ch9 prepU chronic illness
The nurse is caring for an adult paraplegic with an ostomy. Which is an appropriate statement for the nurse to make?
"Do you need assistance managing your ostomy?"
An elderly male client was in an automobile accident 2 weeks ago and incurred a spinal cord injury with resulting paralysis. The nurse assesses this disability as
Acquired
A client who is blind is admitted for treatment of a small bowel obstruction and has been vomitting for days. Which nursing diagnosis takes highest priority for this client?
Deficient fluid volume
A nursing instructor is discussing the causes of the increasing number of people with chronic conditions. Which of the following would the nurse correctly identify as a cause?
Early detection and treatment of diseases
Which is a cause related to the increasing number of people with chronic conditions?
Improved screening and diagnostic procedures
Which disability model is most appropriate for the nurse to use as a guide for planning care?
Interface Model
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?
Stable
The nurse is planning community education on the prevalence and incidence of disabilities in the United States. The nurse includes that, according to the U.S. Census (2010), what percentage of people are diagnosed with a disability?
20
The number of people with disabilities is expected to increase over time. What is a major contributor to this prediction?
The survival of people with severe trauma, chronic disorders, and early-onset disabilites
A cause related to the increasing number of people with chronic conditions is
improved screening and diagnostic procedures.
According to the U.S. Census (2010), what percentage of people are diagnosed with a disability?
20
The nurse is caring for a client with diabetes. Which of the following is a characteristic of chronic illness?
Chronic illness affects the entire family.
Which statement is a misconception about chronic disease?
Chronic illnesses cannot be prevented.
Which statement provides accurate information related to chronic illness?
Most people with chronic conditions do not consider themselves sick or ill.
A nurse prepares a diabetes prevention health seminar for community residents. Her teaching points should emphasize the most important factor influencing metabolic syndrome (pre-diabetes). What is that factor?
Obesity
Which phase of the Trajectory Model of Chronic Illness is characterized by reactivation of an illness?
Unstable the unstable phase is characterized by development of complications or reactivation of the illness. The stable phase indicates that the symptoms and disability are under control or managed. The acute phase is characterized by sudden onset of severe or unrelieved symptoms or complications that may necessitate hospitalization for their management. The comeback phase is the period in the trajectory marked by recovery after an acute period.
A young female client smokes two packs of cigarettes and drinks a six-pack of beer each day. The nurse is attempting to teach the client about smoking cessation and decreasing alcohol intake. The client states, "My grandmother lived to be in her 90s, and she smoked and drank. I come from good genes." What is the most apropriate statement the nurse can make in response?
"Certain illnesses can be traced to common risk factors and can be prevented."
When caring for clients with disabilities, nurses need to understand not only pathophysiological issues but also the concept of disability. Which of the following statements to the client demonstrates that the nurse understands the concept of disability?
"I have collaborated with a social worker to assess your needs for after discharge."
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 have succeeded in making positive progress."
A client is diagnosed with type 2 diabetes mellitus. The client takes metformin and exenatide and reports adhering to a diet. The glycohemoglobin is 5.9%. According to the stable phase of the Trajectory Model of Chronic Illness, how should the nurse respond?
Acknowledges that the client is performing satisfactorily
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
Acknowledges the client's achievement when she walks to the bedside commode with her walker
A nurse practitioner would be applying the pre-trajectory model of chronic illness when she:
Advised a woman, whose mother has Huntington's chorea, and who is considering pregnancy, to get genetic testing.
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.
Alleviate and manage symptoms Validate individual self-worth Validate family functioning
A nurse is assigned to work with a client who has a disability. The nurse believes that all people with disabilities have a poor quality of life and are dependent and nonproductive. What type of barrier will this client experience?
Attitudinal barrier
The instructor provides corrective information to the nursing student when the student refers to the client as the
COPDer in 216 "People-first" language means referring to the person first. Examples include patient who is disabled, man with an MI, and woman who has diabetes. Using "COPDer in 216" conveys that the illness or disability is of greater importance than the person.
Which phase of the Trajectory Model does the nurse recognize is present when the patient is in remission, after an exacerbation of illness?
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.
Developmental
A client has had multiple admissions for heart failure. The client is now on continuous oxygen, bedridden, and provided care by his family. The nurse discusses end-of-life preferences with the client. The nurse assesses the client is in the phase of the Trajectory Model of Chronic Illness known as
Downward
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
Guide the client's hand to the armrest on the bedside commode prior to the client sitting on the commode.
A nursing instructor is discussing characteristics of chronic illness with a class. The instructor asks the students to name one characteristic. Which of the following answers is correct?
Managing chronic conditions must be a collaborative process.
A nursing student shares that he read that chronic conditions are costly to people, families, and society, and that one of the major goals of nursing today should be the prevention of chronic conditions and the care of people with them. The student asks the instructor what can nurses do to help. Which of the following is a correct answer given by the instructor?
Promote wearing seat belts.
The client had a cerebrovascular accident with drooping of the face. Speech is slurred. The nurse is obtaining the admission assessment data. It would be best for the nurse to
Repeat back what the client states.
A community nurse is working to decrease the incidence of cardiac disease in Nicaragua. The nurse should plan educational health promotion activities around which element?
Smoking cessation
During which phase of the Trajectory Model of chronic illness is the focus of nursing care on reinforcing positive behaviors and offering ongoing monitoring?
Stable
In which phase of the trajectory model of chronic illness are symptoms under control and managed?
Stable
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 stops taking some medications due to side effects that are disturbing to the client.
Down syndrome is categorized as a(n)
developmental disability.
A patient has had a traumatic amputation of the left leg above the knee following an industrial accident. What type of disability does this patient have?
Acquired disability
