Chronic Disease Flashcards
Plunked :)
Chronicity
10/10
Palliative approach
Having a meaningful QOL when death is foreseeable
Acute illness
Occurs suddenly without warning
i.e. hemorrhafigic CVA, myocardial infarciton, hip fracture, infection etc.
Chronic illness
Managed rather than cured
Always present but not always visible
Cells have a narrow range of ideal conditions, these include? *
Temp
Hydration
Nutrients
Acid-base balance
Elecotrolytes
Waste?toxicity eolerance
Touch and pressure
Signalling mechanisms such as hormones
If conditions are not ideal for a cell
It will try to adapt
Cell injury can lead to
Disease because cells lose their ability to adapt
4 types of cell injury
Deficit injury (Deficit of water, o2, nutrients, appropriate, temp, adequate waste disposal
Physical injury (result of disruption of intracellular organells = electrical, thermal or mechanical
Infection injury
Toxic (inside or outside the body toxins like alcohol)
Different ways a cell adapts
Short term adaptation
Long-term adaption - Can be unhelpful (smooth muscle atrophy)
Atrophy
Reduction in cell size due to disuese, poor blood flow denervation, malnutrion etc.
Hypertrophy
Enlargement of tissue or organ caused by increased cell size
Hyperplasia
Enlargement of tissue or organ caused by increased rate of cell proliferation
Most common type of hyperplasia
Cancer
Metaplasia (transdifferentiation)
Reversible transformation of one type of adult cell into another type of fully differentiated cell that is less specialized
Is a sign of adaptive response to envormonetal stress
Ducts and bladder epithelial changes in presence of stones
Can be reversed
Dysplasia
Premalignant condition
Abnormal changes in size, number, shape., orientation of cells
May still be reversible in the early stages
Neoplasia
Malignant
Abnormal uncoordinated and excessibe cell growth
Many involve metabolic processes that affect other cells
Purpose of staging chronic disease
Helps standardize treatment and promotes evidence-based care
What determines a different stage
Varies from pre-conditions indicating increased risk for chronic disease
to the end stage (terminal phase)
Purpose of identification of pre conditions
Help stop or slow some chronic diseases
Treatment does not = cure
Kidney disease stages based on
Glomular filtration rate (How well kidneys are filtering everything)
5 stages
Heart failure disease staging
Class 1-4 (Mild to Severe)
Morbidity
Sickness. In chronic illness, the meaning is ‘sick days’ where you are
unwell to the extent that your ability to do what you are meant to do is
adversely impacted
degree to which morbidity occurs
Mortality
Death. Chronic illness generally shortens life. The amount of shortened
life is associated with the amount of morbidity, disease exacerbations,
and sequelae.
Acute exacerbations
Episodes of increased signs and symptoms of disease. Chronic disease
can be fairly silent (minimal symptoms) or can flare dramatically. An
example of an acute exacerbation of a chronic disease is an asthma
attack.
Disease Sequelae
Chronic disease is notoriously insidious, causing known damage to
multiple tissue/organ systems. Treatment is aimed at slowing/halting
the sequelae. For example, diabetes is known to cause neuropathy
(nerve damage), retinopathy (retinal damage), nephropathy (renal
damage)
M and M round
Morbidity and mortality round
Opportunities to talk about case studies that occurred in the hospital
Litigation free zones
s/sx
Signs and symptoms
Pre-trajectory
Before the illness begins; the preventive phase no s/sx
Trajectory onset
s/sx are present; diagnostic period
Crisis (disease s/sx)
Life-threatening situation (rapid increase in s/sx or significant disease manifestation
Acute exacerbation of disease
Active ilness or comlication, person requires hospitalization for manasgement
Stable
Illness course/symptoms controlled by regimen
Unstable
Ilness course/sumptoms not controlled by regimen, but patients gernally treated at home
Downward Spiral
Progressive deterioration in physical/mental status characterized by increasing disability/symptoms
Focus on care not cure involves
Provide relief from pain and other symptoms
* Support QOL
* Reduce morbidity (exacerbations and disease sequela)
* Reduce mortality (due to morbidity
Examples of nursing diagnoses of risk
- Risk for infection due to/related to ____________
- Risk for decreased perfusion due to history of smoking
- Risk for impaired wound healing due to poor nutrition
- Risk for poor nutrition due to food insecurity
Example of short term cell adaption
Dehydtation and osmotic gradient (fluid shifts)
Acid base compensation
Hormone feedback mechanismes
Blood glucose/insulin/glycogen pathways
Is long term adaption to stressors helpful
No
Examples of long term cell adaption
Atrophy
Hypertrophy
Hyperplasia
Example of metaplasia
Ducts and bladder epithelial changinging in presence of stones
