Module 1.4: intro to acute and chronic diseases Flashcards
?which disease has increased prevalence at 3-5 imes the national avg among First Nations, Metis, & Inuits?
diabetes
? what are 2 common associated symptoms of chronic conditions? what is a third issue that generally accompanies severe or advanced chronic illness?
pain and fatigue
disability
are chronic diseases generally curable?
no
chronic condition definition
medical or health problems with associated symptoms that require long-term mgmt (3 months or longer)
?adjustment to chronic illness is generally affected by: (6 things)
- personality before illness
- unresolved anger
- stages of indiv or family life cycle
- previous experience w illness and crises
- family and indiv resources for dealing w stress
- suddenness, extent, and duration of lifetyle changes necessitated by the illness
? when are psychological, emotional, and cognitive reactions to chronic conditions likely to occur?
onset & may recur if symptoms worsen after a period of remission
what do chronic conditions encompass (are they always a disease or illness)? How are they caused?
seemingly disparate health issues
- they may be a result of illness
- may be a communicable disease eg HIV
- may be d/t genetics, consequence of life circumstances
what type of approach do chronic conditions necessitate? think length and how you would organize care
long-term, systematic
holistic
what type of adjustments must a person make with a chronic condition? in general
may need to adjust their roles
lifestyle alterations
change their self-care
What causes the majority of deaths in Canada, acute or chronic disease?
chronic diseases (89% of all deaths)
are deaths from chronic conditions predicted to inc or dec in the next 10 year?
inc (15%)
? T or F: young people are expected to have shorter lives than their parents. why or why not?
True. Young people are inactive, use tobacco and have unhealthy diets
are all chronic conditions disabling?
no. Many people dont experience significant limitations
what ratio/percent of Canadian’s have at least one modifiable risk factor for chronic disease
2/3 or 66%
what are the modifiable risk factors for chronic disease?
smoking unhealthy diet physical inactivity overweight and obesity WHO says alcohol
what should be acknowledged that is equally as important as assisting people with making healthier individual lifestyle choices to decrease the prevalence of chronic conditions?
acknowledging the link between societal conditions and other personal factors eg resources
which income bracket or type of Canadians has the most risk factors for chronic illness
low income or disadvantaged groups
when treating an individual with chronic illness what should the nurse keep in mind other than treating the illness? in relation to the person
seek to understand the meaning of the chronic illness to the person who has it
? are smoking rates increasing
no, theyre decreasing
?what is smoking a risk factor for?
diseases of resp, cardio vascular, cancer
?what does improving diet have most significant impact upon improving mortality rates of?
diabetes 30%
coronary heart disease and stroke 20%
? overweight and obesity are imp risk factors for? 3 things
diabetes, some cancers, coronary heart disease
11 characteristic patterns of chronic illness (very long cue card)
- Managing illness isn’t just about medical problems
- Involve many diff phases over the pts life eg acute, remission, wellness
- Adherence to therapeutic regimens is imp.
- One disease can lead to development of another disease,
- Affect the whole family
- Major responsibility of everyday mgmt of chronic illness fals on ill people and their family
- Learning to manage chronic conditions is a dev process of trial and error, discovery, and fine tuning
- Managing chronic illness is collaborative.
- Medical mgmt of chronic conditions is expensive to every party
- Chronic conditions raise ethical issues for pt, hcw and society.
- Living w chronic illness also means living w uncertainty
How can you support pts in managment of chronic illness in relation to adaptation of the family and the pt (not symptom related)?
use effective and supportive communication
How might a person be affected by managing a chronic illness (not symptom related)? How might this affect their condition?
