Chapter 14 Developmental Considerations and Chronic Illness in the Nursing Care of Adults

Answers CHAPTER 14 DEVELOPMENTAL CONSIDERATIONS AND CHRONIC ILLNESS IN THE NURSING CARE OF ADULTS AUDIO CASE STUDY Julie and Older Adult Developmental Stages 1. Integrity versus Despair. 2. Integrity means accepting responsibility for one’s life and reflecting on it in a positive way. 3. Despair. He seems sad, lonely, hopeless, goalless, and regretful. This shows there is unresolved work in earlier stages. 4. Reminiscence therapy, a memory book of significant events and photos of his life to share with his grandchildren, or an audiotape or videotape of his life story. and give up hope if they feel that they are a burden to others. Establishing short-term goals or self-care activities that allow them to participate or have small successes is an important nursing action that can increase their self-esteem. CRITICAL THINKING 1. The nurse should explore Mrs. Martin’s spiritual needs: Is she hopeful? What makes her feel at peace? How does she usually meet her spiritual needs? Does she have certain religious customs? 2. Spiritual Distress, Readiness for Enhanced Spiritual Well-Being, Hopelessness, and Powerlessness. 3. Interventions may include arranging for Mrs. Martin to use the meditation room for quiet reflection or prayer, visit with a chaplain, or attend worship services; assisting Mrs. Martin with transportation to the meditation room or worship services; and providing desired reading material such as the Bible or a prayer book. 4. If Mrs. Martin expresses a feeling of peace or hopefulness. REVIEW QUESTIONS—CONTENT REVIEW VOCABULARY The correct answers are in boldface. 1. respite care 2. powerlessness 3. chronic 4. spirituality 5. hopelessness 6. developmental stage 1. (4) is correct. (1, 2, 3) are developmental stages typically carried out in earlier years of life. 2. (4) is correct. A lack of respite care would increase stress. Stress decreases when the caregiver is given personal time away from the patient, which everyone needs. (1, 2) are incorrect. If respite care is not available, then (1) personal time decreases and (2) rest time decreases. (3) is incorrect. There is no cost for most volunteer respite services, so costs would not be increased. 3. (4) is correct. Allowing the patient to make informed decisions should foster health promotion. (1, 2, 3) are incorrect. Making the choices or setting goals for the patient and family may not result in implementation of those choices or accomplishment of the goals because input was not obtained from them. 4. (1) is correct. Arthritis is a chronic illness. (2, 3, 4) are acute illnesses. 5. (1) is correct. Being willing and able to carry out the medical regimen is important in dealing positively with the illness. (2, 3, 4) would be unhelpful behaviors in adapting to a chronic illness. 6. (2, 6) are correct. Malabsorption syndrome and spina bifida are congenital chronic disorders. (1, 3, 4) are acquired illnesses. (5) is a genetic illness. CHRONIC ILLNESS AND THE OLDER ADULT Corrections are in boldface. Older adults constitute one of the largest age groups living with chronic illness. Older adult spouses or older family members are increasingly being called on to care for a chronically ill family member. Children of older adults who themselves are reaching their 60s are being expected to care for their parents. These older adult caregivers may also be experiencing chronic illness themselves. For older adult spouses, it is usually the less ill spouse who provides care to the other spouse. The older adult family unit is at great risk for ineffective coping or further development of health problems. Nurses should collect data on all members of the older adult family to ensure that their health needs are being met. Older adults are very concerned about becoming dependent and a burden to others. They may become depressed 1 2 Chapter 14 Answers REVIEW QUESTIONS—TEST PREPARATION The correct answers are in boldface. 7. (1) is correct. Stress management directly influences how a patient ages. (2, 3, 4) do not directly influence a patient’s aging. 8. (4) is correct. This empowers patients to control their own health care. (1, 2, 3) take control away from the patient. 9. (2) is correct. Home health care nurses can strengthen a patient’s self-care capacity by saying, “Let me assist you” instead of “Let me do this for you.” (1) is incorrect. Being a caregiver instead of a partner is not helpful in improving self-esteem. (3) is incorrect. Empowering the patient instead of doing it all for the patient would be helpful. (4) is incorrect. Doing everything for the patient instead of assisting makes the patient feel dependent and useless. 10. (1) is correct. Offering praise for small patient efforts shows interest in the patient and motivates the patient to try other tasks. (2) is incorrect. If praise is offered only for major patient efforts, opportunities to praise small tasks are lost; if the patient never accomplishes major tasks, no praise is ever given. (3) is incorrect. If activities of daily living are done for the patient, no opportunity for independence and success is allowed for the patient. (4) is incorrect. Assisting the patient at the first sign of difficulty with activities of daily living allows the patient no opportunity to succeed at a difficult task. 11. (2) is correct. Using humor can be helpful, and this is one method of using humor. (1) is incorrect. Avoiding the use of humor is not beneficial because humor has been shown to enhance health. (3) is incorrect. A serious demeanor may not be helpful in improving a patient’s mood. (4) is incorrect. Limiting conversation to a minimum further isolates the patient. 12. (1) is correct. Providing educational information empowers the patient to make informed choices. (2) is incorrect. Limiting visiting hours for family members isolates the patient and does not allow the patient free choice. (3) is incorrect. Asking family members to provide care makes the patient dependent even if some independence is possible. (4) is incorrect. Setting the goals for the patient and family takes the decisionmaking process away from the patient. 13. (1) is correct. Huntington disease is a genetic condition. (2, 3, 4) are incorrect.