Chapter 8 - Health and Illness

What is resistance?

Adaptation to the stressor. If the stressor can be overcome or the damage repaired, the body begins to heal. If the stressor is long term, an individual may enter the third stage of adaptation

What are the specific activities thought to promote health?

Adequate nutrition based on the "pyramid" concept, moderate exercise on a routine schedule, rest: 7 to 8 hours of sleep every 24 hours, healthy lifestyle, especially no smoking and limited consumption of alcohol, balance of work and recreation

General adaptation syndrome consists of what 3 stages?

Alarm reaction, resistance, exhaustion

What is the sick role?

Allows time to recover from the disease. When patients cant get well on their own, others must care for them. Temporarily exempt from social responsibilities so that they can concentrate on getting well. People who are sick want to get well should seek the help of health professionals and cooperate with prescribed health care regimen. Some are reluctant to give up the sick role because of the attention they get or to avoid work

What is coping?

Any behavioral or cognitive activity used to deal with stress. People cope with stress in different ways

What is exhaustion?

Body is drained of energy; can't defend against stressors. Death may be the ultimate outcome

What is illness?

Broader definition because it incorporates personal, interpersonal, cultural perceptions of and reactions to disease. Deviation from a healthy state that may occur acutely or as a series of long-term events

What is alarm reaction?

Causes body to respond to stress physiologically. Hormone levels, heart rate, cardiac output, respiratory rate, oxygen intake, mental energy are increased. The pupils are dilated to cover a larger visual field. These reactions are called the fight or flight response, which helps the body defend against stressors

How can you help patients adjust to changes in the course of the disease?

Chronic illnesses often have unpredictable courses, they must learn to live with the ups and downs. Patients need support if they are to achieve their highest potential

How can you help patients prevent social isolation?

Chronically ill individuals and their families often become socially isolated. The ill person may withdraw from others, or others may feel uncomfortable and withdraw. Support groups are helpful for providing a social outlet with others in the same situation

How can you help patients manage symptoms?

Chronically ill individuals must learn to manage symptoms to continue desired activities. Help patients learn about symptoms (typical onset, duration, severity) and ability to control them. Arrange daily routines so that the highest-level activities are carried out when symptoms are lessened or absent and periods of rest are taken when symptoms are most acute

How can you help patients normalize social interactions?

Chronically ill people need to maintain as normal a lifestyle as possible despite having to manage symptoms, adapt to changes in appearance caused by the illness, or use adaptive equipment or prostheses. Encourage them to live as independently as possible in spite of their illness

What are the signs and symptoms of stress?

Cold hands and feet, tensed muscles, nervous movements, excessive sweating, tooth grinding, headaches, insomnia, tension or nervousness. When individuals don't cope well with stressors and are unable to adapt, they may withdraw and become depressed

What is disease?

Condition that is recognized through objective findings such as fever, the presence of bacteria, or an individual's inability to perform social role tasks

What is engaging in activities that should be avoided just to prove to themselves that symptoms dont exist?

Counteraction

How can you increase adaptability?

Determine what the patient perceives as stressful and how stressful it is. Assess past methods of coping with stress that have been successful for the patient. Help older patients use past coping mechanisms to deal with new stressors. Emphasize strengths rather than limitations. Older persons have particular difficulty coping with stress and adapting to new situations

What is emotion-focused strategies?

Distancing oneself from the stress-provoking situation, denying its seriousness, self-isolation, withdrawal, blaming oneself or accepting responsibility for the problem, drawing strength from adversity, tension reduction, hostility, fatalism, social support, faith

What is adaptation?

Essential to maintaining health. Constructively coping with stressful conditions. Depends on accurate appraisal of stressful situations and effective coping. Can lead to physiologic and psychological well-being

Who provides bulk of support for chronically ill, and the burden of caregiving is heavy for them?

Families, they must take on more physical work because of need to assist with activities of daily living, deal with changes in the disease, cope with feeling psychologically and physically overwhelmed, adapt to changes in their own roles as well as those of the ill family member. Many communities have adult day care centers for older adults with particular chronic illnesses

What is primary prevention?

First level of prevention; includes steps taken to improve health and prevent disease and injury.

What are external resources in dealing with stress?

Getting help from family, friends, and service agencies in the community

How can nurses help patients deal with stress?

