Illness Experience
Chronic illness and disability effects what types of people?
Effects all types of people
Older adults may be stereotyped as different from other age groups and having "outlived their usefulness." The term for this is:
Ageism
Processes that are initiated to restore balance when the steady state within the body encounters stress that causes the body function to deviate from its stable ranges is called
Homeostasis
Focuses on symptom management
Palliative Care
Is the restoration of a person to the fullest physical, mental, social, vocational and economic usefulness possible/ dynamic process/ teaching patients to compensate and maximize functional independence
Rehabilitation
What are modifiable risk factors of chronic illness: (5 Things)
Physical activity
Nutrition
Tobacco use
Alcohol use
Weight/BMI
Most common mental health disorder of the elderly/ underdiagnosed & undertreated
Depression
The initiation of homeostasis is through the _____________ system
Endocrine systems
Is a type of palliative care the focuses on comfort at the end of life
Hospice Care
Is to prevent complications and enhance the person's quality of life while promoting independence and self-care
Goal
What are non-modifiable risk factors of chronic illness: (4 things)
Gender
Age
Genetics
Family history
Slowly progressive cognitive decline
Dementia
A dysfunctional response of the body caused by inadequate compensatory mechanisms
Disease
Any significant loss that necessitates adaptation through the grieving process
Personal loss
Rehab team assesses cognitive and physical demands of client's job and ascertains whether he/she can return or whether retraining in another field is necessary
Vocational assessment
What type of disability? Birth to 22 years
Developmental Disability
Acute state of confusion/ medical emergency/ may lead to brain damage or death
Delirium
A state produced by change and seen as threatening
Stress
Loss that can be recognized by others as well as by the person sustaining the loss, such as loss of a limb or a spouse
Actual loss
Constitutes civil rights legislation designed to permit those with disabilities access to job opportunities and to the community
American with Disabilities Act (1990)
What type of disability? May occur as a result of an acute and sudden injury
acute sudden injury(traumatic): TBI, fall, act of violence
acute non-traumatic disorder: stroke, MI
progression of a chronic disorder: arthritis, Parkinson's disease
Acquired Disability
Written documentation that specifies medical treatment for a competent patient should the patient become unable to make decisions; also called a living will or health care directive.
Advance directive
•Inflammatory response and repair process at local site of tissue injury
•Occurs in small injuries e.g. a cut knee
•If local injury severe enough → GAS
Local Adaptation Syndrome (LAS)
Loss of youth, of financial independence, and of a valued environment experienced by a person, but intangible to others
Perceived Loss
Rehabilitation nursing deals with many and varied problems. When caring for a male client with urinary incontinence, the nurse should avoid which of the following interventions:
A. Intermittent self-catheterization
B. Indwelling urinary catheter
C. External condom catheter
D. Incontinence pads
A...indwelling catheter. Makes person more prone to UTIs. An indwelling catheter should only be used if it will make the patient more comfortable.
Loss or abnormality of psychological, physiologic, or anatomic structure or function at the organ level (e.g., dysphagia, hemiparesis); an abnormality of body structure, appearance, and organ or system function resulting from any cause
Impairment
A document that indicates what medical intervention an individual wants if he or she becomes incapable of expressing those wishes.
A living will
What stage in the general adaptation syndrome is this?: Fight or flight; release of catecholamines; defensive and anti-inflammatory; self-limited
Alarm Stage
A form of necessary loss and includes all normally expected life changes across the life span
Maturational loss
Rehabilitation requires a team of professionals working together with the client and family. The member of the rehabilitation team who determines the final outcome of the process is the:
A. Nurse
B. Physician
C. Client
D. Family
C Client
Restriction or lack of ability to perform an activity in a normal manner; the consequences of impairment in terms of an individual's functional performance and activity—disabilities represent disturbances at the level of the person (e.g., bathing, dressing, communication, walking, grooming)
Disability
A legal agreement that allows an agent or representative of the patient to act on behalf of the patient
Durable Power of Attorney
What stage in the general adaptation syndrome is this?: Adaptation to the noxious stressor occurs; if exposure to stressor prolonged
Resistance
A situation in which certain people, although they are bereaved, are prevented from mourning publicly by cultural customs or social restrictions.
