Concepts of chronic care, illness and restorative care

Question 1

Chronic disease

Answer 1

The actual medical or health problem with associated symptoms or disabilities that require long term mgmt

Question 2

Chronic illness

Answer 2

A person’s perception of a chronic disease and their experience with it, as well as other’s perception and responses to the disease

Question 3

Secondary Health condition

Answer 3

Any physical, mental or social disorders resulting directly or indirectly from an initial condition

Example, a person that experienced a car crash may develop anxiety or depression

Question 4

Non-communicable diseases

Answer 4

Diseases not caused by an acute infection

Question 5

General definition of chronic disease

Answer 5

Irreversible, having a prolonged course, unlikely to resolve spontaneously

Question 6

Chronic disease effect on functioning

Answer 6

Physical, emotional, intellectual, social, and spiritual and can have some degree of disability

Question 7

Disabilities

Answer 7

-Restriction to perform an activity in a “normal” matter
-Can be related to a effects of a chronic illness or a disease state or caused by modifiable and non-modifiable risk factors

Question 8

Risks of having MCC (Multiple chronic conditions)

Answer 8

-Conflicting medical advice (doctor hopping)
-Adverse effects to medication (Htn and other meds)
-Unnecessary and duplicative test
-Preventable hospitalization

Question 9

Modifiable risk factors for chronic disease

Answer 9

-Diet, weight, glucose control, Medications, substance abuse

Question 10

Phases of chronic care: Pre-trajectory

Answer 10

You have genetic or lifestyle habits that place you at risk of a chronic disease which are identified

-No symptoms of disease yet

Question 11

Phases of chronic care: Trajectory onset

Answer 11

-Onset of symptoms that occur with the disease
-Focus on the diagnostic workup
-Nurses role: Explain testing and procedures, offering emotional support

Question 12

Phases of chronic care: Stable

Answer 12

-Symptoms are managed usually in the home
-Nurses role, reinforcement of positive behaviors, offer ongoing monitoring, offer education and encourage health promoting activities

Question 13

Phases of chronic care: Unstable

Answer 13

-Exasperation of symptoms, complications occurring or reactivation of overall illness
-Difficult to keep symptoms under control
-May need more testing or regiment readjustment to get symptoms under control
-Care is still occurring at home
-Nurses role: Guidance and support, keep up and reinforce previous education

Question 14

Phases of chronic care: Acute

Answer 14

-Severe and unrelieved symptoms or development of illness or complications
-REQUIRES hospitalization
-Nurses role provide direct care and emotional support

Question 15

Phases of chronic care: Crisis

Answer 15

Critical or life-threatening, situation requiring emergency treatment

Nurses role, collab with other health care providers to stabilize the patients condition

Question 16

Phases of chronic care: Comeback

Answer 16

-Gradual recovery after an acute period, learning to live with disabilities and return to an acceptable standard of living (Independence)
-Nurses role, assist in care coordination, rehab

Question 17

Phases of chronic care: Downward

Answer 17

-Rapid or gradual worsening of condition, physical decline with increasing disability or difficulty in controlling symptoms.
-Differs from acute or crisis stage as this associated with increased disability
-Nurses role: Provide home care, and other community based care to help patient and family adjust to changes . Integration with new treatment strats

Question 18

Phases of chronic care: Dying

Answer 18

Patient is dying, final days or weeks with the body shutting down
_nurses role, provide emotional support and direct care

Question 19

Direct Care

Answer 19

-Assessment, wound care, mgmt , overseeing , and admin of meds as well as technical skills

-Alot can be done at home now as well

Question 20

Supportive care

Answer 20

-Monitoring, education, consoling , patient advocate, referrals, case mgmt

Question 21

Primary prevention chronic disease

Answer 21

-Prevent people from developing the disease
-Education about exercise, diet, immunizations

Question 22

Secondary prevention, chronic diseases

Answer 22

-Early intervention to slow or halt the progression of the disease

-Low dose aspirin to prevent acute MI after development of htn

Question 23

Tertiary prevention: Chronic disease

Answer 23

Treating and rehab
-Preventing further exasperations of the disease, or deteriorating worse
-Example: Chronic pain mgmt programs, cardiac rehab programs, follow up care after a surgery

Question 24

Goals of restorative care

Answer 24

-Increase functional levels
-Maximize existing abilities
-Increase independence
-Utilize available resources
-Multidisciplinary approach for best results

-Preserve self esteem
-Improve quality of life
-Assist in adaptation to lifestyle changes
-Achieve tasks independently
-Provide psychosocial support to client and family
-Help the patient set realistic goals