Chronic Illness

Question 1

Chronic illness is responsible for ___ percent of deaths in the US

Answer 1

70%

Question 2

What are examples of chronic illnesses?

Answer 2

• Arthritis
• Cancer
• Diabetes
• Coronary Artery Disease
• Stroke
• Obesity

Question 3

• Usually self-limiting
• Responds readily to treatment
• Complications are infrequent
• After illness, person returns to previous level of functioning

Answer 3

Acute Illness

Question 4

• permanent impairments or deviations from normal
• nonreversible pathological changes
• residual disability
• special rehabilitation required
• need for long term medical and/or nursing care

Answer 4

Chronic Illness

Question 5

Tasks of the chronically ill:

Answer 5

1. preventing and managing crisis
2. carrying out prescribed treatment regimen
3. controlling symptoms
4. reordering time
5. adjusting to changes of course of disease
6. preventing social isolation
7. attempt to normalize interactions with others

Question 6

What are the stages of the Trajectory Model?

Answer 6

• Onset
• Stable
• Acute
• Comeback
• Crisis
• Unstable
• Downward
• Dying

Question 7

• Signs and Symptoms present

- Disease Diagnosed

Answer 7

Onset

Question 8

• Illness controlled by regimen

- Person maintains everyday activities

Answer 8

Stable

Question 9

• Active illness with severe and unrelieved symptoms

- Hospitalization required for management

Answer 9

Acute

Question 10

Gradual return to an acceptable way of life (after hospitalization)

Answer 10

Comeback

Question 11

• Life threatening situation occurs

- Emergency services are necessary

Answer 11

Crisis

Question 12

• Unable to keep symptoms/disease under control
• Life becomes disrupted while one works to regain stability
• Hospitalization is NOT required

Answer 12

Unstable

Question 13

• Gradual and progressive deterioration in physical/mental status
• Accompanied by increasing disability and symptoms
• Continuous alterations in everyday activities

Answer 13

Downward

Question 14

• One has to relinquish everyday life interests

- Immediate days/weeks before death

Answer 14

Dying

Question 15

What is the nurse’s role in shaping the illness trajectory?

Answer 15

• encourage “self-managment”
• consider developmental stage
• care planning
• patient and caregiver education
• implementing strategies for symptom management
• assessing patient outcomes

Question 16

Are able to reach out and connect with others

• become intimate with someone
• work toward career

Answer 16

intimacy vs. isolation

Question 17

look beyond self to embrace society and future generations

• begin family
• develop concern for those outside of family

Answer 17

generativity vs. stagnation

Question 18

take stock of one’s past/ get sense of satisfaction from looking at the past

Answer 18

integrity vs. dispair

Question 19

face new sense of self over failing body and need for care

Answer 19

despair vs. hope and faith

Question 20

• Autonomous
• Multi-taskers
• prefer interactive and virtual environments
• technology focused
• interactive thinking
• short attention span

Answer 20

Millennials (1981-2000)

Question 21

• Interaction with groups
• self-directed learning
• self-reliant

Answer 21

Generation X (1961-1980)

Question 22

• Emphasis on self-knowledge

- Acquisition of knowledge from authoritative sources

Answer 22

Baby Boomers (1945-1960)

Question 23

• Emphasis is on rote learning

- Memorization of knowledge

Answer 23

Veterans (Born before 1945)

Question 24

When formulating a teaching plan, what is important to consider?

Answer 24

• Who
• Does
• What
• Where
• When

Question 25

Identify some different teaching strategies

Answer 25

• Discussion
• Lecture (community)
• Demonstration
• Role Play
• Learning Material (watch before hand)

Question 26

What are the stages of the transtheoretical model of change?

Answer 26

• Precontemplation
• Contemplation
• Preparation
• Action
• Maintenance
• Relapse/Termination

Question 27

where they do not think that what they are doing is a problem (smoking). It is not that they do not know that people get lung cancer. But they may not think that it will happen to them. Generally not ready to learn.

Answer 27

Precontemplation

Question 28

You think about the change, but you identify a lot of barriers. I get really tired when I eat diet coke, and I got a headache.

Answer 28

Contemplation

Question 29

Planning to make a change. May set a date. May start talking about it with other people. Tell people that you got a membership to the gym and that you are going to start working out.

Answer 29

Preparation

Question 30

May be tentative at first. When they are first starting to implement change, when they are most likely to relapse. Need encouragement.

Answer 30

Action

Question 31

practicing regularly, feel like they will be able to sustain it.

Answer 31

Maintenance

Question 32

Do not really see it as a change anymore. Engrained in daily activities.

Answer 32

Termination

*Some argue that there will never be a termination

Question 33

Validate lack of readiness/Clarify: Decision is theirs
Encourage re-evaluation of behavior
Encourage self-exploration (not action)
Explain and personalize the risk

Answer 33

Precontemplation

Question 34

Validate lack of readiness/Clarify: Decision is theirs
Encourage evaluation of pros and cons of behavior change
Identify and promote new, positive outcome expectations

Answer 34

Contemplation

Question 35

Identify and assist in problem solving obstacles
Help identify social support
Verify underlying skills for behavior change
Encourage small initial steps

Answer 35

Preparation

Question 36

Focus on restructuring cues and social support
Bolster self-efficacy for dealing with obstacles
Combat feelings of loss and reiterate long-term benefits

Answer 36

Action

Question 37

Plan for follow-up support
Reinforce internal rewards
Discuss coping with relapse

Answer 37

Maintenance

Question 38

Evaluate trigger for relapse
Reassess motivation and barriers
Plan stronger coping strategies

Answer 38

Relapse