Module 8 - Common Chronic Conditions Flashcards
What are the categories of the Chronic Illness trajectory model (8)?
1) Pre-trajectory - before illness occurs - preventative phase
2) Trajectory onset - Signs and Symptoms
3) Crisis - Life threatening
4) Acute - Active illness
5) Stable - Symptoms controlled
6) Unstable - Symptoms not controlled
7) Downward - Progressive deterioration
8) Dying
Holistic approach to chronic conditions
- Use of non-chemical medications
- Naturally sourced medications - herbal supplements, cannabis
- Healthy nutrition
- Exercise
- Essential oils
- Accupuncture
- Massage therapy
- Physical therapy
Pathophysiology and Etiology - Osteoporosis
- Metabolic bone disorder
- Decrease in bone mass
- Loss of calcium
- Severe low bone mineral density
Signs and Symptoms -Osteoporosis
- Early stage is asymptomatic
- Back pain
- Psychosis
- Scoliosis
- Fractures
Treatment - Osteoporosis
- Exercise
- Nutrition
- Lifestyle changes (Smoking)
- Physiotherapy
- Fall prevention
- Increase in calcium and vitamin D
- PTH injections
Pathophysiology and Etiology - Osteoarthritis
- Degenerative arthritis or degenerative joint disease
- Cartilaginous lining becomes thin and damaged
- Joint space narrows and bones of the joint rub together causing destruction
Signs and Symptoms -Osteoarthritis
- Older age
- Obesity
- Pain and joint stiffness
- Crepitations
- Joint movement is limited
- Fingers can look disfigured
Treatments- Osteoarthritis
- Medications - Analgesics/NSAID’s
- Physiotherapy
- Surgery
- Heat and Cold applications
- Diet changes
Pathophysiology and Etiology - Polymyalgia Rheumatic Arthritis
Inflammatory disease of the joints
- Mainly in the neck, shoulders and upper arms
Signs and Symptoms- Polymyalgia Rheumatic Arthritis
- Acute onset pain in neck, shoulders and upper arms
- Low grade fever
- Fatigue
- Stiffness
- Swelling
- Redness
Treatments- Polymyalgia Rheumatic Arthritis
- Corticosteroid medication/injection
- Physiotherapy
Pathophysiology and Etiology - Rheumatoid Arthritis
- Autoimmune disease
- Inflammation of joint and destroys cartilage and bone within the joint
- Persistent and systemic inflammation
Signs and Symptoms- Rheumatoid Arthritis
- Redness
- Pain
- Swelling
- Fatigue
- Low grade fever
- Aching
- Depression
- Progression to heart valves/pleura (severe)
Treatments - Rheumatoid Arthritis
- Physiotherapy
- Analgesics/NSAID’s
- Heat and cold application
- Glucocorticoid injections
- Disease-modifying anti-rheumatic drugs (NDMARD)
- Rest between activities
Pathophysiology and Etiology - Benign prostatic hypertrophy
- Hyperplasia related to imbalance of estrogen and testosterone due to aging
- Changes in prostate tissue surrounding urethra causing compression and obstruction
Signs and Symptoms - Benign prostatic hypertrophy
- Dribbling urine
- Hesitancy to urinate
- Age
Treatment - Benign prostatic hypertrophy
- Surgery
- Cystoscopy
- Medications to smooth and relax muscles
Pathophysiology and Etiology - Parkinson’s disease
- Progressive neurological disorder
- Neurons that produce dopamine are destroyed and die
- May be genetic
Signs and Symptoms- Parkinson’s disease
- Decreased sensations
- Decreased fine motor skills
- Voice changes
- Stooped posture
- Tremors
- Slow movements
- Stiffness of arms and legs
- Problems with balance, tend to fall a lot
Treatment - Parkinson’s disease
- Lifestyle changes
- Medications
o Dopamine agonists
o Anticholinergics - Nutrition
- PT/OT
- Holistic care
- Exercises – slow and steady
Nursing care assessments, management, patient teaching - Osteoporosis
- ROM Assessment
- Nutrition assessment
- Vitamin supplements
- Promote physiotherapy
- DEXA bone Scan
- Follow ups with care provider
- Encourage healthier lifestyle
Nursing care assessments, management, patient teaching - Arthritis - ALL (osteoarthritis, polymyalgia rheumatics, rheumatoid arthritis, gout)
- Encourage a healthier lifestyle- Nutrition, No smoking, Avoid alcohol
- Exercise
- Vitamin supplements
- Follow ups with care provider
- ROM
- Dexterity of hands
- Ensure client rest after activities
Nursing care assessments, management, patient teaching - Benign prostatic hypertrophy
- Follow ups with health provider
- Ensure education on what to look for with BPH
- Encourage increase fluid intake
- Exercise and mobility
Nursing care assessments, management, patient teaching - Parkinson’s disease
- Nutrition
- Vitamin supplements
- Exercise and mobility
- Test ROM
- Physio/OT
- Encourage follow ups with health professionals
- Education on signs and symptoms of worsening condition
Pathophysiology and S/S - Glaucoma
