Chapter 7 Chronic Illness NUR 235

A client who is obese and the nurse have established a goal for the client to achieve a weight loss of 1 pound each week. One month later, the nurse evaluates that the client has lost 2 pounds. The nurse first states "You need to work harder to achieve your goal." "You have succeeded in making positive progress." "You are not achieving satisfactory weight loss." "We will have to re-evaluate your goal."

"You have succeeded in making positive progress."

The nurse is concerned that a client with a chronic illness is becoming more debilitated due to increasing body mass index. Which health promotion education will the nurse provide to this client? Select all that apply. "You should aim for 30 minutes of physical activity daily." "Eat a diet high in fruits and vegetables." "Prompt smoking cessation will reverse your symptoms." "Limit consumption of sodium and saturated fats." "Moving from the city to rural areas will improve your health."

"You should aim for 30 minutes of physical activity daily." "Eat a diet high in fruits and vegetables." "Limit consumption of sodium and saturated fats."

According to the U.S. Census (2010), what percentage of people are diagnosed with a disability?

20

The client who has the chronic condition of diabetes, reports blurry vision, and admits to nonadherence to the diet and medications. The home health nurse checks the client's fasting blood glucose level, which is 412 mg/dL. What phase of the Trajectory Model of Chronic Illness does the nurse assess this client is in? Comeback Pretrajectory Stable Acute

Acute

The nurse provides corrective instruction to the nursing assistant when the assistant refers to the client as the Blind diabetic patient Person who is disabled Man with a stroke Woman who has multiple sclerosis

Blind diabetic patient

Which statement is a misconception about chronic disease? The major cause of chronic disease is known. Almost half of chronic disease-related deaths occur prematurely in people <70 years of age. Chronic illness typically does not result in sudden death. Chronic illnesses cannot be prevented.

Chronic illnesses cannot be prevented.

Which phase of the Trajectory Model does the nurse recognize is present when the patient is in remission, after an exacerbation of illness? Acute Downward course Comeback Crisis

Comeback

This type of disability represents one that occurs any time from birth to 22 years and results in impairment of physical or mental health, cognition, speech, language, or self-care. Acute nontraumatic Developmental Acquired Age-related

Developmental

The nurse is caring for a client with chronic obstructive pulmonary disease (COPD). Despite various medication regimes, the client's symptoms are gradually increasing. The nurse realizes that this client is which phase of the Trajectory Model of Chronic Illness? Acute Dying Downward Unstable

Downward

Which is a cause related to the increasing number of people with chronic conditions? A tendency for these conditions to develop in younger people Improved screening and diagnostic procedures Shorter lifespans An increase in mortality from infectious disease

Improved screening and diagnostic procedures

The nurse is caring for a client with a chronic condition. On which areas will the nurse focus when planning care for this client? Select all that apply. Prevent acute illnesses Focus on quality of life Avoid complications Manage symptoms Limit activity

Manage symptoms Avoid complications Focus on quality of life Prevent acute illnesses

Which statement provides accurate information related to chronic illness? Chronic conditions do not result from injury. Most people with chronic conditions do not consider themselves sick or ill. Most people with chronic conditions take on a sick role identity. Most chronic conditions are easily controlled.

Most people with chronic conditions do not consider themselves sick or ill.

An older adult with severe cardiac disease is concerned about the future care of an adult child with intellectual and developmental disabilities. Which action will the nurse take to help the client? Discuss the issue with the adult child. Give infomration about long-term care facility placement. Ask family members provide the bulk of care of the adult child. Provide a list of community resources.

Provide a list of community resources.

A client has constant pain and peripheral neuropathy following chemotherapy for cancer. The nurse assesses the following behavior as a common characteristic of a person with a chronic illness: The client and family do not allow the chronic illness to be the focal point of their lives. The client stops taking some medications due to side effects that are disturbing to the client. The client does not believe that the illness threatens self identity and body image. The client adheres to the prescribed therapeutic regimen.

The client stops taking some medications due to side effects that are disturbing to the client.

A nurse cares for a client with a chronic illness who has a diagnostic workup for the illness and announces the diagnosis to friends and family. According to the Trajectory Model of Chronic Illness, what phase is the client displaying? Acute Trajectory onset Pretrajectory Stable

Trajectory onset

The nurse forms a nursing diagnosis during which phase of the trajectory model of chronic illness? Stable phase Pre-trajectory Trajectory onset Phase of crisis

Trajectory onset

Which phase in the trajectory model of chronic illness is characterized by the reactivation of an illness in remission? Crisis Unstable Pretrajectory Stable

Unstable

Which phase in the trajectory model of chronic illness is characterized by the reactivation of an illness in remission? Stable Unstable Crisis Pretrajectory

Unstable

A client with multiple sclerosis is being discharged. The nurse understands that living with chronic conditions imposes many challenges, including the need for which accomplishments? Select all that apply. Validate family functioning Alleviate and manage symptoms Validate individual self-worth Return to a better state of health than prior Ignore threats to identity

Validate individual self-worth Alleviate and manage symptoms Validate family functioning

The nurse is conducting a community education program on chronic illness. The nurse evaluates that additional education is needed when the participants make which statement? "Most people with chronic illness have health insurance." "Out-of-pocket expenses for chronic illness are low." "Chronic illness is a leading cause of death." "Chronic illness is increasing in developing countries."