Identifying the patient's usual methods of coping or adapting

What is problem-solving strategies?

Identifying the problem, generating alternatives, choosing best alternative, applying it to the problem

Effect of Illness on the Family has three factors, what are they?

Identity of the member of the family who is ill, seriousness and duration of the disease, social and cultural customs of the family

What is illness behavior?

Individuals' actions influenced by the availability and affordability of health care, perception of the problem, others' perceptions of problem, and the failure or success of self-prescribed treatment

How can you help people engage in healthier lifestyles?

Inform patients of daily activities: proper diet, exercise, adequate sleep, help maintain optimal health. Inform about diseases for which they're at risk. Explain the consequences of the disease for which they're at risk. Give patients specific information about how they can reduce their risk for the disease

What factors can trigger stress?

Internal and external factors. Environmental factors, life changes, and physiologic or emotional illness contribute to stress

What is Chronic illness?

Involves permanent impairment or disability and requires long term rehab and medical or nursing treatment. Examples: coronary artery disease, chronic obstructive pulmonary disease, hypothyroidism, diabetes mellitus. Some chronic illnesses like rheumatoid arthritis and asthma are characterized by periods of remission and exacerbation. During remissions, the disease seems to go away. During episodes of exacerbation, acute symptoms occur

Are life changes positive or negative?

Life changes are positive/negative, but they require people to expend energy to adapt to change

What is 3rd in Maslow's Hierarchy of human needs?

Love and belonging needs: feeling loved by one's family and friends and accepted by one's peers and community. Love &belonging are related to self-esteem, which is essential for carrying out health promoting behaviors

What are ego Developmental needs?

Must be met to sustain cognitive and perceptual growth and memory development. Satisfied through education and training. They enable individuals to develop motor coordination, independence, self-identity, social skills, communication skills, problem solving skills, moral view

How are needs met in Maslow's Hierarchy of Human Needs?

Needs must be met in ascending order

What is complementary Therapy?

Nontraditional therapies that are used along with conventional therapies. Example: a patient with chronic pain might take analgesics but also practice guided imagery.

What are Henderson's 14 Components of Basic Nursing Care?

Normal breathing, eating and drinking adequately, eliminating body wastes, maintaining desirable posture, sleeping, resting, selecting suitable clothing (dressing and undressing), maintaining normal body temperature, keeping the body clean, avoiding dangers in the environment, communicating with others, worshiping, working to achieve a sense of accomplishment, playing, learning

How can nurses assist terminally ill patients to a peaceful death?

Nurses should be supportive of decisions made by patients and families. Nurses must have knowledge of the dying process and the needs of the dying person to provide compassionate care, promote comfort, and make the pain and physical treatment bearable. Dying patients and their loved ones should be informed of the options for care and their consequences.

Who has the most intimate relationship with terminally ill people?

Nurses. When disease is chronic, patients and families often need to make difficult decisions regarding death. Families have to live with the memory of their loved ones and events surrounding their death. In today's health care system, with its sophisticated technology, terminally ill patients can be kept alive longer than was ever possible in the past.

What are the physiologic needs?

Oxygen, water, food, elimination, sleep, shelter, safety, and mobility. Must be met for individuals to survive

How can you help patients reorder time?

People with chronic illness may find they have either too much or too little available time. The chronically ill and their family may become frustrated and depressed. Help patients and caregivers develop a daily schedule that allows time for desired activities yet manages regimens of the chronic illness

What influences how one views health and illness?

Personal, psychosocial, spiritual values, beliefs

What is stress?

Physical and emotional state always present in individuals, which is intensified when an internal or external environmental change or threat occurs to which the individuals must respond.

What are Internal resources in dealing with stress?

Physiologic and psychological responses that occur when one is faced with a stressful situation. Smoking, drinking alcohol, eating, crying, and exercise

What is the base (basic needs) of Maslow's Hierarchy of Human needs?

Physiologic needs: oxygen, fluids, nutrition, life-sustaining environmental temperature, elimination, shelter, rest, sex. Fundamental needs because they sustain life (Cannot live without air, water, and food)

What is general adaptation syndrome?