- Natural fluids of the eye are blocked by ciliary muscle causing build up of pressure
- Damage to optic nerve
- Redness
- Acute pain
- Severe headache
- Impaired vision
- Nausea/Vomiting
Nursing Assessments/Intervention - Glaucoma
- Obtain a medical history
- Eye drop administrations
- Ophthalmology appointments
- Vision Exam/- Routine screening
Pathophysiology - Cataracts
Caused by oxidation damage to lens’s protein and fatty deposits
Signs and Symptoms- Cataracts
- Clear lens becomes cloudy
- Halos around objects
- Blurred Vision
- Changed perception of light and colour (yellow tinge)
- Sensitivity to glare
- Increased rate of impairment
- Age
Nursing Assessment/Interventions - Cataracts
Assessments; - Assess renal function - Assess for tumors/lesions - Education and preparation to vision changes Treatments: - Surgery - Counselling - Vision exams/Routine screenings
Pathophysiology - Macular degeneration (AMD)
- Degenerative eye disease that affects macula
- Progressive loss to central vision
- Peripheral vision intact
- Genetics
Nursing Assessments - Macular degeneration (AMD)
- No cure
- Limited treatment options due to slow progression
- Screening and early detection and prevention
- Eye exams
Interventions - Macular degeneration (AMD)
Want to slow progression by:
- Antioxidant and zinc formulas - Vitamin C and E and Zinc oxide
- PDT (photo-dynamic therapy)
- Laser Therapy
- Medications
Pathophysiology - Diabetic retinopathy
- Increased vessel permeability due to Diabetes Mellitus
- Blood and lipid leakage causes macular edema and hard exudate
Assessments - Diabetic retinopathy
- Assess for Micro-aneurysms, hemorrhages and hard exudates
- Eye exams– 5 years after diagnosis of Type 1 and at the time of diagnosis for Type 2
Interventions - Diabetic retinopathy
- Constant, strict control of glucose, cholesterol and blood pressure
- Laser photo-coagulation treatments
Pathophysiology - Tinnitus
- Perception of sound with the absence of sound
- Can be ringing, buzzing, hissing, whistling and swishing
Assessments - Tinnitus
- Collect data from person
- Tinnitus questionnaire
- Causes vary- Loud noises, allergies and obstruction
- May never be determined
- Medication toxicity
Interventions - Tinnitus
- Hearing aids
- Electrostimulation
- Masking with white noise
- Dental treatment
- Cochlear implants
Pathophysiology - Hearing Loss
- Conduction deafness - Blocked sound to external or middle ear
- Accumulation of wax/foreign object, scar tissue or adhesions
- Sensorineural deafness- Damage to organ of corti – auditory nerve
Assessments - Hearing Loss
- Hearing test
- Collecting data from the person
- Interpreter may be able to gather information for sign language use
Interventions - Hearing Loss
- Cochlear implant
- Hearing aid
- Removal of wax or foreign objects
- Education on sign language
Strategies to maintain maximal function for people to self care
- Education on disease prevention
- Immunizations
- Access to resources
- Follow ups with health provider
- Vision and hearing assessments
Immunization need for older adults
- Booster dose of tetanus/diphtheria every 10 years
- Annual influenza vaccine
- Booster dose for the whooping cough
- Pneumococcal vaccine – over 65 years and older adults with health issues
- Herpes Zoster (Shingles) - Over 50 years
Describe the geriatric syndrome of frailty
Fatal/chronic conditions in which the body has few reserves left and any disturbances can cause multiple health conditions
- Increase in physical and mental decline
- Leads to increase risk of morbidity and mortality
Responsible for:
- Metabolic factors
- Atherosclerosis
- Cognitive impairment
- Malnutrition
- Weight loss, fatigue, muscle weakness, slow and unsteady gait and decline in activity
What is the scale that is used to manage frailty and prevent further functional decline?
Clinical Frailty Scale: Scores individuals from levels of very fit to terminally ill based on common symptoms
Causes - Arterial and Venous Ulcers
- Venous and arterial insufficiency
- Immobility
- Obesity
- Diabetes
- Atherosclerosis
- Thrombocyte activity
- Sickle cell disease
- Wounds
Management - Arterial ad Venous Ulcers
- Change in position
- Examination of the wound
- Understanding and treatment of underlying cause
- Assess medical history
- Change of Dressings
- Encourage fluid intake
- Medications
Gout
- Form of arthritis
- Urate crystals accumulation in the joint causing the inflammation
Gout - Signs and Symptoms
- Intense Pain
- Redness
- Swelling
- Discharge
- Limited ROM
- Obesity
- Diabetes
Gout - Treatment
- Medications - NSAID’s
- Corticosteriods
- Change of diet
- Limit alcohol
- Exercise recovery
