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NC3- Chronic Illness


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What is the goal in family centered care?
the goal is to maintain the integrity of the ledership role and support the family during times of crisis or stress
refers to behaviors and intentions of the disabled to integrate into society by living life as person without disability.
paralleling normalization and home care is the process of mainstreaming or integrating children with special needs into regular classrooms
approach behaviors
approach behaviors are coping mechanisms that result in movement toward adjustment and resolution of the crisis
avoidance behaviors
result in movement away from adjustment or maladaptation to the crisis
overprotection with a chronically ill child
parents fear letting the child achieve any new skill, avoid all discipline and cater to every desire to prevent frustration
rejection by parents of a chronically ill child
parents detach themselves emotionally from the child but usually provide adequate physical care or constantly nag and sold the child
denial of parents with a chronically ill child
parents act as if the disorder does not exist or attempt to have the child overcompensate for it
gradual acceptance of chronically ill child by parents
parents place necessary and realistic restrictions on the child, encourage self-care activities, and promote reasonable physical and social abilities
chronic sorrow
feelings of sorrow and loss that recur in waves over time
functional burden
issues related to caring for and living with the child in relation the family's resources and coping ability
American Disabilities Act & day cares
requires that day care providers make "reasonable modification" for equal access to program participation
use of scopalamine in dying children
this is used for patients who are dying to reduce noisy respirations (applied topically)
holistic health
promotion of the total health of mind, body and spirit
complementary therapies
used as an anjunct to traditional health modalities, they typically influence the effects of stress, anxiety, depression and other physical and emotional states
concept of emotional health
ecompasses a person's ability to function as comfortable and productively as possible
Risk factors for mental health that cannot be changed
Age, gender, genetic background, family history
Risk factors for mental health that can be changed
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
What are the five family functions related to illness
management, boundary setting, communication, education and support, socialization
Effective coping skills
communication skills, spirituality, cognitive abilities, emotional strengths, relationship capabilities, willingness to use community resources and individual strengths and talents
somatic signs of depression
headache, backache, abd. pain, fatigue, malaise, anxiety and decreased desire or problems with sexual functioning
clinical signs of depression
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
Four major task of the grief process
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
Two basic goals of the grieving process
1-healing the self and 2-recovering from the loss
the way in which a process or event develops over a period of time
Five stages of grieving by Kubler Ross
denial, anger, bargaining, depression and acceptance
Stages of berevement by Bowlby
protest, disorganization and reorganization
Successful grieving by Engel
shock and disbelief, development of awareness and restitution
Common to all models of grieving by Cooley
avoidance, confrontation and acceptance
stage at which individual may develope a chronic condition b/c/o genetic factors or lifestyle behaviors that increase susceptibility to chronic illness
trajectory phase
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.
Stable phase
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
unstable phase
characterised by an exacerbation of illness symptoms development of complications, or reactivation of an illness in remission
acute phase
sudden onset of severe unrelieved symptoms or complications that require hospitalization for their management
crisis phase
characterized by a critical or life-threatening situation taht requires emergency treatment or care
comeback phase
trajectory marked by recovery after an acute period- learning to live with or overcome disabilites and a return to an acceptabl way of life.
downward phase
marks the worsening of a condition. Symtoms and disability continue to pogress despite attempts to gain some control through treatment and management regimens
dyeing phase
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.
Traumatic brain injury
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
Acquired Brain Injury
This is an injury to the brain that is not hereditary, congenital or degenerative
Hypercalciuria in SCI patients
immobility leads to an imbalance in calciym metabolism with a loss of bone calcium and its secretion in the urine
removal of blood plasma from patients with Guillaine Barre syndrome, to remove antibodies and replaced when done
Life expectancy with AlS patient
3 years
external appliance that provides support, prevents or corrects deformities and improves function
Protein difiency
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
signs of infection
purulent drainage, foul odor, warmth, elevated temp
(triplication) of the 21st chromosome.
Avoid massaging reddened areas because
this may increase the damage to the already traumatized skin and tissue
urge incontinence
involuntary elimination of urine associated with a strong perceived ned to void
Reflex (neurogenic) incontinence
assoc. with a spinal cord lesion that interrupts cerbra control, resulting in no sensory awareness of the need to void
stress incontinence
assoc. /c weak perinal muscles that permit leakage of urine when intra-abd. pressure is increased eg /c coughing or sneezing
functional incontinence
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
total incontinence
occurs in pts. who are unable to control excreta b/c of physiologic or psychological impairment
any waste matter discharged from the body, e.g. feces or urine
causes of bowel incontinence and constipation
diminished or absent sphincter control, congnitive or perceptual impairment, neurogenic factors, diet and immobility
pelvic floor excercises
keigel excercises
life expectancy
avg. number of years that a person can be expected to live
Patinet Self-Determination Act (PSDA)
law enacted to require patient educatio about advance directives at the time of hospital admission along with documentation of this education
involution of the uterus
atrophy of the uterus

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