Physiologic response of the whole body to stress. Involves primarily the autonomic nervous system and the endocrine system. Often referred to as the neuroendocrine response

What is 2nd in Maslow's Hierarchy of human needs?

Safety and security needs: protection from harm and freedom from anxiety and fear. People need order and structure in their lives. Illness or disease can be very disruptive

What is secondary prevention?

Secondary level of prevention; includes steps taken to detect disease early and begin treatment as soon as possible.

What is 5th in Maslow's Hierarchy of human needs?

Self-actualization needs: characteristics of a self-actualized individuals. Ability to solve problems, willingness to accept suggestions and criticism from others, broad interests, good communication skills, self-confidence and high self-esteem, maturity, desire for new experiences and knowledge. Individuals rarely achieve self-actualization; spend their lives attempting to live more fully

What is 4th in Maslow's Hierarchy of human needs?

Self-esteem needs: essential for health-promoting behaviors. Feeling good about oneself and feeling that others hold one in high regard. Individuals with high self esteem feel confident about themselves and that they are appreciated by others. People with low self esteem may feel helpless and inferior

What are libidinal needs?

Sensual-sexual needs encompass the physiologic and psychological aspects of sexuality. Affectional-emotional needs are satisfied through love, security, approval, respect, support, care

What is local adaptation syndrome?

Short term, localized response to a specific stressor that restores a body region/body part to homeostasis Examples: blood clotting, wound healing, pain, inflammation

How can you help patients during hospitalization?

Some patients and families benefit from detailed information about the disease and hospital procedures; others prefer not to know. Allowing patients to have as much control as possible helps reduce stress: biofeedback, progressive muscle relaxation, meditation, and imagery may help. Even people who are very dependent on hospital personnel need to believe that they have some control over their lives.

What is a typical dictionary definition of health?

Soundness, especially of body or mind; freedom from disease or abnormality

What is maintenance?

Specific activities thought to promote health

How can you help patients carry out prescribed regimens?

Teach patients about need to carry out regimens. Provide moral support and encouragement. Find ways to make carrying out regimens easier. Increase patient compliance by forming "alliances" with them so they understand that they are important participants in developing their own health regimen

How does the World Health Organization define health?

The state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

What is homeostasis?

The tendency of the body to maintain stability of its internal environment, body adapts to internal/external changes in the environment, adjusts to changes, maintains equilibrium, or homeostasis. Continual adaptation and change in the internal environment are essential for the organism to exist in the external environment. Examples: body adjusts heart rate, b/p, respiration, temperature, hormone secretions.

What are nontraditional therapies?

They are called alternative if they are used in place of conventional medicine. Nontraditional therapies used along with conventional therapies are called complementary. Use of relaxation therapy or acupuncture instead of analgesics to treat pain.

How can health care providers help families with support?

They need to assist patients &their family members in developing a collaborative plan of care. Relief or respite may be obtained to ease the caregiving responsibility. Formal support services should be used whenever they are needed to assist families in caring for their chronically ill loved ones

What is tertiary prevention?

Third level of prevention; includes steps taken to prevent disease recurrence or complications of diagnosed disease or injury

What are the current views of health and illness?

Viewed as relative states along a continuum. Individuals are neither absolute health nor absolute illness but are in an ever-changing state of being, ranging from peak or high-level wellness to extremely poor health, with death imminent

What are the traditional views of health and illness?

Viewed as separate entities. People were either healthy or sick

What happens when people take no action when they are sick?

Wait to see whether the symptoms go away and they deny something is wrong; refuse to admit they are ill

How can you help patients prevent and manage crises?

When symptoms flare up, a crisis situation may arise. You can help patients and families prevent and control a crisis situation. Patient and family must learn the signs/symptoms of the onset of a crisis and make a plan for how to deal with it

How does hospitalization affect people?

While ill, people seek control regarding: avoidance of pain and incapacitation, immediate hospital environment, treatments, procedures, relationships with hospital personnel, emotional balance, satisfactory self-image, relationships with family and friends, preparation for an uncertain future. The hospital environment introduces new sights, sounds, smells, and routines into daily life. These changes challenge the patient's autonomy and control.

What is Acute illness?

illness or disease that has a relatively rapid onset and short duration. The condition usually responds to a specific treatment and ends in full recovery. Examples: common cold, influenza, appendicitis, urinary tract infections