienummer | pat04-overgevoeligheid-01 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.3) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 60 dagen om 11:15:46 uur | ||||
Registratie gegevens RegGegevens-pat04-reactie-01 | |||||
Identificatienummer | pat04-reactie-01 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.4) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 60 dagen om 11:15:46 uur | ||||
Registratie gegevens RegGegevens-pat04-overg-02 | |||||
Identificatienummer | pat04-overgevoeligheid-02 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.3) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 10 dagen om 15:55:30 uur | ||||
Registratie gegevens RegGegevens-pat04-reactie-02 | |||||
Identificatienummer | pat04-reactie-02 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.4) | ||||
Auteur | |||||
Zorgverlener | Zie Zorgverlener: zv-Peter-van-Pulver | ||||
Registratie datum tijd | T - 10 dagen om 15:55:30 uur | ||||
Zorgverlener zv-Peter-van-Pulver | |||||
Zorgverlener identificatienummer | 000001111 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.139) | ||||
Naamgegevens | |||||
Voornamen | Peter | ||||
Geslachtsnaam | |||||
Voorvoegsels | van | ||||
Achternaam | Pulver | ||||
Specialisme | Huisartsen, niet nader gespecificeerd (code = '0100' in codeSystem 'COD016-VEKT Vektis Zorgverlenersspecificatie (subberoepsgroep)') | ||||
Zorgaanbieder | Zie Zorgaanbieder: za-Huisartsenpraktijk-Pulver-en-Partners | ||||
Zorgaanbieder za-Huisartsenpraktijk-Pulver-en-Partners | |||||
Zorgaanbieder identificatienummer | 00001111 (in identificerend systeem: 2.16.840.1.113883.2.4.3.11.999.26.1.205) | ||||
Organisatie naam | Huisartsenpraktijk Pulver & Partners | ||||
Adresgegevens | |||||
Straat | Dorpstraat | ||||
Huisnummer | 1 | ||||
Postcode | 1234AA | ||||
Woonplaats | Ons Dorp | ||||
Adres soort | Werkadres (code = 'WP' in codeSystem 'HL7 AddressUse') |