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HTH 471 E2 Chronic Illnesses Chapter 4
Gerontology
212
Health Care
Undergraduate 4
02/11/2013

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Term
Chronic is what amount of time?
Definition
3 months or more
Term
Acute is what amount of time?
Definition
3 months or less
Term
Three aspects of chronic illness
Definition
-Incurable
-Worsen over time
-Endure many years
Term
Two causes of chronic diseases?
Definition
-Lifestyle choices
-Heredity
Term
What is a major cause of death & majority of health care costs in the US
Definition
chronic disease
Term
Chronic diseases are associated with
Definition
reduced ability to function
Term
How is the function of people with chronic diseases measured?
Definition
Activities of Daily Living Scale
Term
Although some chronic illnesses have mild symptoms, a majority of them are responsible for extending _______, ________, and a decreased ________
Definition
suffering, disability, quality of life
Term
Chronic illness care compromises what percentage of the nation's medical care expenses?
Definition
75%
Term
Health professionals need to know illnesses, influences on every life, how to ______, ______ and _______ chronic illnesses
Definition
prevent, treat, manage
Term
Five activities of risky youth/middle age that can lead to chronic disease
Definition
Being overweight
Not exercising enough
Smoking cigarettes
Eating an unhealthy diet
Abusing alcohol
Term
Two or more risk factors =
Definition
“at risk” for chronic condition and more likely to be limited in ability to perform in daily activities
Term
Chronic disease can be tough to
Definition
diagnose, manage
Term
Five reasons chronic diseases may be difficult to diagnose
Definition
1. may be no symptoms
2. symptoms may be vague
3. more than one chronic disease can attribute to symptoms
4. Medications may be attributed to be the cause of symptoms
5. Misinterpret symptoms as old age
Term
Four reasons chronic diseases may be tough to manage
Definition
Reduced ability to handle stress
Usually have more than one condition
Increased risk of medication side effects
Not following/understanding doctor’s orders
Term
Reasons why a chronic disease might be tough to manage may also equal
Definition
more complications
Term
Because chronic illness is ongoing, elders must try to maintain
Definition
a normal life
Term
Miscarried helping can be detrimental to
Definition
the patient and the caregiver and health care professionals need to watch for it
f
Term
Sick role
Definition
reduces coping efectiveness and encourages further decline in function
Term
People may have both a ______ and ______ illnesses.
Definition
chronic and acute
Term
Miscarried helping
Definition
when diagnosed, family has empathy; optimism fades, increases anxiety to meet needs, and some neglect social engagements, get tired and drained and elder feels guilty. Distress between elder and caregiver can begin as well as anger and frustration.
Term
Chronic Illnesses are hard on elder and family ______, ________ and _______.
Definition
financially, socially, and emotionally
Term
Elders cope with chronic illness in many different ways depending on what five things
Definition
-extent of illness
-personality
-coping skills
-financial situation
-degree of family support
Term
How elders cope with chronic illness can be said to be a ___________ aspect of chronic disease
Definition
psychosocial
Term
Five major killers
Definition
Heart Disease
Cancer
Stroke
Chronic Obstructive Pulmonary Disease (COPD)
Diabetes
Term
Heart disease is a result of
Definition
blood vessels’ inability to carry oxygen and nutrients to the heart which allow it to pump blood effectively
Term
To determine who is at risk for heart disease, health care professionals look at risk factors:
Definition
age, gender, race, family history, lifestyle
Term
The best thing you can do to prevent heart disease is to
Definition
stop smoking
Term
__ out of ___ people who die of heart disease are 65+
Definition
4 out of 5
Term
What gender is more at risk for heart disease?
Definition
men
Term
Racial risks for heart disease
Definition
Black more than Whites, higher with Mexican, Indian, Hawaiian and some Asian
Term
How much more of a risk for heart disease do smokers have than non-smokers?
Definition
double
Term
There are ____ symptoms associated with high cholesterol
Definition
no
Term
Bad lipoproteins
Definition
Low density lipoproteins (LDL)
Term
Good lipoproteins
Definition
High density lipoproteins (HDL)
Term
Lower cholesterol with _____ first, _________ second
Definition
lifestyle changes, lipid lower medications second
Term
Medication seem to work on all age groups ________
Definition
equally well
Term
High cholesterol is when
Definition
excess lipids thicken blood and accumulate inside artery walls causing atherosclerosis
Term
What is borderline high cholesterol?
