Prep U- Chapter 9: Chronic Illness and Disability

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? -Pretrajectory -Comeback -Stable -Acute

Acute -acute phase of the Trajectory Model of Chronic Illness the client has severe and unrelieved symptoms or complications that necessitate hospitalization.

The nurse recognizes which disorder as a developmental disability in a patient? -Spinal cord injury -Cerebral palsy -Osteoarthritis -Stroke

Cerebral palsy

A client who is blind is admitted for treatment of a small bowel obstruction and has been vomiting for days. Which nursing diagnosis takes highest priority for this client? -Impaired physical mobility -Activity intolerance -Deficient fluid volume -Risk for injury

Deficient fluid volume

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. -Age-related -Acquired -Developmental -Acute nontraumatic

Developmental -Developmental disabilities occur any time from birth to 22 years and result in impairment of physical or mental health, cognition, speech, language, or self-care. Examples are spina bifida, cerebral palsy, and Down syndrome

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? -Lowered stress and increased physical activity lifestyles -Early detection and treatment of diseases -Shorter lifespans -An increased mortality rate from infectious diseases

Early detection and treatment of diseases

Clients must contend with chronic illness daily. Nurses relate more effectively to clients when they understand the following as characteristics of chronic illness. Choose all that apply. -Chronic illness affects the entire family. -Chronic conditions only involve one phase of a person's life. -Chronic illness involves treating only the medical problems. -The management of chronic conditions is a process of discovery. -Managing chronic conditions must be a collaborative process.

-The management of chronic conditions is a process of discovery. -Managing chronic conditions must be a collaborative process. -Chronic illness affects the entire family.

Down syndrome is categorized as a(n) -acquired disability. -developmental disability. -age-related disability. -acute nontraumatic disorder.

developmental disability.

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 individual self-worth -Return to a better state of health than prior -Ignore threats to identity -Validate family functioning -Alleviate and manage symptoms

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

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 individual self-worth -Validate family functioning -Return to a better state of health than prior -Ignore threats to identity -Alleviate and manage symptoms

-Alleviate and manage symptoms -Validate individual self-worth -Validate family functioning -challenges of living with chronic conditions include the need to accomplish the following: alleviate and manage symptoms, validate individual self-worth and family functioning, manage threats to identity, and die with dignity and comfort.

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 -Responds, "There are some adjustments to your medications that need to be made" -Advises the client that changes must be made to the diet -States, "The glycohemoglobin is too high"

Acknowledges that the client is performing satisfactorily -Acknowledges that the client is performing satisfactorily

A nurse practitioner would be applying the pre-trajectory model of chronic illness when she: -Explained the significance of a serum glucose level of 160 mg/dL. -Encouraged a post-fracture patient to continue physical therapy. -Advised a woman, whose mother has Huntington's chorea, and who is considering pregnancy, to get genetic testing. -Suggested home health care to a stroke victim.

Advised a woman, whose mother has Huntington's chorea, and who is considering pregnancy, to get genetic testing. -pre-trajectory phase involves the prevention of a chronic illness. For example, the focus of nursing care would be to refer the patient for genetic testing and counseling, if indicated, and provide education about prevention of modifiable risk factors and behaviors.

A nurse is talking on the phone with a doctor and states, "I am calling you about Mrs. Nye, my client with cancer in room 213." This is an example of what type of language that is important to all people? -Nursing speak -People-first -First nation -Medical jargon

People-first

The nurse is providing teaching for a client in a wheelchair. How will the nurse provide teaching? -Sitting down in a chair during the teaching. -Standing next to the client during the teaching. -Providing modified teaching materials. -Providing alternative communication devices.

Sitting down in a chair during the teaching.

