Nursing- concept of chronicity

diabetes, non traumatic lower extremity amputation and blindness among those 20-74

• slow with gradual onset
• symptoms come and go with periods of remission and exacerbation.
• requires long term medicla and nursing management
• accepts inability to be well
• role inferior - does not feel as valued
• knowledge of patient role
• retains decision making often seen as problem patient

• sudden dynamic onset.
• signs and symptoms resolve infrequently.
• ends in recovery or death
• responds readily to treatment
• desire to get wellrole less desirable but acceptable. decision making by staffsick role reinforced by staff

need to focus on promoting the highest level possible of independence, sense of control and wellness.

• initial/pretrajectory
• trajectory
• crises
• acute
• stable
• unstable
• downward
• dying

occur before signs and symptom appear

occurs with first onset of signs and symptoms and includes diagnostic period

potentially life threatening situation occurs

patient symptoms are controlled by regimen. follows crises phase

symptoms become uncontrolled by regimen

progressive deterioration in mental and physical status

period preceding death.

• increased demand on time
• increased stress due to anxiety
• financial problems with healthcare cost
• lonelines as a result of pending loss
• change in social customs

• phycal experience of syptom
• interpretations of symptoms
• emotional response

• validation of illnes
• explanation of terms
• reassurance they will be alright
• accepts or rejects diagnoses. if accepted they follow advice

• palliative care for symptom control
• provide info and educate
• discuss self care practices to enhance independence
• promote psychological well being by enhancing the client's sese of control or power, self esteem, sense of meaning or purpose
• promote good communication

a disability that has existed since birth but not necessarily hereditary

a maturational lag, an abnormal slower rate of development in which a child demonstrate functional level below that observed in normal children of the same age

documents energy expenditures within the community setting. provides visualization of how the family unit interacts.

family that includes teh relatives of the nuclear family - eg grandparents and uncles

considers the health of the family as a unit in addition to the health of indivdual family members

gender and line of birth

a condition or barier imposed by society, not synonym for disability

a loss or abnormality of structure or function

a family of parents and their offsprings

considers the health of the family as a unit in addition to the health of the individuals

• family structure- age /gender, size and type of family
• family roles and function- job outside home, child rearing responsibilities
• physical health status- current health of each family members. preventive care and routine.
• interaction patters- ways of expressing affection, love, sorrow, anger
• family values- cultural religious practices, use of leisure time, view of education, and school system. health values
• coping resources- degree of emotional support found in family. availability of suport persons, afiliations outside family, friends church. sources of stress and how its handled. financial ability to meet current and future needs

• comfort work- what client has to do to function. exercise, ap of heat cold, keeping warm
• usual life work- whatever it takes for client to maintain their family life, work life, student life, and relationship, firends, community.
• clinical safety work- involves adding the things the client must do to keep their illness under control and avoid crises. ie taking meds, visit doc, daily blood sugar check, having plan when crisis occurs

• prevention and management of crisis- pot risk,, signs and sx
• carrying prescribed regimen
• Controlling symptoms
• reordering time- has to do with illnes management- client report having no time or to little time. client need to learn about the pattern of symptoms, onset, duration, severity
• adjusting to changes in course of disease. client must develop personal identity
• prevention of isolation
• attempting to normalize

• involves client working on what their future hold . ask should you buy long term care insurance. should you sell your home should you move
• how will illness affect future. who will be there

• the reshaping and remolding of self concept. new story to write. questiosn client must answer. who am i now that i have illnes
• how will illness change me as a person
• how will it effect my life.

appearance, values and beliefs

• self knowledge
• self expectation
• social self
• social evaluation

• personal identity
• body image
• role performance

• incred self confidence
• rewarding relationship with others
• succes at work

• lower self confidence
• impaired relationship with others
• failures in the workplace

• growth and development.
• age and life

• difficulty performing routine tasks for client
• reports of declining physcial energy or insufficient tirme for caregiving
• concern caregiving responsibility interfere with other roles
• anxiety about ability to meet future care need of client
• feeling of anger and depression
• dramatic change in the home environment's appearance

• caring, nurturing and educating chilfren on how to get along in the owrld
• maintaining continuity of society
• receiving and givng love
• preparing the next generation
• meeting the needs of its members
• serving as a buffer between family members and demands from outside

peripheral resitance agianst which the left ventrical must pump to eject blood.

chest pain-

• clinical manifestation of reversible myocardial ischemia. chest apin that occur interittently over long period with the same pattern of onset, duration and intensity of symptoms
• unstable engina- chest pain that is new in onset ocurs at rest or has a worsening pattern

an ischemic muscle ache or pain that is precipitated by consistent level of exercise, resolves within 10 minutes or less with rest, and is reproducible.

deficiency of blood supply cause by obstruction of circulation to the body part

respiratory problems bought on by lying flat. ability to breathe only when in upright position.

attacks of shortness of breath especially at night that awaken the patient; caused by reabsorption of fluid from dependent body areas when patient is recumbent

volume of blood in the ventricles at the end of diastole. determines stretch on cardiac muscle.

discoloration or redness caused by inflammation; one of the four classic symptoms of inflammation.

force opposing the movement of blood within the blood vessels.

the blocking of a blood vessel by a clot

enlarge, dilated uperficial vein, can occur in any part of body, but most common in lower extremities.