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 family functioning
Return to a better state of health than prior
Ignore threats to identity
Validate individual self-worth
A patient who is at risk for developing a chronic condition because of genetic factors is said to be in which phase of the Trajectory Model?
Pretrajectory
Acute
Unstable
Trajectory
Which phase of the Trajectory Model does the nurse recognize is present when the patient is in remission, after an exacerbation of illness?
Downward course
Comeback
Crisis
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
Chronic disability
Developmental disability
Impaired disability
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.
Suggested home health care to a stroke victim.
Encouraged a post-fracture patient to continue physical therapy.
Explained the significance of a serum glucose level of 160 mg/dL.
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?
Responds, "There are some adjustments to your medications that need to be made"
Acknowledges that the client is performing satisfactorily
States, "The glycohemoglobin is too high"
Advises the client that changes must be made to the diet
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
Permanent
Acquired
Age–related
Developmental
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
Assist the family in obtaining equipment that would help the client to walk.
Refer the client to physical therapy for ambulation exercise two times a week.
Plan with the client how to incorporate the regimen into the client's activities of daily living.
Instruct the client what he or she must do.
The nurse is working with a client who has difficulty controlling her blood sugar. The overweight client does not adhere to a low-calorie diet and forgets to take medications and check her blood glucose level. The client's glycohemoglobin is 8.5%. When establishing a goal for the client, the nurse first
Informs the client about what goal the nurse wants the client to achieve
Plans the short–term goal as "the client's blood sugar each AM will be less than 110 mg/dL"
Sets the long–term goal as "the client's glycohemoglobin will be 6.9% in 3 months"
Collaborates with the client to establish an agreed-upon goal
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 and family do not allow the chronic illness to be the focal point of their lives.
The client adheres to the prescribed therapeutic regimen.
The client does not believe that the illness threatens self identity and body image.
The client stops taking some medications due to side effects that are disturbing to the client.
A graduate nurse is assigned to care for a client with an acute exacerbation of chronic obstructive pulmonary disease. The client also has Down syndrome. During the shift, the nurse discovers that the client lives alone and holds a full-time job. Which type of disability would the nurse state the client has?
Acute nontraumatic
Age-related
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.
The management of chronic conditions is a process of discovery.
Chronic illness involves treating only the medical problems.
Chronic illness affects the entire family.
Managing chronic conditions must be a collaborative process.
Chronic conditions only involve one phase of a person's life.
Which of the following describes the crisis phase of the trajectory model of chronic illness?
The client is in the final days or weeks before death characterized by gradual or rapid shutting down of body processes.
The course of the illness and symptoms are under control.
The client may require more diagnostic tests.
The client is experiencing a critical or life-threatening situation requiring emergency treatment.
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
Downward
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?
