Chronic Disease

Question 1

Chronicity

Answer 1

10/10

Question 2

Palliative approach

Answer 2

Having a meaningful QOL when death is foreseeable

Question 3

Acute illness

Answer 3

Occurs suddenly without warning

i.e. hemorrhafigic CVA, myocardial infarciton, hip fracture, infection etc.

Question 4

Chronic illness

Answer 4

Managed rather than cured
Always present but not always visible

Question 5

Cells have a narrow range of ideal conditions, these include? *

Answer 5

Temp
Hydration
Nutrients
Acid-base balance
Elecotrolytes
Waste?toxicity eolerance
Touch and pressure
Signalling mechanisms such as hormones

Question 6

If conditions are not ideal for a cell

Answer 6

It will try to adapt

Question 7

Cell injury can lead to

Answer 7

Disease because cells lose their ability to adapt

Question 8

4 types of cell injury

Answer 8

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)

Question 9

Different ways a cell adapts

Answer 9

Short term adaptation

Long-term adaption - Can be unhelpful (smooth muscle atrophy)

Question 10

Atrophy

Answer 10

Reduction in cell size due to disuese, poor blood flow denervation, malnutrion etc.

Question 11

Hypertrophy

Answer 11

Enlargement of tissue or organ caused by increased cell size

Question 12

Hyperplasia

Answer 12

Enlargement of tissue or organ caused by increased rate of cell proliferation

Question 13

Most common type of hyperplasia

Answer 13

Cancer

Question 14

Metaplasia (transdifferentiation)

Answer 14

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

Question 15

Dysplasia

Answer 15

Premalignant condition

Abnormal changes in size, number, shape., orientation of cells

May still be reversible in the early stages

Question 16

Neoplasia

Answer 16

Malignant

Abnormal uncoordinated and excessibe cell growth

Many involve metabolic processes that affect other cells

Question 17

Purpose of staging chronic disease

Answer 17

Helps standardize treatment and promotes evidence-based care

Question 18

What determines a different stage

Answer 18

Varies from pre-conditions indicating increased risk for chronic disease

to the end stage (terminal phase)

Question 19

Purpose of identification of pre conditions

Answer 19

Help stop or slow some chronic diseases

Treatment does not = cure

Question 20

Kidney disease stages based on

Answer 20

Glomular filtration rate (How well kidneys are filtering everything)

5 stages

Question 21

Heart failure disease staging

Answer 21

Class 1-4 (Mild to Severe)

Question 22

Morbidity

Answer 22

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

Question 23

Mortality

Answer 23

Death. Chronic illness generally shortens life. The amount of shortened
life is associated with the amount of morbidity, disease exacerbations,
and sequelae.

Question 24

Acute exacerbations

Answer 24

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.

Question 25

Disease Sequelae

Answer 25

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)

Question 26

M and M round

Answer 26

Morbidity and mortality round

Opportunities to talk about case studies that occurred in the hospital

Litigation free zones

Question 27

s/sx

Answer 27

Signs and symptoms

Question 28

Pre-trajectory

Answer 28

Before the illness begins; the preventive phase no s/sx

Question 29

Trajectory onset

Answer 29

s/sx are present; diagnostic period

Question 30

Crisis (disease s/sx)

Answer 30

Life-threatening situation (rapid increase in s/sx or significant disease manifestation

Question 31

Acute exacerbation of disease

Answer 31

Active ilness or comlication, person requires hospitalization for manasgement

Question 32

Stable

Answer 32

Illness course/symptoms controlled by regimen

Question 33

Unstable

Answer 33

Ilness course/sumptoms not controlled by regimen, but patients gernally treated at home

Question 34

Downward Spiral

Answer 34

Progressive deterioration in physical/mental status characterized by increasing disability/symptoms

Question 35

Focus on care not cure involves

Answer 35

Provide relief from pain and other symptoms
* Support QOL
* Reduce morbidity (exacerbations and disease sequela)
* Reduce mortality (due to morbidity

Question 36

Examples of nursing diagnoses of risk

Answer 36

• 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

Question 37

Example of short term cell adaption

Answer 37

Dehydtation and osmotic gradient (fluid shifts)
Acid base compensation
Hormone feedback mechanismes
Blood glucose/insulin/glycogen pathways

Question 38

Is long term adaption to stressors helpful

Answer 38

No

Question 39

Examples of long term cell adaption

Answer 39

Atrophy
Hypertrophy
Hyperplasia

Question 40

Example of metaplasia

Answer 40

Ducts and bladder epithelial changinging in presence of stones