Chronic Illness Flashcards
Chronic illness is responsible for ___ percent of deaths in the US
70%
What are examples of chronic illnesses?
- Arthritis
- Cancer
- Diabetes
- Coronary Artery Disease
- Stroke
- Obesity
- Usually self-limiting
- Responds readily to treatment
- Complications are infrequent
- After illness, person returns to previous level of functioning
Acute Illness
- permanent impairments or deviations from normal
- nonreversible pathological changes
- residual disability
- special rehabilitation required
- need for long term medical and/or nursing care
Chronic Illness
Tasks of the chronically ill:
- preventing and managing crisis
- carrying out prescribed treatment regimen
- controlling symptoms
- reordering time
- adjusting to changes of course of disease
- preventing social isolation
- attempt to normalize interactions with others
What are the stages of the Trajectory Model?
- Onset
- Stable
- Acute
- Comeback
- Crisis
- Unstable
- Downward
- Dying
- Signs and Symptoms present
- Disease Diagnosed
Onset
- Illness controlled by regimen
- Person maintains everyday activities
Stable
- Active illness with severe and unrelieved symptoms
- Hospitalization required for management
Acute
Gradual return to an acceptable way of life (after hospitalization)
Comeback
- Life threatening situation occurs
- Emergency services are necessary
Crisis
- Unable to keep symptoms/disease under control
- Life becomes disrupted while one works to regain stability
- Hospitalization is NOT required
Unstable
- Gradual and progressive deterioration in physical/mental status
- Accompanied by increasing disability and symptoms
- Continuous alterations in everyday activities
Downward
- One has to relinquish everyday life interests
- Immediate days/weeks before death
Dying
What is the nurse’s role in shaping the illness trajectory?
- encourage “self-managment”
- consider developmental stage
- care planning
- patient and caregiver education
- implementing strategies for symptom management
- assessing patient outcomes
Are able to reach out and connect with others
- become intimate with someone
- work toward career
intimacy vs. isolation
look beyond self to embrace society and future generations
- begin family
- develop concern for those outside of family
generativity vs. stagnation
take stock of one’s past/ get sense of satisfaction from looking at the past
integrity vs. dispair
face new sense of self over failing body and need for care
despair vs. hope and faith
- Autonomous
- Multi-taskers
- prefer interactive and virtual environments
- technology focused
- interactive thinking
- short attention span
Millennials (1981-2000)
- Interaction with groups
- self-directed learning
- self-reliant
Generation X (1961-1980)
- Emphasis on self-knowledge
- Acquisition of knowledge from authoritative sources
Baby Boomers (1945-1960)
- Emphasis is on rote learning
- Memorization of knowledge
Veterans (Born before 1945)
When formulating a teaching plan, what is important to consider?
- Who
- Does
- What
- Where
- When
Identify some different teaching strategies
- Discussion
- Lecture (community)
- Demonstration
- Role Play
- Learning Material (watch before hand)
What are the stages of the transtheoretical model of change?
- Precontemplation
- Contemplation
- Preparation
- Action
- Maintenance
- Relapse/Termination
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.
Precontemplation
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.
Contemplation
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.
Preparation
May be tentative at first. When they are first starting to implement change, when they are most likely to relapse. Need encouragement.
Action
practicing regularly, feel like they will be able to sustain it.
Maintenance
Do not really see it as a change anymore. Engrained in daily activities.
Termination
*Some argue that there will never be a termination
Validate lack of readiness/Clarify: Decision is theirs
Encourage re-evaluation of behavior
Encourage self-exploration (not action)
Explain and personalize the risk
Precontemplation
Validate lack of readiness/Clarify: Decision is theirs
Encourage evaluation of pros and cons of behavior change
Identify and promote new, positive outcome expectations
Contemplation
Identify and assist in problem solving obstacles
Help identify social support
Verify underlying skills for behavior change
Encourage small initial steps
Preparation
Focus on restructuring cues and social support
Bolster self-efficacy for dealing with obstacles
Combat feelings of loss and reiterate long-term benefits
Action
Plan for follow-up support
Reinforce internal rewards
Discuss coping with relapse
Maintenance
Evaluate trigger for relapse
Reassess motivation and barriers
Plan stronger coping strategies
Relapse