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

Stable -Stable phase, the focus of nursing care is on reinforcing positive behaviors and offering ongoing monitoring

A client is hospitalized with a traumatic brain injury following an automobile accident. The client has difficulty processing information and needs information to be repeated. A consulting physician enters the room. The nurse -Leaves the room -Communicates with the daughter while the physician talks with the client -Turns off the television -Removes unnecessary items from the beside table while the physician meets with the client

Turns off the television

A client who is blind and has a guide dog is hospitalized. The nurse states -"Someone needs to stay with you at all times to walk the dog outside." -"What can I do to assist you in keeping your dog with you?" -"Your dog must stay in a corner of the room." -"You are unable to have your guide dog here."

"What can I do to assist you in keeping your dog with you?"

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 -Teaches the client about osteoporosis -Acknowledges the client's achievement when she walks to the bedside commode with her walker -Discontinues the intravenous needle and changes the surgical dressing prior to discharge from the hospital -Assesses postural blood pressures

Acknowledges the client's achievement when she walks to the bedside commode with her walker -comeback phase of the Trajectory Model of Chronic Illness, the nurse provides positive reinforcement for goals identified and accomplished by the client. This would be acknowledging the client's achievement when she ambulates to the bedside commode with her walker

The nurse is caring for a client with diabetes. Which of the following is a characteristic of chronic illness? -Chronic conditions only involve one aspect of a person's life. -One chronic disease never develops into another chronic condition. -Chronic illness affects the entire family. -Managing chronic conditions must be an individual process.

Chronic illness affects the entire family.

The nurse practitioner has four patients with chronic illness that require consistent medical and nursing management. Select the condition that is the best example of a "chronically critical and progressively ill" condition. -Coronary artery disease -Type 2 diabetes mellitus -End-stage renal disease -Carcinoma-in-situ

End-stage renal disease

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? -Smoking -Obesity -Stress -Sedentary lifestyle

Obesity

A client who is hearing impaired and communicates through sign language only is scheduled for an endoscopy. She does not read lips. It would be best for the nurse to -Obtain a sign interpreter. -Continue with the procedure without someone to interpret. -Talk to the client while also writing messages for the client. -Ask a family member to interpret.

Obtain a sign interpreter. -

A client has lost mobility following a stroke. The nurse has established interventions that include providing direct care to the client, teaching, making referrals, and managing the case, to meet the goal. The next step is to -Instruct the client what he or she must do. -Plan with the client how to incorporate the regimen into the client's activities of daily living. -Refer the client to physical therapy for ambulation exercise two times a week. -Assist the familly in obtaining equipment that would help the client to walk.

Plan with the client how to incorporate the regimen into the client's activities of daily living.

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 -Comeback -Downward -Acute

Stable -stable phase indicates that the symptoms and disability are under control or managed. -acute phase is characterized by sudden onset of severe or unrelieved symptoms or complications that may necessitate hospitalization for their management. -comeback phase is the period in the trajectory marked by recovery after an acute period. -downward phase occurs when symptoms worsen or the disability progresses despite attempts to control the course through proper management.

A nurse is caring for a client with multiple chronic conditions and some physical disabilities. The nurse is using "people-first" language with the following statement during end-of-shift report: -"Last evening, Mr. Rudd, a 44-year-old patient with diabetes was admitted to the unit." -"I admitted another diabetic patient last evening; his name is Mr. Rudd." -"A new diabetic admit came to the floor last night during my shift. He is 44 and his name is Mr. Rudd." -"Mr. Rudd is a 44-year-old diabetic patient who was admitted last evening."

"Last evening, Mr. Rudd, a 44-year-old patient with diabetes was admitted to the unit." -important to all people, both those with and those without disabilities, that they not be equated with their illness or physical condition. Therefore, it is important to refer to all people using "people-first" language.

An older adult in the hospital with a fractured hip is being prepared for surgical repair. The bilateral hearing aids were forgotten at the client's home and the client is having difficulty hearing. To promote communication, which of the following actions should the nurse perform? Select all answers that apply. -Ask the client to repeat what was stated. -Talk directly to the client. -Use a deeper tone of voice. -Allow the television to remain on while talking to the client. -Speak in a loud voice.

-Talk directly to the client. -Use a deeper tone of voice. -Ask the client to repeat what was stated.