diabetes, non traumatic lower extremity amputation and blindness among those 20-74
characteristics of chronic illness
slow with gradual onset
symptoms come and go with periods of remission and exacerbation.
requires long term medicla and nursing management
accepts inability to be well
role inferior - does not feel as valued
knowledge of patient role
retains decision making often seen as problem patient
characteristics of acute disorders
sudden dynamic onset.
signs and symptoms resolve infrequently.
ends in recovery or death
responds readily to treatment
desire to get wellrole less desirable but acceptable. decision making by staffsick role reinforced by staff
in caring for the chronically ill a nurse should
need to focus on promoting the highest level possible of independence, sense of control and wellness.
eight stages of chronic illness trajectory
initial /prejectory phase
occur before signs and symptom appear
occurs with first onset of signs and symptoms and includes diagnostic period
potentially life threatening situation occurs
patient symptoms are controlled by regimen. follows crises phase
symptoms are controlled
symptoms become uncontrolled by regimen
progressive deterioration in mental and physical status
period preceding death.
Caregiver strain (feelings of caregiver)
increased demand on time
increased stress due to anxiety
financial problems with healthcare cost
lonelines as a result of pending loss
change in social customs
3 aspect of client response to symptom experience
phycal experience of syptom
interpretations of symptoms
why medical care contact
validation of illnes
explanation of terms
reassurance they will be alright
accepts or rejects diagnoses. if accepted they follow advice
nurses role in caring for chronically ill
palliative care for symptom control
provide info and educate
discuss self care practices to enhance independence
promote psychological well being by enhancing the client's sese of control or power, self esteem, sense of meaning or purpose
promote good communication
a disability that has existed since birth but not necessarily hereditary
a maturational lag, an abnormal slower rate of development in which a child demonstrate functional level below that observed in normal children of the same age
documents energy expenditures within the community setting. provides visualization of how the family unit interacts.
family that includes teh relatives of the nuclear family - eg grandparents and uncles
family centered nursing
considers the health of the family as a unit in addition to the health of indivdual family members
gender and line of birth
a condition or barier imposed by society, not synonym for disability
a loss or abnormality of structure or function
a family of parents and their offsprings
descrive family centered nursing
considers the health of the family as a unit in addition to the health of the individuals
components of a comprehensive family assessment
family structure- age /gender, size and type of family
family roles and function- job outside home, child rearing responsibilities
physical health status- current health of each family members. preventive care and routine.
interaction patters- ways of expressing affection, love, sorrow, anger
family values- cultural religious practices, use of leisure time, view of education, and school system. health values
coping resources- degree of emotional support found in family. availability of suport persons, afiliations outside family, friends church. sources of stress and how its handled. financial ability to meet current and future needs
types of work
comfort work- what client has to do to function. exercise, ap of heat cold, keeping warm
usual life work- whatever it takes for client to maintain their family life, work life, student life, and relationship, firends, community.
clinical safety work- involves adding the things the client must do to keep their illness under control and avoid crises. ie taking meds, visit doc, daily blood sugar check, having plan when crisis occurs
tasks of chronically ill
prevention and management of crisis- pot risk,, signs and sx
carrying prescribed regimen
reordering time- has to do with illnes management- client report having no time or to little time. client need to learn about the pattern of symptoms, onset, duration, severity
adjusting to changes in course of disease. client must develop personal identity
prevention of isolation
attempting to normalize
Work on trajectory scheme
involves client working on what their future hold . ask should you buy long term care insurance. should you sell your home should you move
how will illness affect future. who will be there
work on biorgraphy
the reshaping and remolding of self concept. new story to write. questiosn client must answer. who am i now that i have illnes
how will illness change me as a person
how will it effect my life.
self concept includes
appearance, values and beliefs
4 dimention of self concept
components of self concept
signs of positive body image
incred self confidence
rewarding relationship with others
succes at work
signs of negative self image
lower self confidence
impaired relationship with others
failures in the workplace
factors that effect illness trajectory
growth and development.
age and life
signs of caregiver overload
difficulty performing routine tasks for client
reports of declining physcial energy or insufficient tirme for caregiving
concern caregiving responsibility interfere with other roles
anxiety about ability to meet future care need of client
feeling of anger and depression
dramatic change in the home environment's appearance
roles of the family
caring, nurturing and educating chilfren on how to get along in the owrld
maintaining continuity of society
receiving and givng love
preparing the next generation
meeting the needs of its members
serving as a buffer between family members and demands from outside
peripheral resitance agianst which the left ventrical must pump to eject blood.
chronic stable angina
clinical manifestation of reversible myocardial ischemia. chest apin that occur interittently over long period with the same pattern of onset, duration and intensity of symptoms
unstable engina- chest pain that is new in onset ocurs at rest or has a worsening pattern
an ischemic muscle ache or pain that is precipitated by consistent level of exercise, resolves within 10 minutes or less with rest, and is reproducible.
deficiency of blood supply cause by obstruction of circulation to the body part
respiratory problems bought on by lying flat. ability to breathe only when in upright position.
paroxysmal nocturnal dyspnea
attacks of shortness of breath especially at night that awaken the patient; caused by reabsorption of fluid from dependent body areas when patient is recumbent
volume of blood in the ventricles at the end of diastole. determines stretch on cardiac muscle.
discoloration or redness caused by inflammation; one of the four classic symptoms of inflammation.
systemic vascular resistance
force opposing the movement of blood within the blood vessels.
the blocking of a blood vessel by a clot
enlarge, dilated uperficial vein, can occur in any part of body, but most common in lower extremities.