Chronic Disease and Palliative Approach

Question 1

acute illness

Answer 1

sudden
often without warning
ex
- hemorrhagic CVA, MI…

Question 2

chronic illness

Answer 2

managed rather than cured
- always present but not always visible

Question 3

basics of pathology

Answer 3

cells > groups of cells > organs > organ systems

Question 4

Palliative approach

Answer 4

a meaningful QoL rather than quantity

Question 5

cells have a narrow range of ideal conditions

Answer 5

• temp
• hydration
• nutrients
• acid-base balance
• electrolytes
• waste/toxicity tolerance
• touch and pressure
• signaling mechanisms such as hormones

Question 6

cell injury

Answer 6

injury to components can lead to disease
injury:
- deficit injury
- physical
- infectious
- toxic

Question 7

cell deficit injury

Answer 7

deficit of:
H2O
O2
nutrients
appropriate temp
adequate waste disposal

Question 8

cell physical injury

Answer 8

resulting in a disruption of the intracellular organelles
- can be electrical, thermal, mechanical injury

Question 9

cell infectious injury

Answer 9

viral
fungal
bacterial
protozoal

Question 10

cell toxic injury

Answer 10

inside or outside the body toxins
such as:
alcohol
lead
CO
drugs
other chemicals

Question 11

cells and adaptation

Answer 11

short term adaptation is normal and helpful
- dehydration and osmotic gradient (fluid shifts)
- acid-base compensations
- hormone feedback mechanisms
- blood glucose/insulin/ glycogen pathways

Question 12

cells and long-term adaptation

Answer 12

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

Question 13

cells and long-term adaptation cont.

Answer 13

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

Question 14

morbidity

Answer 14

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

Question 15

mortality

Answer 15

death
- chronic illness generally shortens life
- the amount of shortened
life is associated with the amount of:
morbidity
disease exacerbations
sequelae

Question 16

acute exacerbations

Answer 16

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

Question 17

disease sequelae

Answer 17

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)

Question 18

nursing focus for chronic disease

Answer 18

focus on care not cure
maintain stable trajectory of care
- provide relief from pain and sx
- support QOL
- reduce morbidity
- reduce mortality