Nc3- Chronic Illness

Front 1

What is the goal in family centered care?

Back 1

the goal is to maintain the integrity of the ledership role and support the family during times of crisis or stress

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normalization

Back 2

refers to behaviors and intentions of the disabled to integrate into society by living life as person without disability.

Front 3

mainstreaming

Back 3

paralleling normalization and home care is the process of mainstreaming or integrating children with special needs into regular classrooms

Front 4

approach behaviors

Back 4

approach behaviors are coping mechanisms that result in movement toward adjustment and resolution of the crisis

Front 5

avoidance behaviors

Back 5

result in movement away from adjustment or maladaptation to the crisis

Front 6

Approach behaviors

Back 6

coping mechanisms that result in movement toward adjustment and resolution of the crisis

Front 7

Avoidance behaviors

Back 7

movement away from adjustment or maldaptation to the crisis

Front 8

overprotection with a chronically ill child

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parents fear letting the child achieve any new skill, avoid all discipline and cater to every desire to prevent frustration

Front 9

rejection by parents of a chronically ill child

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parents detach themselves emotionally from the child but usually provide adequate physical care or constantly nag and sold the child

Front 10

denial of parents with a chronically ill child

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parents act as if the disorder does not exist or attempt to have the child overcompensate for it

Front 11

gradual acceptance of chronically ill child by parents

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parents place necessary and realistic restrictions on the child, encourage self-care activities, and promote reasonable physical and social abilities

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chronic sorrow

Back 12

feelings of sorrow and loss that recur in waves over time

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functional burden

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issues related to caring for and living with the child in relation the family's resources and coping ability

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American Disabilities Act & day cares

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requires that day care providers make "reasonable modification" for equal access to program participation

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use of scopalamine in dying children

Back 15

this is used for patients who are dying to reduce noisy respirations (applied topically)

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holistic health

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promotion of the total health of mind, body and spirit

Front 17

complementary therapies

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used as an anjunct to traditional health modalities, they typically influence the effects of stress, anxiety, depression and other physical and emotional states

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concept of emotional health

Back 18

ecompasses a person's ability to function as comfortable and productively as possible

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Risk factors for mental health that cannot be changed

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Age, gender, genetic background, family history

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Risk factors for mental health that can be changed

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marital status, family environment, housing problem, poverty or economic difficulties, physical health, nutritional status, stress level, social environment and activities, exposure to trauma, alcohol and drug abuse, environmental toxins or other pollutants, availabiltiy, accessibility and cost of health services

Front 21

What are the five family functions related to illness

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management, boundary setting, communication, education and support, socialization

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Effective coping skills

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communication skills, spirituality, cognitive abilities, emotional strengths, relationship capabilities, willingness to use community resources and individual strengths and talents

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somatic signs of depression

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headache, backache, abd. pain, fatigue, malaise, anxiety and decreased desire or problems with sexual functioning

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clinical signs of depression

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feelings of sadness, worthlessness, fatigue and guilt and difficulty concentratin or making decisions. Changes in appetite, wgt gain or loss,sleep disturbances and psychomotor retardation or agitation, recurrent thoughts of suicide or suicide attempts

Front 25

Four major task of the grief process

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a. acceptance of loss, b.acknowledgment of the intensity of the pain, c.adaptation to life after the loss and cultivation of new relationships and activities

Front 26

Two basic goals of the grieving process

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1-healing the self and 2-recovering from the loss

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trajectory

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the way in which a process or event develops over a period of time

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Five stages of grieving by Kubler Ross

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denial, anger, bargaining, depression and acceptance

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Stages of berevement by Bowlby

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protest, disorganization and reorganization

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Successful grieving by Engel

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shock and disbelief, development of awareness and restitution

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Common to all models of grieving by Cooley

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avoidance, confrontation and acceptance

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pre-trajectory

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stage at which individual may develope a chronic condition b/c/o genetic factors or lifestyle behaviors that increase susceptibility to chronic illness

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trajectory phase

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onset of symptoms or disability assoc. with a chronic condition. Since symptoms are being evaluated and diagnostic tests are perfomed, this phase is often accompanied by uncertainty as the person awaits a diagnosis.

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Stable phase

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symptoms and disability are being managed adequately. Although the pt. is doing well, nursing care is still important ath this time to reinforce positive behaviors and offer ongoing monitoring

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unstable phase

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characterised by an exacerbation of illness symptoms development of complications, or reactivation of an illness in remission

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acute phase

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sudden onset of severe unrelieved symptoms or complications that require hospitalization for their management

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crisis phase

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characterized by a critical or life-threatening situation taht requires emergency treatment or care

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comeback phase

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trajectory marked by recovery after an acute period- learning to live with or overcome disabilites and a return to an acceptabl way of life.

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downward phase

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marks the worsening of a condition. Symtoms and disability continue to pogress despite attempts to gain some control through treatment and management regimens

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dyeing phase

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gradual or rapid decline in the trjectory despite eforts to halt the disorder or slow the decline ghrough illness mgmnt, failure of life-mainting body functions.

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Traumatic brain injury

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An insult to the brain, ot a degenerative or congenital naute, caused byu and external physicl force that may produce a diminished or altered state of consciousness, which results in an impairment of congnitive abilities or physical functioning, and disturbance of behavioral or emotional functioning

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Acquired Brain Injury

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This is an injury to the brain that is not hereditary, congenital or degenerative

Front 43

Hypercalciuria in SCI patients

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immobility leads to an imbalance in calciym metabolism with a loss of bone calcium and its secretion in the urine

Front 44

Plasmaparesis

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removal of blood plasma from patients with Guillaine Barre syndrome, to remove antibodies and replaced when done

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Life expectancy with AlS patient

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3 years

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orthosis

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external appliance that provides support, prevents or corrects deformities and improves function

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Protein difiency

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serum albumin is a senstitive indicatior of protein deficiency, serum albumin levelsof < 3g/ml are associated /c hypoalbuminemic tissue edema and increased risk of presure ulcers

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signs of infection

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purulent drainage, foul odor, warmth, elevated temp

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trisomy

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(triplication) of the 21st chromosome.

Front 50

Avoid massaging reddened areas because

Back 50

this may increase the damage to the already traumatized skin and tissue

Front 51

urge incontinence

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involuntary elimination of urine associated with a strong perceived ned to void

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Reflex (neurogenic) incontinence

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assoc. with a spinal cord lesion that interrupts cerbra control, resulting in no sensory awareness of the need to void

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stress incontinence

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assoc. /c weak perinal muscles that permit leakage of urine when intra-abd. pressure is increased eg /c coughing or sneezing

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functional incontinence

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refers to incontinence in pts /c intact urinary physiology who experience mobility impairment, environmental barriers, or cognitive problems and are unable to reach and use the toilet before soiling themselves

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total incontinence

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occurs in pts. who are unable to control excreta b/c of physiologic or psychological impairment

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excreta

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any waste matter discharged from the body, e.g. feces or urine

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causes of bowel incontinence and constipation

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diminished or absent sphincter control, congnitive or perceptual impairment, neurogenic factors, diet and immobility

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pelvic floor excercises

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keigel excercises

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life expectancy

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avg. number of years that a person can be expected to live

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Patinet Self-Determination Act (PSDA)

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law enacted to require patient educatio about advance directives at the time of hospital admission along with documentation of this education

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involution of the uterus

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atrophy of the uterus