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65 Cards in this Set
- Front
- Back
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an impairment or deviation from the normal and has a duration longer than 3 months
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chronic illness
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In the "long haul stage" of a chronic illness, changes in fx are marked by ________ & _________
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remissions
exacerbations |
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how long does the long haul stage of the chronic illness last?
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for the rest of the client's life
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In the terminal stage of the chronic illness, death is expected within _________
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6 months
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risk factors for the chronic illness:
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age
physical environment lifestyle stress smoking drugs obesity immobility sports |
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the ______ stage of the chronic illness occurs when changes in the body systems become irreversible
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terminal
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an abnormalitiy of a body structure or structures or an alteration in system function. It can be temporary or permanent and may or may not be associated with active pathology.
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impairment
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2 examples of impairment:
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renal disease
colostomy pts. |
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_________ is the consequence of impairment and is described in terms of a client's altered functional ability and represents a disturbance at the personal level.
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disability
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___________ is an ex. of a disability
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amputee
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the disadvantage experienced by a person as a result of impairments and disabilities and represents disturbance at the societal level
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handicap.
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Name the 6 theories r/t chronic and disabling conditions
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-powerlessness
-adaptation -coping -self care -body image -family |
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_________ theory- teach pt. to care for self. (some cultures don't adhere to this) "be respectful"
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self care theory
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with the ________ theory- pt. leans on nurse for "golden answers"
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coping
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________ theory- ability to accomodate change (ppl adapt differently) (1st step-determine if client has ______)
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adaptation
ability to adjust |
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_________ theory- ones action can't effect outcome (no matter what they do, nothing will ever change)
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powerlessness
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_________theory. It's individual and it's linked to self esteem. ex., some ppl could care less if they are in a wheel chair.
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body image
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Common emotional/behavioral responses are:
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disbelief
developing awareness rational acceptance coping |
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with the disbelief response to a chronic/disabling condition, pt goes into "_____ __ ____"...asks _____? give one ex.____
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fight or flight
why me 18 y.o. paralyzed |
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If a pt. is in the disbelief phase, do what 2 things?
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-be supportive
-use knowledge to give positive goals. |
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when the pt. with a chronic or disabling illness is in the developing awareness stage of behavioral responses, they will go through:_________, _______, _________, ________, _______, ________.
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anger
withdrawal preoccupation with self crying depression guilt |
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when the pt. with a chronic or disabling illness is in the developing awareness stage of behavioral responses, they will start to:
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grieve what is lost. (roles at work) ex. survivor guilt
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What are some major chronic problems of the elderly
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arthrities
htn hearing impairment cardiac condition cataracts chronic sinusitis deformity or orthopedic impairment henia (abd) diabetes visual impairment varicose veins hemorrhoids |
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usually _____ that bother the elderly (ex. hemorrhoids may bother more then learning about cardiac prob)
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smaller
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rehabilitation starts _________ and continues _____. Who coordinates care throughout the continuum?
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-in the hospital
-after d/c from hospital -nurse |
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This type of rehab only accepts pt's that can stand 3 hrs of therapy in 1 day.
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free standing rehab
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These offer rehab that allows client to move from total help to independent living (ex. apt.)
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transitional living facilities
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ppl with mental retardation may live here, where they will receive rehabilitation. (it works well, there is a group leader which may be a health care provider)
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group home
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___________-@ nsg home, 1hr/day (full range of activities available (OT, PT, recreational therapy))
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long term care settings
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___________________-rehab setting where APRN's move into a specialty
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nurse managed clinics
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_____________- glue that holds client in system. may be a social worker or a nurse
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case management
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___________- a disability that has existed since birth but is not necessarily hereditary
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congenital disability
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an abnormal slower rate of development in which a child demonstrates a functioning level below that observed in normal children of the same age.
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developmental delay
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_____________ - any mental and/or physical disability that is manifested before age 22 and is likely to continue indefinitely
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developmental disability
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__________________- a child between birth and 22 years with a chronic disability that requires the routine use of a medical device to compensate for the loss of life sustaining body function.
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technology dependent child
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coping strategies used by children with special needs:
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-develops competence and optimism
-feels different/withdraws -irritable, moody, act out -complies c txt -seeks support |
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with the chronic ill child, know that the _________
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family is impacted
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with the chronic ill child, encourage:
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things they can do
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3 types of parent characteristics:
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silent in care
recipient of care monitor of care |
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what is important to do, when you have a parent who is the "silent in care" type?
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find out why they are participating, but don't force participation
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The parent who is the "recipient of care" type:
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wants ideas, but they want to do their own way of care
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The parent who is the "monitor of care" type:
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may come off as critical. they know what works @ home.
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Avoid _______ _______ when interacting with a parent
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authoritarian stance
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the "goal" of pain managment is to ________________ while _________ and______
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relieve pain
minimizing side effects adverse effects |
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who often get undermedicated?
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very young and very old.
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acute pain is ______.
acute pain is attributed to_______. acute pain usually signifies _______. |
-sudden.
-a specific cause -underlying trauma or disease and may be easily localized |
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what are 3 good pain assessment tools?
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wong baker faces scale
visual analog scale(vas/pis) mcgill-melzack questionnaire |
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Pain assessment in children QUESTTL
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Question child
Use pain rating scale Evaluate behavioral/physiologic changes (is usually continent child suddenly incontinent?) Secure parent's involvement Take cause of the pain into acct Take action/evaluate results |
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WHO stands for
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world health organization
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The W.H.O's 3 step approach:
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mild pain
mild/moderate-increasing pain severe or increasing pain |
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The WHO says if the pt. has mild pain, give them: ______
For ex.___ or__ |
non opiod
tylenol nsaid |
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The WHO says if the pt. has mild-to-moderate or increasing pain, the following meds can be given: (5).
S/E of these meds: One downside of these meds: |
tylenol c codeine (children)
oxycodone percocet hydrocodone vicodan -Groggy -short acting |
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non opiods offer pain relief without:
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s/e's
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The WHO says if the pt. has severe or increasing pain, give them: _______. 3 ex.'s of opiods:
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Morphine
MS Contin Dilaudid |
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morphine may cause__________
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resp. distress.
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_________: the phenomnenon of developing gradual adaptation to the narcotic on the CNS
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tolerance
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_________:physiologic adaptation of the body to the drug
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dependence
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Chronic pain is pain that persists past the normal time of healing (usually ___-___months)
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3-6
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what is the most freq. causes of suffering and disability in the w'n world.
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chronic pain
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In north america, it is estimated that chronic pain causes _____ suicides annually
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7,000
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chronic pain poses as a major ____ and major_____ issue
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economic/health
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Nursing care for the pt. with acute illness: provide comfort measures such as: (2)
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repositioning
proper body alignment |
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Some adjuvant therapies for the pt. with acute illness:
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hydroxyzine
promethazine neuropathic pain-NSAIDS Anticonvulsants |
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Adjuvant therapies for Acute pain:
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hydroxyzine
promethazine neuropathic pain anticonvulsants |
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what can be taken with percocet to make it last longer?
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ibuprofin
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