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Adult 1 > Chapter 5 - Chronic Illnesses + Care of Elderly > Flashcards

Chapter 5 - Chronic Illnesses + Care of Elderly Flashcards

1
Q

Chronic illness vs acute disease

A

Chronic -> long-term

Acute -> short-term

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2
Q

(T/F) Chronic illnesses are always steady and predictable

A

FALSE; can potentially have exacerbations and degenerate into an acute condition

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3
Q

Describe the characteristics of an acute illness (4)

A
  1. Usually go away on their own
  2. Treatment is effective
  3. Rarely have complications
  4. Return to previous level of function after disease
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4
Q

Describe the characteristics of a chronic disease (4)

A
  1. Cause PERMANENT deviations from normal function
  2. Lead to irreversible changes
  3. Have residual/lasting disability
  4. Require special rehabilitation and potential need for long-term medical care
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5
Q

(T/F) The onset of a chronic disease always starts with an actue illness

A

False

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6
Q

For each of the following steps of the illness trajectory, describe what they are:

  1. Onset
  2. Period stability
  3. Acute exacerbation
  4. Comeback
  5. Period stability
  6. Acute crisis/decline
  7. Stabilizing at lower level
  8. Comeback to lower level
  9. Period stability
  10. Downward trend
  11. Dying

Draw a graph, then verify against book

A
  1. Onset -> signs/symptoms appear, disease is initially diagnosed but person has normal funcitoning
  2. Period stability -> illness controlled via treatment, so person can keep normal life
  3. Acute -> illness exacerbates for first time, leading to severe complications and potential need for hospitalization
  4. Comeback -> after acute crisis, person gradually returns to normal life
  5. Crisis -> life-threatening situation occurs leading to need for emergency services
  6. Lower level stabilization -> life-threatening disease is controlled; further decline is stopped, but patient has very low functionign
  7. Comeback to lower level -> gradually person can return to higher level of functioning, though not as high as before crisis
  8. Period stability -> person is able to maintain lower peak with treatment
  9. Downward trend -> person gradually gets worse, with signs/symptoms and disability getting progressively worse over time
  10. Dying -> patient is now in critical condition, and death is inevitable
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7
Q

Onset (disease trajectory); what step out of 11?

A

Initial appearance of signs/symptoms and diagnosis of disease; #1

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8
Q

Period stability (first - disease trajectory); what step out of 11?

A

Following diagnosis (onset), normal patient functioning is maintained via treatment; #2

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9
Q

Acute exacerbation; what step out of 11?

A

Severe illness event with symptoms/complications lost out of control; requires hospitalization; #3

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10
Q

Comeback; what does it follow?

A

Gradual return of a patient to an acceptable quality of life following exacerbation or crisis

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11
Q

Crisis

A

Life-threatening situation of chronic illness in which emergency service is neeeded

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12
Q

Downward Trend/Decline

A

Gradual deterioration of person’s physical and mental state, and increase in disability/symptoms

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13
Q

Dying

A

Patient has become so deteriorated that they inevitably die

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14
Q

What are special needs necessary for those managing a chronically ill disease after onset? (5)

A
  1. Managing/preventing crisis
  2. Doing treatment regimen
  3. Keeping symptoms under control
  4. Altering schedule and social relationships to try and maintain as normal a life as possible
  5. Adjusting to and monitoring changes in disease course
  6. Avoiding social isolation
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15
Q

The biggest way to stop chronic diseases is via ____; give some examples

A

PREVENTION (most are preventable)

  1. Exercise
  2. Proper diet
  3. Avoiding tobacco/drugs
  4. Managing stress
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16
Q

Describe the role of an elderly caregiver and patient in patient care

A

Teach them about what their treatment is, and include them as much as possible

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17
Q

What things should be assessed by nurse for those with chronic illness? (4)

A
  1. Daily functioning
  2. Personal perception of their health
  3. Ability to perform ADL and iADL
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18
Q

What is the difference between ADL and iADL? Give examples

A

ADL -> basic tasks necessary for survival (i.e. walking, bathroom, eating, hygiene)

iADL -> additional tasks necessary for person to survive, but are less mechanical
(transporation, ability to make meals, ability to write checks, etc)

Just remember: ADLs are things that babies would need to survive (bare minimum), iADL are more adult tasks

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19
Q

Self-management

A

Ability ot a person to manage their own symptoms, treatment and lifestyle changes for a chronic disorder

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20
Q

Young-old adult

A

Adult which is 65-74 years old

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21
Q

Old-old adult

A

Older adult which is 85 yo or older

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22
Q

Frail Older Adult

A

Older adult over age 75 which has physical , cognitive or mental problems which prevent them from performing ADL

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23
Q

Ageism

A

Negative attitude/discrimination towards older people

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24
Q

Aging

A

Progressive loss of function

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25
Q

What are common disease problems of chronically ill older adults? Which is most common?

