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47 Cards in this Set
- Front
- Back
identify the stages seen in all chronic conditions.
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•Prediagnostic stage
•Diagnostic stage •Chronic Illness •Terminal stage |
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Prediagnostic stage of chronic illness
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Person has no disease, may have risk factors, no s&s (lifestyle, family history)
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Diagnostic Stage of chronic illness
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Confirmed by tests, studies and with S&S
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Chronic Illness Stage
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Experiencing illness, management critical
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Terminal stage of chronic illness
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Body system failure (transplant, dialysis)
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List the 8 phases in the trajectory framework of chronic illness
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1 pre-trajectory phase
2 trajectory phase 3 crisis phase 4 acute phase 5 stable phase 6 unstable phase 7 downward phase 8 dying phase |
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describe the pre-trajectory phase of chronic illness
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risk factors are present
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describe the trajectory phase of chronic illness
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signs & symptoms present
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describe the crisis phase of chronic illness
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diagnostic phase - pt may be in shock, surprised
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describe the acute phase of chronic illness
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hospitalization required to manage
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describe the stable phase of chronic illness
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symptoms managed (breathing better, blood sugar controlled)
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describe the unstable phase of chronic illness
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have to make lifestyle changes to manage illness
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describe the downward phase of chronic illness
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some body system failure is evident
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describe the dying phase of chronic illness
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terminal stage
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4 parts to pattern of psychological adaptation to chronic illness
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disbelief
developing awareness of illness integration into life coping |
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Explain who can be covered under Medicare and Medicaid
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Medicare – health insurance program for people at least 65 yrs old, or under age 65 & disabled. Also for people w/end stage renal disease requiring dialysis or transplant.
Medicaid - For indigent persons under age 65 and some poor elderly |
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Describe the purpose of hospice
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• Hospice is a means of support and care for people in the last phases of incurable disease to make life as full and comfortable as possible.
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Describe the advantages of hospice
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Only if patient wants it
One physician leads the team 24/7 access to nurse Covered by Medicare/ Medicaid No unwanted treatments will happen All equipment & therapy is paid for 100% |
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Describe the disadvantages of hospice
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Certain care may be rejected (x-ray, blood transfusion)
Experimental therapies not allowed (feeding tube) Hospitalizations discouraged |
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What are advance directives?
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a written plan stating what health care treatments you would or would not want if you could not speak for yourself
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Advantages of advance directives
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Don’t need attorney
Describes what patients wants Document can be changed at any time Document can make it easier to express your thoughts Free |
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Disadvantages of advance directives
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Not always readily available
May not be specific enough Can be overridden by physician Physician must order Nurse alone cannot follow living will |
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Humoral Immunity
Cells involved? Products? Memory cells where? Protect against? common reactions? |
Cells involved? B lymphocytes
Products? antibodies Memory cells where? outside cell Protect against? bacteria, extracellular viruses, respiratory & GI pathogens common reactions? anaphylactic shock, blood transfusion reactions |
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Cell-mediated immunity
Cells involved? Products? Memory cells where? Protect against? common reactions? |
Cells involved? t lymphocytes & macrophages
Products? sensitized T cells & cytokines Memory cells where? inside cell Protect against? fungus, intracellular viruses, chronic infectious agents, tumor cells common reactions? cancer, graft rejections, contact dermititis |
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type of immunity that is lifelong (or may need a booster) by creating memory cells
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active acquired immunity
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examples of active acquired immunity
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exposure to infection
immunizations |
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type of immunity that is immediate but not long lasting
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passive acquired immunity
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examples of passive acquired immunity
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mom to baby
immunoglobulins |
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a state in which an individual is at risk for deterioration of body systems as a result of prescribed or unavoidable musculoskeletal inactivity
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disuse syndrome
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symptoms of disuse syndrome
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Symptoms include constipation, altered respiratory patterns, lose strength in extremities, will get powerlessness if they do not try. They will have injury, activity intolerance, body image problems. Entire ...current health status must be considered because most patients will have a comorbidity such as patients with strokes. There is a balance you have to reach.
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proper sequence of immune systems response to an invader?
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inflammation - neutrophils first to arrive
monocytes engulf bacteria lymphocytes remove bacteria eosinophils/basophils attack allergens |
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Diagnostic studies performed for a pt w/hypersensitivities
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skin tests
RAST CBC Diff PFT |
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Nursing mgmt for anaphylaxis
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ensure airway - epi
O2 non-rebreather mask admin meds benadryl, histamine blockers, maintain BP thorough history for allergies |
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Medications used to treat MS, their side effects & pt education related to them?
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steroids-weight gain-restrict salt intake
Immunosuppressives-cardiotoxic-lifetime limit muscle relaxers-drowsiness-no driving CNS stimulants-insomnia-stop caffeine anticholinergics-dry mouth, constipation- antidepressants antiseizures |
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S&S exacerbation of SLE
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fever, weight loss, arthralgia, excessive fatigue
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S&S exacerbation of GB
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pain
respiratory failure usually 1-3wks after URI or UTI weakness lower extremities |
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describe cause of GB
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Unknown etiology but is believed to be cell-mediated immunologic reaction directed at peripheral nerves. Often preceded by viral infection, trauma, surgery, or HIV
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what causes MG?
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an autoimmune process in which antibodies attack ACh receptors, which prevents ACh molecules from attaching & stimulating muscle contraction.
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S&S of MG
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fluctuating weakness, restored after period of rest
facial muscles often involved incl eyes, mouth, throat & resp |
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Crises of MG
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myasthenic crisis is an acute exacerbation of muscle weakness triggered by infection, surgery, emotional distress, drug overdose or inadequate drugs. major complications result from muscle weakness in swallowing & breathing
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Treatments for MG
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plasmapheresis
thymectomy |
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Side effects of glucocorticoids/
cortcosteroids |
weight gain
moon face redistribution of body fat |
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5 points necessary to teach pt/family about MS
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drug therapy & s/e
proper nutrition (standard-hi protein diet) how to reduce exacerbations & build general resistance to illness avoid exposure to cold balance exercise & rest avoid immobility hazards (contractures, ulcers) |
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5 points to teach pt/family about SLE
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pace activities to save energy
restrict exposure to sun & use sunscreen s/e of meds plan activities later in day if bothered in am |
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3 meds for SLE and 2 s/e each
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steroids - moon face, weight gain
NSAIDs-bleeding, hepatotoxicity Antimalarials-toxicity, vision problems |
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Diagnostics tests to confirm SLE
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+ANA
+Smith anti-DNA |
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what can you teach a patient about the causes of SLE
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Etiology unknown
Environmental triggers such as sun exposure & sunburns Production of antibodies against your own nucleic acids, RBCs, WBCs |