- role changes
- changes in self identity
- chronic sorrow
- depression
the above issues exacerbate the condition especially depression
keeping in mind that an important part of chronic disease mgmt is adherence to therapeutic regimens what type of planning must the nurse do?
anticipatory planning for noncompliance etc
who does the major responsibility of everyday mgmt of chronic illness fall upon
the family and pt
where is the center of care (location) in chronic conditions
the home. Hospitals, care homes etc are back up services
is it best to have one type of health professional working with an indiv w a chronic condition?
no. multidisciplinary is best since it is complex to care for all aspects of a chronic condition
what should the focus of self care be?
living life well with chronic disease
examples of ethical issues raised by chronic conditions
- allocation of resources eg organs for transplant
- how to etablish cost controls
- how to determine what constitutes quality of life
- when to terminate life support
living with chronic conditions means living with _______? (this is a characteristic pattern of chronic illness)
uncertainty.
eg even when in remission a pt may question or feel dread that the disease may return
? headings for Corbin and Strauss’ Chroni Illness Trajectory Model
- Pretrajectory phase at risk for dev chronic condition due to genetic factors, lifestyle, health limiting behaviours
- Trajectory phase-char by onset of symptoms or disabily assoc w chronic condition. Nursing care involves preparing people for diagnostics tests and offering emot support
- Stable phase-symptoms and disability are being managed adequately. Nursing care is imp to support pos behave.
- Unstable phase- exacerbation of illness symptoms, dev of complications or reactivation of illness in remission. May be more diagnostics and trial of new regimens until some degree of control over symptoms is achieved. Duing this time of uncertainty people often look to nurses for guidance and support.
- Acute phase sudden onset. Requires major modifying of pts life. Nurses are intensely involved.
- Crisis phase- char by critical life threatening situation that requires emergent care. Require hcw to support stabilize conditions.
- Comeback phase-recovery after an acute period. Nurses role as collaborators and organizers is nec.
- Downward phase- worsening of a condition. Doesn’t nec mean imminent death. Since not yet acute or dying contact w nurse is limited. Nurses nec to help w understanding and adjustment
- Dying phase- char by gradual or rapid decline. Nurses give hospice care
what is the essential contribution of nurses to (care of) chronic illnesses? how should we approach care of pts w chronic illness?
seeking to base care holistically, from an understanding of what living with the illness is like for the indiv
definition of acute illness (not from med surg)
Acute: Of abrupt onset, in reference to a disease. Acute often also connotes an illness that is of short duration, rapidly progressive, and in need of urgent care.
nurses can provide direct care and ______ care to pts w chronic illness? examples of this type of care
supportive
eg ongoing monitoring, making referrals, counselling, case managing
what can nurses use to guide their care of a pt w a chronic illness? How can they know whether its appropriate to implement rehabilitation or palliative care?
by thinking in terms of phases. What phase of the illness trajectory is the pt in
do all patients go through each phase of a chronic condition?
no. Not all are fatal or life threatening
?when implementing the plan and interventions what two tasks are of key importance?
1=incorporating disease mgmt regimens into life in a way that controls symptoms, keeps the disease stable, and is manageable within ones life context
2=addressing the psychological, social, and emotional issues that often accompany chronic disease and that can potentially hinder one’s ability to self care and live well
if a pt isnt making any progress towards a goal what can you do?
redefine the goals to make them achievable
Common chronic diseases from in class notes
- Diabetes
- CVS-CAD-HTN-atherosclerosis
- Resp diseases-COPD-asthma
- Cancer
- Arthritis
- Chronic kidney disease
- Mental illness
? WHO which type of disease accounts for most noncommunicable disease deaths?
Cardiovascular diseases account for most NCD deaths
?WHO: metabolic or physiological risk factors for disease
- raised blood pressure,
- overweight/obesity,
- hyperglycemia (high blood glucose levels) and -hyperlipidemia (high levels of fat in the blood).
?WHO: leading Metabolic/physiological risk factor attributed to disease
high BP (18% of global deaths)
Missing are the signs and symptoms for selected chronic illnesses
look them up. She covered them in class
ongoing monitoring and case management are examples of ________ type of care?
supportive
