Focus on Adult Health Chapter 3

Assessment of family cohesion and boundaries

focuses on how autonomous and interdependent family members are, such as their bonding and their ability to work as a team

4 most common chronic illnesses

heart disease, stroke, cancer and diabetes

what is the largest chronic illness

hypercholesterolemia, then it is hypertension and arthritis

Mourning

is an individuals, family or cultures expression of grief and associted behaviors

Communication

is revealed by how open, clear, and direct the family is with information and by any topics that are avoided

Flexibility and adaptability

is revealed by the family's ability to integrate new information and how they manage change.

Family constellation

is revealed by the members of the family, who is important to the client and the roles and relationships among family members

bereavement

is the TIME when mourning a loss takes place

4 criteria that need to be met before a patient can go to hospice

less then 6 months to live, informed choice, serious/progressive illness, health care certifies its a terminal illness

healthcare power of attorney

letting another person handle your healthcare and treatment decisions in the case that you are unable

proxy directive/durable power of attorney for health

made by competent individual in writing who will make there medical decisions for them if they become incompetent

5 characteristics that defined chronic illness

nonreversible, progressive decline, no permanent cure, 3 or more months of management, leaves residual disability.

Mutual Pretense Awareness

occurs then the patient, the family, and the health care professionals are aware that the patient is dying but all pretend otherwise

Closed Awareness

occurs when the patient is unaware of his or her terminal state, whereas others are aware

Suspected awareness

occurs when the patient suspects what others know and attempts to find out details about his or her condition

medical directive

(living will)a set of instructions based on likely scenarios of illness, goals for care, and specific treatments, combined with a general values statement. It is also combined with a proxy designation section.

The nurse identifies a nursing diagnosis of Imbalanced nutrition: less than body requirements for a terminally ill client who is near the end of life. Which of the following would the nurse expect to include in the client's plan of care?

Advice for the family to have fruit juices readily available at the client's bedside.

The family members of a dying patient are finding it difficult to verbalize feelings and show tenderness for the dying person. Which of the following nursing interventions should a nurse perform in such situations?

Encourage the family members to express their feelings and listen to them in their frank communication.

Which of the following is an appropriate method of assessing the dying client?

Focus on the client's basic needs.

Which of the following nursing interventions will a nurse perform to transfer heat and improve circulation in a dying client?

Gently massage the arms and legs.

which chronic disease has the LEAST %

Stroke

The comeback phase

The comeback phase is one in which there is a gradual recovery to an acceptable way of life. (less)

Kubler-Ross stages of grief

They are in this order usually. The stages include: denial, anger, bargaining, depression, and acceptance. Anger is the second stage of the process. Bargaining is the third stage of the process. Depression is the fourth stage of the process.

Trajectory Model of Chronic Illness

pre-trajectory, trajectory, stable, unstable, acute, crisis, comeback, downward and dying.

Pretajectory phase

pretrajectory phase is one in which lifestyle behaviors place a client at risk for a chronic condition.

Levsin and Atropine

reduce oral/respiratory secretions.

lorezepam

reduces anxiety

haldol

reduces hallucinations

Acute phase

the client has severe and unrelieved symptoms or complications that necessitate hospitalization.

4 preventable causes of chronic illnesses

tobacco use, sedetary lifestyle, improper diet, alcohol use

Palliative sedation

uses a benzodiazepine or barbituate that induce sleep or help alleviate discomfort.

The stable phase

characterized by symptoms of illness being under control.

Glaser and Strauss identified 4 awareness contexts

closed awareness, suspected awareness, open awareness and mutual pretense awareness

Open Awareness

when the patient, the family, and the health care professionals are aware that the patient is dying and openly acknowledge that reality.