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65 Cards in this Set

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