A
  1. Hypertension -> most common
  2. Osteoarthritis
  3. heart disease
  4. Cancer
  5. Diabetes
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26
Q

What are common problems for older adult women?

A
  1. Likely to live alone
  2. More likely to have poverty
  3. Have greater incidence of chronic diseases
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27
Q

List 4 different older adult populations with special needs

A
  1. Chronically ill older adults
  2. Older adult women
  3. Those with cognitive impairments
  4. Those living in rural areas
  5. Homeless older adults
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28
Q

The incidence rate of chronic disease is more common in which sex?

A

Females

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29
Q

What kinds of problems can cognitively impaired older adults have? How can this be treated?

A
  1. Memory loss/forgetfulness and loss

Use memory helping devices (i.e. pillboxes) or techniques (i.e. mnemonics)

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30
Q

(T/F) Most adults have a decline in cognitive abilities

A

False; though some of them have memory problems

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31
Q

What special problesm do older adults living in rural areas have?

A

Have impaired ability to get access to health care due to:

  1. Transportation problems
  2. Limited number of facilities in area
  3. Lack of quality health care
  4. Social isolation
  5. FInancial issues
32
Q

What special problems do homeless older adults have?

A
  1. Have higher mortality rates than non-homeless
  2. Have more health problems
  3. Are less likely to get benefit from community/hospital services, since they don’t target homeless
33
Q

**A frail adult is defined by having what signs/symptoms (6)

What are risk factors for frail adults?

A

You have to have at least 3 of these:

  1. Old age
  2. Unplanned loss of 10 or more pounds in last year
  3. Weakness
  4. Poor endurance/energy
  5. Slowness
  6. Low activity level
  7. Disability
  8. Dementia
  9. Multiple chronic illnesses
34
Q

What are 3 risk factors for frail adults?

A
  1. Disability
  2. Having multiple chronic illnesses
  3. Dementia
35
Q

Big differences between medicare and medicaid

A
  1. Medicare -> is federally funded and goes to those over 65; you have to pay into it
  2. Medicaid -> is run by states, and is given to low-income people
36
Q

Medicare; list the 3 parts (ABD) and what they cover

A

FEDERALLY funded health insurance given to those over 65

A -> inpatient hospital, rehab, home care, DME

B -> outpatient/physicians

D -> prescription drugs

37
Q

Part A medicare covers what?

A
  1. Inpatient
  2. Rehab
  3. Home care
  4. DMEs
38
Q

Part B medicare covers what?

A
  1. Outpatient

2. Phyiscians

39
Q

Part D medicaid covers what?

A

Prescription drugs

D = drugs

40
Q

Medicaid

A

STATE-run program for low income people

41
Q

Describe the housing arrangements of older adults; when do they leave?

A

Can live alone, with spouse, with children or family members

–Prefer to stay at home until it is no longer affordable or capable to do so

42
Q

Elder mistrreatment

A

INtentional acts or omission of acts by a caregiver to elder which causes harm or risk of harm

43
Q

Physical abuse of elder; what are signs/symptoms

A

Slapping striking, restraining, oversedation of misplacement of elderly

Bruises, injuries in various healing stages, oversedation, emergency room repeat visits

44
Q

Neglect

A

Inability or refusal to:

  1. Provide for basic needs of life (i.e. food, water, clothing)
  2. Provide hygiene
  3. Provide medications
  4. Provide physical aids like eyeglasses or dentures
  5. Make sure safety is maintained
  6. Socially interact (leave them socially isolated)
45
Q

Psychological abuse of elder examples

A
  1. Verbal abuse
  2. Harassment
  3. Intimidation
  4. Threats of violence/punishment
  5. Treating them like child
  6. Isolating them
46
Q

Sexual abuse of elder

A

Nonconsensual sexual activity (touching, sex, etc)

47
Q

Financial abuse of elder

A
  1. Denying of access to money/possessions
  2. Forcing elderly to sign contracts
  3. Changing will against the will of elderly
48
Q

Violation of personal righst of elder

A
  1. Denying right to privacy
  2. Denying rights of elderly to make personal decisions about health/living situation
  3. Forcibly evicting elderly
49
Q

Abandonment of Elderly

A

Desertion of an elderly person by an individual who was given responsibility for their care

50
Q

Adult day care/adult day health care

A

Adult day care -> areas to provide supervision + help in ADL and social activities for elderly during day

Adult day health care -> same thing, but for patients with more severe conditions; includes monitoring of health, therapy help, etc

51
Q

A caregiver is unable to maintain employment and care for elderly adult at same time. What is a good resource for them to use?

