Chronic Disease and Palliative Approach Flashcards
acute illness
sudden
often without warning
ex
- hemorrhagic CVA, MI…
chronic illness
managed rather than cured
- always present but not always visible
basics of pathology
cells > groups of cells > organs > organ systems
Palliative approach
a meaningful QoL rather than quantity
cells have a narrow range of ideal conditions
- temp
- hydration
- nutrients
- acid-base balance
- electrolytes
- waste/toxicity tolerance
- touch and pressure
- signaling mechanisms such as hormones
cell injury
injury to components can lead to disease
injury:
- deficit injury
- physical
- infectious
- toxic
cell deficit injury
deficit of:
H2O
O2
nutrients
appropriate temp
adequate waste disposal
cell physical injury
resulting in a disruption of the intracellular organelles
- can be electrical, thermal, mechanical injury
cell infectious injury
viral
fungal
bacterial
protozoal
cell toxic injury
inside or outside the body toxins
such as:
alcohol
lead
CO
drugs
other chemicals
cells and adaptation
short term adaptation is normal and helpful
- dehydration and osmotic gradient (fluid shifts)
- acid-base compensations
- hormone feedback mechanisms
- blood glucose/insulin/ glycogen pathways
cells and long-term adaptation
atrophy
- reduction in cell size
hypertrophy
- enlargement of tissue or organ caused by increased cell size
hyperplasia
- enlargement of tissue or organ caused by increased rate of cell proliferation
> cancer
cells and long-term adaptation cont.
metaplasia
- trans differentiation
- reversable
- cell changes personality
dysplasia
- premalignant condition
- abnormal changed in size, number, shape, orientation of cells
- can be reversable if caught early
neoplasia
- malignant
- abnormal uncoordinated and excessive cell growth
- many involve metabolic processes that affect other
cell
morbidity
sickness
- chronic illness, the meaning is ‘sick days’ where you’re unwell to the extent that your ability to do what you’re meant to do is impacted
mortality
death
- chronic illness generally shortens life
- the amount of shortened
life is associated with the amount of:
morbidity
disease exacerbations
sequelae
acute exacerbations
episodes of increased signs and symptoms of disease
Chronic disease:
- can be fairly silent (minimal symptoms) or can flare dramatically
ex. of an acute exacerbation of a chronic disease is an asthma attack
disease sequelae
Chronic disease is insidious, causing known damage to multiple tissue/organ systems
- treatment is aimed at slowing/halting the sequelae
ex. diabetes is known to cause neuropathy (nerve damage), retinopathy (retinal damage), nephropathy (renal damage)
nursing focus for chronic disease
focus on care not cure
maintain stable trajectory of care
- provide relief from pain and sx
- support QOL
- reduce morbidity
- reduce mortality
