Chronic Illness Management
April 19, 2021
As people age, their hormonal changes make them less active than they were when younger. As they age, people tend to be more disadvantaged as they experience more health problems than young people. The muscles of older people tend to decrease in their bodies. Lower muscle mass results in reduced metabolism in the human body which leads to inactivity. These changes with age reduce calorie needs in the body and make it hard to avoid excess weight. Excess body weight or obesity causes many health problems. The health problems may decrease in the older people’s physical and mental capacity and a growing risk of medical conditions and diseases such as hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD).
Chronic illnesses are long-term medical conditions that do not have a cure. Jim was diagnosed with chronic obstructive pulmonary disease (COPD) in 2018 when he was forty-five years. This disease is a severe inflammatory lung disease that obstructs airflow from the lungs. The signs and symptoms of this disease are coughs, breathing difficulty, wheezing, and mucus production. The medical condition has affected the intimate life of Jim as he cannot effectively have sex with his partner. Jim being a married partner, Sexual health is a crucial factor in human life since it affects Jim’s quality of life. Today’s health care providers, especially nurses, must help people maintain a healthy life because diseases and health conditions such as Chronic Obstructive Pulmonary Disease (COPD) present several adverse health and psychological outcomes which occur immediately and in the future.
What areas of health promotion would you consider to be most important? How will you present these to your client?
Health promotion is significant in ensuring certain diseases and medical conditions are well maintained, keeping the patient in a good state. Jim requires numerous health promotions such as monitoring his vital signs, modifying his lifestyle, changing his diet, administering medication, and consistent oxygen therapy to stabilize his oxygen level in the body. These health promotion practices would ensure balanced blood circulation, thus efficient oxygen and nutrients supply in the body. Jim should quit smoking to reduce the risk of chronic heart disease. Besides, he can eliminate many of the risk factors of his heart disease by making significant lifestyle changes and taking the required medications as prescribed by medical providers (Martire & Helgeson, 2017).
What preventive services would be appropriate for your client? How will you justify your recommendations if your client is reluctant?
Jim can prevent his medical condition by quitting smoking. Smoking is an addictive habit that is very hard to stop; suitable programs and products can be applied in helping Jim quit his smoking habits. Jim should stay far away from secondhand smoke, which comes from burning tobacco products such as cigarettes, pipes, and cigars. If Jim is reluctant to quit smoking, I would have a session with him to elaborate on the dangers of smoking to his condition and the adverse effects it may cause to his general health.
How will you assess your client and his or his family’s health literacy?
I t is essential to know the health literacy level of both Jim and his family. Jim’s family is integral in the health care system as they act as an intermediary between Jim and the healthcare providers and act as caregivers. Health knowledge would enable the health care providers to match the verbal instructions and the materials readability level to the health literacy skills of Jim and his family. It is essential to know that poor communication skills of patients may not indicate a lack of intelligence but a lack of health literacy skills. Jim and his family’s literacy level can be assessed through the Newest Vital Sign. These clues would help identify patients with low health literacy and evaluate questions to determine soft health literacy skills. Newest Vital Sign is a quick and accurate bilingual test for general literacy, comprehension skills, and numeracy applied to health information. Jim would read a specific label, and I would ask him six questions on how they would act on the information (Araújo-Soares et al., 2018)
What interventions could be used to enhance health literacy with your client and his or his family?
Effective communication strategies would be of great help to patients with low health literacy and also benefit more literate patients. Communication with the patients is one of the fundamental elements in the nursing practice and forms the foundation of good patient care. The Communication between Jim, his family, and the medical providers could be enhanced by arranging regular health care forums to all interact and raise their concerns on the health care system. Through the standard health care forums, Jim and his family would gain a lot of information on managing his condition effectively. The enhanced literacy level of Jim and his family would assist medical providers in providing optimal health care and ensure patients and their families have a positive experience of receiving health care.
If your client expressed a desire to implement complementary and alternative therapies into his or his overall regimen, how would you proceed with the care of your client?
There are several ways of treating Jim’s medical condition to help him maintain good health. One of the best ways of maintaining Jim’s situation is through consistent oxygen therapy to stabilize his oxygen level in the body. First, I would start with the most crucial treatments prescribed by the medical professionals then add the complementary therapies as desired by Jim. Alternative therapies would be analyzed as to whether they are suitable to be implemented in Jim’s health care. If the alternative therapies suggested by Jim are found to be fit with his condition, then they would be appropriately incorporated into Jim’s health care. Jim needs treatments that would help in enhancing his sex life; thus, they can be assessed and properly designed to fit in his health care (Wytrychiewicz et al., 2019)
Discuss how advanced practice nurses can apply health promotion or care coordination to enhance your client’s care.