Definition
200-239
Term
What is considered high cholesterol?
Definition
240+
Term
HDL should be more than
Definition
40
Term
If HDL is more than 60, then
Definition
lower heart disease risk
Term
LDL should be less than
Definition
160
Term
Optimal LDL
Definition
100 to 129 is near optimal or lower optimal
Term
How to treat heart disease with high cholesterol
Definition
Normally give three months of good nutrition and exercise then placed on medication
Term
Hypertension has _____ symptoms
Definition
no
Term
What is hypertension also known as?
Definition
the silent killer, high blood pressure
Term
Which gender is more likely to have hypertension?
Definition
women
Term
What is the best way to reduce hypertension
Definition
weight loss
Term
Two parts of medications for hypertension
Definition
-may be taken for life
-may have side effects that are noticable
Term
Why are women more likely to have hypertension?
Definition
stress levels
Term
Five ways (other than weight loss) to reduce hypertension
Definition
stop smoking, reduce salt, fat and alcohol and increase physical activity.
Term
Uncontrolled high blood pressure causes excessive damage to
Definition
body organs and blood vessels (including brain).
Term
Atherosclerosis
Definition
A slow, progressive condition of the blood vessels
Term
In atherosclerosuis, arteries become narrowed due to
Definition
build-up of fat and cholesterol, causing inflammation
Term
Deposits in arteries harden, causing
Definition
plaque
Term
Plaque can break off and
Definition
clog an artery leading to heart attack or stroke
Term
Treatment of atheroschlerosis
Definition
lowering fat intake and cholesterol levels, losing weight
Term
Atheroschlerosis is a ______ condition that can begin as early as childhood in countries with _____ ____ ______.
Definition
progressive, high fat diets
Term
plaque doesn’t allow walls to ______ or ______ as needed.
Definition
expand, constrict
Term
Plaque can clog anywhere in the body but most dangerous in
Definition
coronary arteries, blood vessels going to brain and in arteries leading to the kidneys
Term
Angina
Definition
The heart muscles does not get enough blood and this causes pain.
Term
Stable angina occurs at
Definition
exertion
Term
Stable angina can be controlled by
Definition
resting
Term
Stable angina is a _______ conditions
Definition
chronic
Term
Unstable angina occurs at _____ and is an _____ condition
Definition
rest, acute
Term
Treatment for angina is
Definition
to change health behaviors, medications to dilate the blood vessels and sometimes surgery
Term
_______ or _______ and can be associated with pain in the left arm/jaw, sweating, panic, nausea or dizziness.
Definition
chest pain or chest pressure
Term
Stable
Definition
exercise stops, pain subsides
Term
Unstable
Definition
plaque breaks away and almost blocks a coronary artery. NEEDS immediate attention.
Term
Heart attack
Definition
A part of the heart starves and dies due to the supply artery becoming completely blocked
Term
Heart attacks are usually not fatal, but can be with
Definition
the very old
Term
At the first sign of a heart attack,
Definition
an aspirin should be chewed and the patient should seek medical attention immediately
Term
What two treatments can be given in the hospital after the attack?
Definition
angioplasty or bypass surgery
Term
At home, patients are who have had heart attacks are encouraged to
Definition
exercise, eat well and can be prescribed medication
Term
Most heart attacks are not fatal but all heart attacks
Definition
permenantly damage heart tissue
Term
Angioplasty
Definition
widen the portion that has dangerously narrowed.
Term
Four types of angioplasty
Definition
-by balloon: deflated balloon
-by laser: laser tipped catheter to vaporize the plaque in the artery
-atherectomy: catheter with rotating shaver to shave off plaque and debris
-wire mesh stent (tube): may be permanently implanted inside the artery to hold it open
Term
Bypass surgery
Definition
removes veins from chest or legs and grafts them into arteries needed.
Term
Congestive Heart Failure
Definition
A progressive weakening of the heart muscle that reduces its ability to pump effectively
Term
What is the biggest cause of congestive heart failure?