"Out-of-pocket expenses for chronic illness are low."

The nurse is caring for a patient who had a stroke and has right-sided hemiparesis. The patient is receiving physical therapy that will continue when discharged through home health care services. After what minimum period of time could this patient's medical condition be termed chronic? 16 weeks 8 weeks 3 months 6 months

3 months

An elderly female client who has dizziness and osteoporosis fell at home and fractured her hip. She underwent surgical intervention for repair of the fractured hip and is now being discharged to a subacute care facility. In the comeback phase of the Trajectory Model of Chronic Illness, the nurse Discontinues the intravenous needle and changes the surgical dressing prior to discharge from the hospital Acknowledges the client's achievement when she walks to the bedside commode with her walker Teaches the client about osteoporosis

Acknowledges the client's achievement when she walks to the bedside commode with her walker

When providing education to the patient with a chronic illness, what is a priority intervention for the nurse to perform? Adapt teaching strategies and materials to the individual patient. If the patient is hearing impaired, teach a family member instead. Provide written information only so that patients will have a reference. Educate all patients the same.

Adapt teaching strategies and materials to the individual patient.

A client has a tentative diagnosis of lung cancer following computed tomography (CT) scanning. He is scheduled for a fiberoptic bronchoscopy with biopsy. In the trajectory phase of the Trajectory Model of Chronic Illness, the nurse Provides postprocedure care following the bronchoscopy Administers the preoperative medication for the bronchoscopy Answers the client's questions about the bronchoscopy procedure Obtains the signature of the client on the consent form

Answers the client's questions about the bronchoscopy procedure

The nurse is concerned that a client with a disability has missed two follow-up appointments. Which action will the nurse take to support this client? Contact the client to inquire if they have transportation to the appointment. Contact the hospital to see if the client has been admitted. Document the client's refusal of follow-up care. Ask the health care provider to contact the client.

Contact the client to inquire if they have transportation to the appointment.

A client who is legally blind had orthopedic surgery 3 days ago and wants to urinate. She is using a walker for ambulation. It would be best for the nurse to Obtain assistance of another staff member and not have the client use the walker. Guide the client's hand to the armrest on the bedside commode prior to the client sitting on the commode. Assist the client in using a bedpan. Place a bedside commode next to the bed.

Guide the client's hand to the armrest on the bedside commode prior to the client sitting on the commode.

The client with blindness is hospitalized following a myocardial infarction. Which care measures would the nurse take with this client? Select all that apply. State when the nurse is leaving the room. Pat the canine service animal immediately upon entering the client's room. Orient the client to the room using a clock reference. Speak in a slightly louder voice. Identify self when walking into the client's room.

Identify self when walking into the client's room. State when the nurse is leaving the room. Orient the client to the room using a clock reference.

A nursing instructor is preparing a class on pressure ulcers. Which of the following would the instructor most likely include as a possible risk factor? Select all that apply. Increased moisture Anemia Enhanced sensory perception Increased tissue perfusion Immobility

Increased moisture Anemia Immobility

Empowering the client with a disability will better serve him or her than will promoting dependency. This type of approach is seen in which type of model of disability? Interface model Social model Medical model Rehabilitation model

Interface model

Nursing care of patients with chronic illness is varied and occurs in a variety of settings. Care must be direct and supportive. To provide supportive care, a nurse would do which of the following? Assess the patient's physical status. Make referrals for additional care. Provide treatments. Manage the medication regime.

Make referrals for additional care.

During which phase of the Trajectory Model of chronic illness is the focus of nursing care on reinforcing positive behaviors and offering ongoing monitoring? Unstable Stable Pretrajectory Trajectory onset

Stable

The nurse is with a client who has a chronic illness and is reinforcing positive behaviors and teaching about health promotion. For which phase of the trajectory model of chronic illness are these nursing actions appropriate? Downward Comeback Acute Stable

Stable

The nurse is caring for a client with COPD who was recently admitted to the hospital with an acute exacerbation of the illness. What indicates to the nurse that the client is in the comeback phase of the Trajectory Model of Chronic Illness? The client begins to cope with implications of the illness. The illness course and symptoms are under control and the client's everyday life activities are managed. Unrelieved symptoms of the illness results in the interruption of the client's everyday life activities. The client gradually returns back to an acceptable way of life within the limits imposed by the illness.

The client gradually returns back to an acceptable way of life within the limits imposed by the illness.