Advanced nursing practice is crucial in ensuring Jim’s medical condition is well maintained, keeping Jim in a good state. Jim requires numerous nursing interventions such as monitoring his vital signs, administering medication, and consistent oxygen therapy to stabilize his oxygen level in the body. These nursing interventions would ensure balanced blood circulation, thus efficient oxygen and nutrients supply in the body. Palliative care can be advanced to Jim as it involves several medical practitioners, from doctors who treat Jim to nurses who administer medication and take care of Jim. Palliative care would help in significantly enhancing Jim’s care with the nurses, thus improving his general health and intimacy urge (Macêdo et al., 2020)
How could the professional nurse work with the advanced practice nurse to implement complementary and alternative therapies into your client’s current treatment plan?
The professional nurse should adopt advanced nursing practices in implementing complementary and alternative therapies that would significantly improve and help manage Jim’s health. The nurses should consult with Jim and his family to identify suitable treatments that would appropriately fit Jim’s health care. A professional nurse would collaborate with Jim’s family and his caregivers to know exactly the needs and preferences of Jim, which would help in appropriately implementing complementary and alternative therapies into Jim’s care. The alternative treatments would be analyzed to ascertain their suitability with Jim’s health care. If the alternative therapies suggested by Jim are found to be fit with his condition, then they would be appropriately incorporated into Jim’s health care (Zysman et al., 2020).
As your client nears the end of his or his acute hospital stay, which theoretical frameworks can be used to manage the client at home?
Person-centered care should be incorporated into the care of patients with multiple chronic diseases such as Jim as it improves patients’ independence. Encouraging Jim to take part in the decision-making of his care would boost his autonomy. Jim would become more confident thus able to look after himself with less input from the nurses or caregivers. Person-centered care helps patients to stick to their treatment plans and to take their medication fully. Jim and his family would be advised to visit their physicians instead of taking medications over the counter to get the medication that would best suit Jim’s conditions and be less reactive with other therapies and drugs. Taking drugs over the pharmacy counter could be dangerous because the pharmacist may not be having a clear record of Jim’s conditions and the medications used previously to assist them in prescribing the drugs that would best suit Jim’s medical condition.
How can a nurse work with a home health agency, primary and specialty care providers to prevent rehospitalization?
The nurses should incorporate person-centered care into Jim’s care, and it would help Jim stick to his treatment plans and fully take their medication, thus preventing rehospitalization. The nurses and other critical stakeholders in the care of Jim should assist him in strictly following his treatment plan and fully taking his medication as prescribed. Several medications can help Jim save his life, prolong his life, and improve his heart function. These medications include Angiotensin-Converting Enzyme (ACE) Inhibitors, Angiotensin II Receptors Inhibitors, and Angiotensin-Receptor Neprilysin Inhibitors (ARNIs). Also, nurses should work with the health care agency and specialist care providers to ensure that Jim’s oxygen therapy is appropriate and timely to maintain a sustainable oxygen level.
Patients with these chronic diseases and other medical conditions like Jim require medication to make them manageable and help the patient lead an everyday life with less suffering. Communication between the health care provides (nurses), patients, and their caregivers is very crucial in the process of delivering health care services as it enables them to know the needs exactly and wants of the patient. Health care professionals should constantly improve palliative care to reach out to many people suffering from complex diseases and save their lives. Consulting their physicians would help prescription the best drug after a proper review of their condition and medical progress. Patients should always have supportive caregivers who will help them maintain a healthy diet and take medication prescribed by the physicians and pharmacist.
Araújo-Soares, V., Hankonen, N., Presseau, J., Rodrigues, A., & Sniehotta, F. F. (2018). Developing behavior change interventions for self-management in chronic illness. European Psychologist.
Macêdo, T. E., da Silva, G., Morano, M. T., Holanda, M. A., & Pereira, E. D. (2020). Sexuality and Associated Factors in Chronic Obstructive Pulmonary Disease (COPD) Patients Attending a Referral Hospital in Northeastern Brazil. Journal of sex & marital therapy, 1-9.
Martire, L. M., & Helgeson, V. S. (2017). Close relationships and the management of chronic illness: Associations and interventions. American Psychologist, 72(6), 601.
Wytrychiewicz, K., Pankowski, D., Bargiel-Matusiewicz, K., Dąbrowski, J., & Fal, A. M. (2019). The role of psychological and medical variables in the process of adaptation to life with chronic illness in a group of COPD outpatients. Psychology, health & medicine, 24(10), 1243-1254.
Zysman, M., Rubenstein, J., Le Guillou, F., Colson, R. M. H., Pochulu, C., Grassion, L., … & Raherison-Semjen, C. (2020). COPD burden on sexual well-being. Respiratory research, 21(1), 1-10.
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