Chapter 13 Flashcards
acute illness
is characterized by severe symptoms that are relatively short lived. symptoms tend to appear suddenly, progress steadily, and subside quickly
chronic illness
usually develops gradually, requires ongoing medical attention, and may continue for a duration of the individuals life. examples: HTN, DM, Parkinson disease. they can be treated but not cured.
chronic illness are caused by permanent changes that leave residual disability.
They vary in severity and outcomes but a state of normal health is elusive. many chronic illness can be managed successfully, some are progressively debilitating and result in premature death.
terminal
is a disease that will end in death
acute
quick onset & short duration example flu, sinus infection
terminal disease
No treatment for issue, treatment exhausted will end in death, hospice for comfort measures. example stage 4 lymphoma
complications
disease from another disease example kidney disease lead to diabetes
remission
signs and symptoms subside (want this outcome)
exacberation
recur in severity (comes back worse)
relapse
returns
chronic illness is one of the fastest growing HC problems in the US
in 2012 about half us pop had one or more chronic illness
some chronic illnesses
go through remission and exacerbation
no guarantee each pt is different
consequences of chronic illness may be life altering
lead to altered individual functioning and disruption to family (care givers).
adjustment to illness
stage 1 disbelief and denial
stage 2 irritability and anger
stage 3 attempting to gain control (fear stimulate treatment seeking
stage 4 depression and despair
stage 5 acceptance and participation
not every person does these the same way may be down out of order
sick role Talcott parsons 1964
5 attributes of the Anglo-American sick role
exemption from social responsibility can't be expected to care for ones self should want to get well should seek medical advice should cooperate with medical experts this definition includes behavior that is dependen, passive, and submissive
contemporary view of sick role
pt have become increasingly likely to challenge doctor and seek own info. nurses are required to be culturally competent in providing pt centered care. there is no normative illness response based on culture. response to illness varies
illness behaviors interactive influences
personality structures contribute to how a pt manages illness: dependence/independence coping ability hardiness learned resourcefulness resilience spiritual
dependence
some adapt a passive attitude and rely on others to care for them. can be frustrating to nurses
independence
continue to be in denial and try to live independently as they can. can be frustrating to nurses
coping ability
strategies a person uses to assess and manage demands. each pt is different.
resourcefulness
refers to use of cognitive skills that minimize the negative effects of thoughts. self mastery reduces feelings of despair. resourcefulness can be taught as a form of coping:
stress management
self regulation
problem solving
conflict resolution
emotion management (emotional intelligence )
resilience
defined as a successful adaption despite challenging or threatening circumstances
resilience can be a result from 3 factors
disposition- temperament personality
family factors- warmth support organization
outside support factors- supportive network, success in school or work
spiritually
defined as belief in a higher power interconnectedness among living beings and an awareness of life purpose and meaning.
nurses responsibility to refrain from from trying to influence pt religious belief. nurses encouraged to view spirituality as an accent of whole person, is a coping mechanism. don’t judge
external influences past experiences
messages from child hood about illness can affect adjustment to it
nurses should determine the nature of past experience related to health and care in order to individualize care accordingly
support system
external influences on illness
culture pattern or learned behavior and values that are reinforced through social interactions.
culture competent nurse
without cultural competence nursing a care can be compromised, including problems with
sterotyping
communication difficulty
misperception about personal space
differing values and role expectations
ethnogpharmacologic pharmacological consider
ethnocentrism similar to ego centric
avoid stereotyping
defined as Pigeon holding or labeling pt with prior assumption
communication difficulties
culture knowledge will help ensure that nurses understand and correctly interpret communication from different cultures.
patterns if communication are strongly influenced by culture
misinterpretation of personal space
culture differ in the amount of personal space that is comfortable for members
nurses must be sensitive to expectations about touch and personal distance
cultural assessment
begins with nurses self assessment
used identify beliefs values and health practices that may help or hinder nursing interventions
impact of illness on pt and family
emotional and behavioral changes
guilt - pt may feel guilt about being sick esp6if illness was result of lifestyle choices
anger- common emotional response when illness requires sacrafice
anxiety- conforms on 4 levels mild moderate severe and panic
stress- both common response to illness and important factor in development of illness.
