Chronic Illness

Question 1

Nurses goal when dealing with chronically ill patients

Answer 1

Help reduce hospitalization and increase patients quality of life, get patient in remission and have less exacerbation

Question 2

Chronic illnesses that could be reduced by lifestyle changes for >65 yr old patients

Answer 2

Heart disease, cancer, chronic lower respiratory, CVAs, Alzheimers, diabetes

Question 3

Health risk behaviors for some chronic illnesses

Answer 3

lack of physical activity, diet-lack of 5 or more servings of fruits or vegetables, smoking, excessive alcohol

Question 4

Chronic conditions vary by:

Answer 4

Age (you’ll see more old ppl), gender, race (hypertension is more prevalent in black ppl), economic status (access to health care, education)

Question 5

Chronic illnesses in children

Answer 5

asthma, sinusitis, bronchitis

Question 6

Chronic illnesses in Adults 45-74

Answer 6

Arthritis, hypertension, orthopedic impairments, heart disease

Question 7

Chronic illness patients are usually which kind of patients

Answer 7

re-admissions, or long-term care patients

Question 8

What is effects with Trust vs. Mistrust (Infant)

Answer 8

bonding, they have no concept of illness but do experience pain, separation, being restricted (tied down)

Question 9

Problems with Toddlers Autonomy vs. Shame and Doubt and what do we need to teach parents

Answer 9

Independence, language delays, temper tantrums, difficulty toilet training (in their on lasix, they might have accidents). *Parents need to be encouraged to allow their child to be as independent as possible

Question 10

Problems with Preschooler Initiative vs. guilt and what do we teach parents

Answer 10

difficulty developing initiative(which comes about by doing things), difficulty problem solving, language problems. Parents cant give kid the choice to take med instead, say “Do you want it with juice or water?”

Question 11

Problems with School-aged with chronic illnesses industry vs inferiority and what we need to teach parents

Answer 11

Education may be interrupted b/c they have to miss school, peer relationships may be disrupted. Parents have to be taught to be advocates by allowing them to do things. Kids will start participating in managing their illness (taking glucose tests)

Question 12

Problems with the older school-aged

Answer 12

They participate more in care. They may use their illness to get what they want.

Question 13

Problems with Adolescents(12-18) identity vs role confusion

Answer 13

Les freedom, affects peer relationships, body image problems

Question 14

Problems with early adulthood (18-45) intimacy & how we can help

Answer 14

Fear of rejections, childbearing difficulties, may not seek out partner/may isolate self, may not be self sufficient. We can give info on support groups, counseling,

Question 15

Problems with middle adulthood (45-65) Generativity vs. Stagnation

Answer 15

loss of vocation (occupation), role changes or role reversal (once was the bread winner & now isn’t), loss of self-esteem, Social-personal-economic factors

Question 16

Problems with older adult (65+) Integrity vs Despair

Answer 16

losses with aging profound, fear of total dependency, fear of placement in nursing home

Question 17

What illness is overlooked with chronic illness?

Answer 17

Depression (MI has the highest rate)

Question 18

Stages of grieving

Answer 18

denial, anger, depression, bargaining, acceptance

Question 19

Factors influencing Response to chronic illness

Answer 19

Point in life cycle, type of limitations, degree of limitations, visibility of impairment or disfigurement(Is family accepting of how they look), Stigma attached (Asians don’t talk about mental health illnesses, its kept in the family), pathophysiology causing illness, is there a significant role reversal, pain, fear

Question 20

Factors that influence coping

Answer 20

nature of event, perception of the event, prior experience, prior coping ability, support system, other stressors, strengths

Question 21

Basic problems when dealing with chronic illness

Answer 21

managing the crises (if they have an excerbation, they may go thru grief process again), managing regimens (using a pill box), controlling symptoms, managing the course/prognosis, managing social isolation

Question 22

Challenges of management of chronic illness

Answer 22

normalizing: realistic expectations, change focus to better living, learn new ways to relate

Question 23

Approach to care

Answer 23

Find out what they about their illness, establish realistic goals, encourage client participation in care, follow up & evaluate outcomes