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Questions and Answers
What is the primary risk factor for pressure ulcers that relates to physical movement?
Which aspect of dysphagia involves bringing food or liquid from the mouth to the stomach?
Which scale is used for predicting the risk of pressure sores?
Which of the following is NOT a recommended strategy for managing dysphagia?
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What classification indicates a person has a severe risk of pressure sore development on the Braden Scale?
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In the context of oropharyngeal dysphagia, what is often impaired?
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What position is recommended for individuals after eating to help manage dysphagia?
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Which of the following describes a person who is very limited in sensory perception according to the Braden Scale?
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What is a characteristic of chronic illness?
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What is an effective strategy for fall prevention?
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What is a potential consequence of polypharmacy?
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What condition is characterized by difficulty falling and staying asleep?
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Which task is NOT typically part of managing chronic illness?
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Which medication class is commonly used to treat anxiety?
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What describes generalized anxiety?
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In which condition is frailty primarily characterized?
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Which clinical manifestation is NOT typically associated with adverse drug reactions?
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What does the term 'nocturia' mean?
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Which of the following is a symptom of panic attacks?
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What term describes unique health conditions in elderly patients that are multifactorial?
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What is defined as the extent to which patients are not willing to follow prescribed treatment instructions?
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Which strategy is NOT typically included in care for sleep disorders?
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What is a significant risk factor of depression?
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What can occur during acute exacerbations of chronic illness?
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What condition describes skin that is kept moist almost constantly?
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Which level of moisture indicates that the linen must be changed at least once a shift?
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What does the condition 'Requires moderate to maximum assistance in moving' represent?
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Which option describes someone who maintains a relatively good position in a bed or chair most of the time but occasionally slides down?
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What is true regarding 'Occasionally Moist' skin?
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Which description best fits 'Moves independently and lifts up completely during a move'?
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What does 'Requires minimum assistance' during a move indicate about the skin condition?
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What condition is indicated by a patient whose skin is usually dry and only requires changing at routine intervals?
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What total score indicates a high risk for pressure ulcers?
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Which tissue type is characterized by being completely covered with epithelium?
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What defines the tissue type classified as granulation tissue?
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What is the significance of nutrition for a client at risk with pressure ulcers?
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In the PUSH Tool 3.0, how is a score of '1' interpreted for length x width?
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What does a total score above 24.0 indicate in relation to pressure ulcers?
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How is slough tissue defined?
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Which of the following statements about necrotic tissue is correct?
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Study Notes
Acute Illness
- Characterized by rapid onset and short duration
- Usually self-limiting
- Respond readily to treatment
- Complications are infrequent
- Full recovery to previous level of functioning expected
Chronic Illness
- Prolonged illnesses with no spontaneous resolution and no complete cure
- Permanent impairments or deviation from normal function
- Irreversible pathologic changes
- Residual disability
- Require special rehabilitation
- Long-term medical and nursing management needed
Trajectory of Chronic Illness
- May have acute exacerbations shifting the individual from optimum functioning to a period of instability where they might need assistance
7 Tasks of People with Chronic Illness
- Prevent and manage a crisis
- Follow prescribed treatment regimens
- Control of symptoms
- Adjustment to disease changes
- Prevention of social isolation
- Normalization of interactions with stress
- Attempt to normalize interactions with stress
Geriatric Syndrome
- Unique health conditions in older adults that are multifactorial in cause and do not fit into specific organ-based categories
Frailty
- Impaired mobility, balance, endurance, physical activity, muscle strength, nutrition, and cognition
Polypharmacy
- Concurrent use of multiple medications. Often defined as 4 or 5 or more medications by a single person
Polypharmacy Implications
- Non-adherence: Patients not following prescribed treatment instructions
- Adverse Drug Reactions: Detrimental, undesired, unintended, or unexpected response to a medication in a recommended dose
Clinical Manifestations of Adverse Drug Reactions
- Nausea
- Dizziness
- Constipation
- Orthostatic hypotension
- Gastrointestinal bleeding
- Falls
- Urinary incontinence
- Muscle aches
- Sexual dysfunction
- Insomnia
- Confusion
Polypharmacy Implications
- Drug-Drug Interactions: Occur when two or more drugs are taken together
Strategies for Fall Prevention
- Modify the environment
- Evaluate gait and balance
- Review medications
- Develop fall prevention plan
- Restrain use (limited/last resort)
Delirium
- Disturbance of consciousness with reduced ability to focus, sustain or shift attention.
- Changes in cognition or perceptual disturbances
Anxiety
- Normal adaptive reaction to new situations or perceived threats.
- Can manifest as tachycardia, palpitations, insomnia, and tachypnea
Generalized Anxiety
- Persistent excessive worry with fluctuating severity of symptoms.
- Symptoms include restlessness, irritability, sleep disturbance, and impaired concentration.
Panic Attacks
- Autonomic arousal and symptoms include tachycardia, difficulty breathing, diaphoresis, lightheadedness, and severe weakness
Strategies for Care
- Instruct patients prior to painful procedures and self-management pain
- Medication to treat anxiety include benzodiazepines, selective serotonin reuptake inhibitors (SSRIs)
Depression
- Linked to decreased quality of life.
- Symptoms include loss of interest and motivation.
- Significant risk for suicide
Strategies for Care
- Aimed toward remission and prevention of recurrence
- Pharmacological therapies include tricyclic antidepressants (TCAs)
- Cognitive behavioral therapy
- Exercise, light therapy, alternative medicine, and counseling.
Urinary Incontinence
- Involuntary leakage of urine
Nocturia
- Awakening from sleep to urinate
Sleep Disorders
- Insomnia: Difficulty falling asleep and staying asleep
- Sleep Apnea: Narrowing or loss of tone in the pharyngeal airway
- Restless Leg Syndrome: Neurological disorder with uncontrollable urge to move to relieve paresthesia or dyesthesias
Strategies for Care
- Environmental restructuring
- Relaxation techniques
- Sleep hygiene
- Aromatherapy
- Herbal therapy
- Medications
Dysphagia
- Underrecognized, poorly diagnosed, and poorly managed health problem negatively impacting quality of life.
Deglutition
- Act of swallowing.
- Food or liquid is transported from the mouth through the pharynx and esophagus into the stomach.
Oropharyngeal Dysphagia
- Usually related to neuromuscular impairments affecting the tongue, pharynx, and upper esophageal sphincter
Strategies for Care
- Compensatory eating techniques: Upright position with supported arms and feet for at least 30 to 60 minutes after eating
- Quiet room to decrease distractions and allow focus on eating
- Diet modifications
- Oral hygiene
- Non-oral feedings
Pressure Ulcers
- Lesions caused by unrelieved pressure with damage to underlying tissue
Risk Factors for Pressure Ulcers
- Advanced age
- Immobility
- Malnutrition
- Diminished level of consciousness
- Impaired sensation
Braden Scale
- Predicts pressure ulcer risk.
- Severe Risk: Total score ≤ 9
- High Risk: Total score 10-12
- Moderate Risk: Total Score 13-14
- Mild Risk: Total score 15-18
Friction and Shear
- Use the Braden Scale to understand these risk factors
Nutrition
- Important for clients at risk of pressure ulcers
Pressure Ulcer Scale for Healing (PUSH Tool 3.0)
- Used to assess pressure ulcers.
- Scores based on length, width, exudate amount and tissue type.
- Higher scores indicate more severe ulcers.
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Description
Explore the key differences between acute and chronic illnesses, including their characteristics, management, and the challenges faced by individuals dealing with chronic conditions. This quiz will delve into the trajectory of chronic illness and outline essential tasks for effective management and rehabilitation.