A

Adult day care

52
Q

Home Health Care

A

Health care resource for patients who need assistance with some activities in daily life (i.e. making food, housekeeping), but have not deteriorated enough to need LTC

53
Q

Long-Term Care Facility; what 3 factors will cause someone to be placed in LTC?

A

Facility designed to assist patients who need 24 hour assistance with basic ADL skills to a degree greater than can be handled by home health care

  1. Rapid deterioration of health
  2. Inability of caregiver to continue care
  3. Loss of or changes in family support system
54
Q

Relocation stress syndrome

A

Anxiety, depression and disorientation in elderly resulting from moving abruptly from an old to a new home environment

55
Q

The most immediate nursing concern following hospitalization of an elderly is ___

A

Where is the person going to go after they leave the hospital

56
Q

Determining where an elderly patient will go after they leave the hospital should be determined ___

A

As soon as possible

57
Q

What are the 2 most common caregivers?

A
  1. Daughter (most common)

2. Spouse

58
Q

Why might it be difficult to diagnose disease in elderly?

A

Elderly may:

  1. Not report symptoms and attribute them to “old age”
  2. Alter lifestyle to hide symptoms
  3. Symptoms are often atypical, and may fly under the radar
59
Q

It is very helpful when doing an assessment of elderly to ___

A

Use geriatric instrument

60
Q

The focus of the nursing assessment in older adults is to ____

A

Determine what interventions are needed to maintain + enhance the functional abilities of the patient

61
Q

What things should be done before doing assessment in elderly? What should be done during

A
  1. Make sure patient is comfortable (no pain)
  2. Have them use bathroom
  3. Make sure assistive devices are in place
  4. Keep as short as possible (so they don’t get tired)
  5. Have enough time to naswer questions
  6. Remember to include the meidcal history, assessment, physical and functional ability assessment and social resources of patient
62
Q

SPICES assessment tool in elderly; what does each letter stand for?

A 
S -> sleep disorders
P -> problems eating
I -> incontinence
C -> confusion
E -> evidence of falls
S -> skin breakdown
63
Q

Mental status evaluation of elderly is important for determining ___

A

If they can live independently

64
Q

List the things which should be included in the assessment of elderly (

A
  1. Health history
  2. Phyiscal assessment
  3. Risk of falls
  4. Mood assessment
  5. ADL/iADL assessment
  6. Mental status assessment
  7. Social-environmental assessment (i.e. social resources)
65
Q

During the planning step of nursing porcess in older adults, it is important to do what for goals?

A

Try to include PERSONAL goals for the patient for as long as possible; don’t just ignore them

66
Q

Tips for planning step of nursing process in elderly (5)

A
  1. Identify the specific strengths/weaknesses of patient
  2. Adjust to functional ability ot patient
  3. Individualize care
  4. Include caregivers
  5. Try to include personal goals for the elderly if possible
67
Q

Special considerations for IMPLEMENTATION in elderly

A
  1. Alter plan based upon physical/mental status
  2. Make sure you have extra time (are slow)
  3. Make sure to give careful explanations and be calm, especially if they have cognitive problems
68
Q

When implementing nursing care for elderly, it is important to ___

A

Make sure to have additional time planned; may get tired or be slow

69
Q

How is the evaluation step of elderly nursing process different from others?

A

It may make more time than expected for health status changes to occur

70
Q

Tips for evaluation step of nursing process in elderly (3)

A
  1. Is ongoing (not static) and similar to other patients
  2. Includes evaluation from both patient and caregiver
  3. It may take longer for health changes to occur than other groups
71
Q

Oftentimes, acute changes in the health status of an elderly person is ______; give some examples

A

Linked to or combined with multiple underlying chronic illnesses occurring simultaneously

While having UTI, they have:

  1. Diabetes
  2. Heart disease
  3. Hypertension
  4. Kidney problems
  5. Arthritis
72
Q

Because older adults oftentimes have multiple chronic illnesses in addition to the acute one that brought them to the hospital, what problems can occur? 95)

A
  1. Care is more complex and intensive
  2. Assessment is complex (multiple body systems, etc)
  3. Polypharmacy
  4. There is high risk for complications for other diseases during hospital stay
  5. Discharge may be complicated
73
Q

Health Promotion Practices in older adults include (3); give an example

A
  1. Reducing diseases/problems
  2. Promoting participation in positive health activities
  3. Introducing services that reduce potential health hazards

I.e. program to get them to stop smoking, reduce abuse at home, reduce home hazards, etc

74
Q

What problems can transitions in care have in elderly? How can you help to alleviate that?

A

Many elderly are in an unstable condition when being transferred (i.e. person being discharged home is very weak, so they have difficulty making meals)

Have a good discharge plan

75
Q

Deconditioning; how is it treated?

A

Loss of functioning in older adult due to inactivity or immobility; rehabilitation

Adult 1 (1 decks)

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