Disenfranchised grief
A 35 year old male has been diagnosed as a paraplegic secondary to a sky diving accident. The nurse anticipates that the client will react emotionally by:
A. Going through all stages of grief in a week so that he can adapt to his new lifestyle
B. Needing the use of humor therapy
C. Progressing sequentially through the 5 stages of the grief process as established by Kubler-Ross
D. Responding to the grief in an individualistic manner
D responding to grief in an individualistic manner. The person will most likely go through the steps of grief and grieving, but they do not have to be sequential. The person may go forward and backward toward the goal of acceptance. The act of grieving takes approximately 1 year.
A group of conditions that are not caused by an acute infection; many are considered chronic diseases and are often due to unhealthy behaviors
Noncommunicable diseases
The field of nursing that relates to the assessment, planning, implementation, and evaluation of older adults in all environments, including acute, intermediate, and skilled care, as well as within the community
Gerontologic/geriatric nursing
In Selye's Theory of Adaptation, there are two syndromes: the general adaptation syndrome (GAS) and the local adaptation syndrome (LAS). Events that may be seen in the LAS include which of the following. Select all that apply.
A. a fight or flight response occurs
B. occurs in small injuries
C. may lead to activation of the GAS
D. death may be the end result
B. occurs in small injuries
C. may lead to activation of the GAS
A type of grief that impedes a person's future life, usually because the person clings to sorrow or is buffeted by contradictory emotions
Complicated grief
Used to measure pt's level of independence in ADLs
Barthel Index
Any physical, mental, or social disorders resulting directly or indirectly from an initial disabling condition; a condition to which a person with a disability is more susceptible because of having a primary disabling condition
Secondary health conditions or disorders
Identify 4 subgroups of older adults
65-74 years of age: young old
75-84 years of age: middle old
85-99 years of age: old old
(fastest growing subgroup)
100 years + : elite old
Indicators of stress can be both objective and subjective. Which of the following are objective indicators: Select all that apply.
A. Concentration difficulties
B. Diarrhea
C. Vomiting
D. Feeling dizzy
E. Bruxism
F. headache
A. Concentration difficulties
D. Feeling dizzy
E. Bruxism
Symptoms of the patient who is close to death (5 Things)
Dyspnea
Inability to clear secretions
Somnolent or unresponsive
Decrease urinary output
Cool skin, mottling
Evaluates change in the course of a problem over time
Katz Index of Activities of Daily Living
What is the difference between medicare and Medicaid?
Medicare- For people 65 years and older and certain younger people with disabilities e.g. ESRD requiring dialysis and ALS; federal health insurance program
Medicaid- An assistance program; serves low-income people of every age; patient usually pays $0 for covered medical expenses; small co-pay sometimes required; is a federal-state program
Leading Causes of Death in Older Adults 2020 (10 Things)
1. Heart diseases
2. Malignant neoplasms (cancer)
3. Covid 19
4. Accidents (OD, falls, vehicles)
5. Cerebrovascular disease (stroke)
6. Chronic lower respiratory diseases
7. Alzheimer's disease
8. Diabetes
9. Influenza & Pneumonia
10. Kidney Disease
Factors influencing responses to stress (5 Things)
Intensity: stress overload (multiple co-existing stressors)
Duration: longer the stressful episode, more injury to person
Scope: broader the cope, more difficult to work with
Number and nature of other stressors
Predictability
Treatment of the patient who is close to death (5 Things)
Cluster Care
Patient side lying
Absorbent pads
Bed bath for comfort
Educate family
Indicates level of independence in life-functioning skills necessary for a person to make adaptations to community living
Pulses Profile