Chapter 6 Support for Self Management Flashcards
What is the competency definition of Self-Management Support?
Systematic provision of education and supportive interventions to increase pt skills and confidence in managing their health problems, including regular assessment of progress and problems, goal setting and problem-solving support.
A. What do you begin to determine self-
management needs for pt?
- What does he know and understand about his chronic conditions?
B. What things do you consider when developing a tailored education for pt/family?
-Health literacy
-Education level
-Cognitive/Developmental level
-Language
-Preferences
-Family/Significantother
-Learning style
-Adult learning principles
-Readiness to learn (info may need to be
repeated
C. Emphasize self-management concepts:
1. Cause of chronic condition: often
multiple causes and contributing
factors. What are they?
a. Heredity
b. Lifestyle
c. Exposure to environmental factors
(second hand smoke)
d. Physiological changes (e.g., electrolyte
imbalance, low levels thyroid hormone,
changes in brain chemistry)
Would you consider pt expertise in living with chronic conditions and social situation?
Yes
Review symptoms and symptom management, disease may differ but symptoms may be similar. Understanding symptoms and self-management strategies is essential to improve quality of live. Assess and support family’s problem solving around the common symptoms
Fatigue: cause may be . . . Inactivity Poor nutrition Ineffective sleep Stress Medications
Pt has fatigue: causes may be . . . Inactivity Poor nutrition Ineffective sleep Stress Medications What do you recommend to manage it?
- Increase physical activity
- Stress management
- Screen for depression
- Improve nutrition
- Improve sleep quality
Patient has pain/physical discomfort: causes may be . . . Muscle tension Deconditioned Stress and emotional responses Medications What do you recommend to manage it?
-Chronic pain has a strong emotional component that can increase perceived pain levels
-Encourage stretching, increased activity
-Ice, heat, massage
-Integrative techniques: distraction,
music, relaxation
-Medication use
Pt has SOB: may be caused by . . .
Multiple disease processes that interfere with pulmonary or cardiac function, overweight, deconditioned state, smoking.
What do you recommend to manage it?
-Teach breathing management techniques diaphramatic pursed lip huffing positions that ease breathing -F/U low sodium diet -Prop with pillows to aid sleeping -Monitor fluid retention and weight gain -Encourage fluid intake unless restricted -Eliminate smoke exposure -Increase activity if possible -Reduce weight if contributing factor
Pt has sleep disturbance: high quality sleep is important.
What do you recommend to manage it?
-Comfortable bed and room temperature
-Comfort positions in bed, pillow, head of
bed
-Regular routine
-Safe environment: lighting, assistive
device
-Avoid ETOH and eating at bedtime
-Avoid caffeine late in day or other
stimulating activities near bedtime
-Avoid sleeping pills or diuretics at
bedtime
-Consider OSA
Pt has memory loss that interferes with life activities.
What do you recommend to manage it?
Do memory test, discuss with pcp.
Pt has itching, may be difficult to pinpoint cause.
What do you recommend to manage it?
- Keep skin dry
- Comfortable clothing
- Soothing medications
- Stress management
- Minimize scratching
Pt has urinary incontinence, more common in women.
What do you recommend to manage it?
What is the history? What has been tried?
-Use of Kegel exercises (PT referral?), bladder emptying techniques, scheduled urination, keep log
-Consume fewer beverages at bedtime,
esp those that stimulate urine production
-Use of absorbent pads
-Medications
What is the impact of disease and treatment
- Physiological
- Psychological
- Social
What is the disease trajectory?
- Full recovery often not possible
- Disease pattern may be unpredictable
- Symptoms can contribute to development of additional symptoms