Definition
atheroschlerosis
Term
When the heart cannot pump well, results in either
Definition
poor output or blood back up
Term
Poor output
Definition
blood cannot get to the vital organs
Term
Blood backup
Definition
leading to excess fluid
Term
Prevention strategies for congestive heart failure
Definition
Medications can be prescribed to prevent episodes, but it is important to watch fluid and salt intake, monitor weight and seek help early
Term
Congestive heart failure reduces ______ and limits ______
Definition
quality of life, activity
Term
What percentage of people who are diagnosed with congestive heart failure die within five years?
Definition
50%
Term
Two types of cardiac arrhythmia
Definition
atrial fibrillation, ventricular fibrilaltion
Term
Atrial fibrillation
Definition
disorganized beat of the upper heart chambers
Term
Ventricular fibrillation
Definition
is a quavering at the bottom of the heart and is a life-threatening emergency
Term
What is common a day or two after a heart attack
Definition
ventricula fibrillation
Term
Cardiac arrhythmia can be helped through
Definition
implanting a pacemaker or a defibrillator, and prescribed medications
Term
Cardiac arrhythmia
Definition
irregular heartbeat
Term
Atrial fibrillation symptoms
Definition
palpitations and pulse is irregular, can be dangerous if rapid heart beat
Term
Ventricular fibillation is life threatening because
Definition
heart is unable to pump blood.
Term
Defibrillator
Definition
stops the heart if it’s beat is irregular, allowing the heart to restart in a normal rhythm
Term
The risk of developing cancer increases with
Definition
age
Term
More than half of cancer patients are over
Definition
65
Term
Why is cancer so hard to diagnose in elders?
Definition
cancer has no specific symptoms and old people already have a lot of symptoms
Term
Most cancers are treatable, with
Definition
high survival rates, when found in the early stages.
Term
Cancer is the _______ leading cause of death in the United States
Definition
second
Term
__ in ___ will die from cancer
Definition
1 in 4
Term
Seven warning signs of cancer
Definition
change in bowels or bladder
sore that doesn’t heal
unusual bleeding or discharge
thickening or lump
indigestion or difficulty swallowing
obvious change in wart or mole
nagging cough or hoarseness
Term
What five cancers are common in the elderly
Definition
Lung, colon, rectum, prostate and breast
Term
Single most effective way to prevent cancer?
Definition
don't smoke
Term
Three treatments for cancer
Definition
Surgery, radiation, or chemotherapy
Term
Elders tend to suffer more complications from what treatment of cancer?
Definition
surgery
Term
What are some complications that elders may experience after surgery to treat cancer?
Definition
wound infections, UTIs
Term
Cancer medications to
Definition
reduce pain, alter mood, and induce sleep help patient feel more comfortable
Term
Treatment plan of cancer considers
Definition
age, rate of cancer growth, type and extent of treatment, state of health, and quality of life
Term
The leading cause of cancer deaths in both men and women
Definition
lung cancer
Term
Two types of lung cancer
Definition
small cell lung cancer and non small cell lung cancer
Term
Which lung cancer is more common and easier to treat
Definition
non small cell lung cancer
Term
Which lung cancer is more strongly linked with smoking and is more deadly
Definition
small cell lung cancer
Term
Warning symptoms of lung cancer
Definition
chronic cough and shortness of breath
Term
Lung cancers are generally _____ by the time it’s diagnosed, and therefore _______
Definition
advanced and deadly
Term
Lung cancer is declining because of
Definition
decreased smoking rates
Term
Average age of those diagnosed with lunch cancer was
Definition
60
Term
____ of lung cancer is attributed to cigarette smoking and environmental factors (asbestos, radon, xray exposure, second hand smoke and air pollution).
Definition
90%
Term
What percent of people with lung cancer survive after five years of being diagnosed?
Definition
15%
Term
What percent of people with lung cancer die within the first year of being diagnosed?
Definition
50%
Term
Almost ¾ of breast cancer cases occur in women over
Definition
50
Term
2nd leading cause of cancer death in women
Definition
breast cancer
Term
Risk factors for breast cancer
Definition
obesity and inactivity, family history, length of estrogen in the body
Term
Best way to beat breast cancer
Definition
detect it early
Term
Treatment for breast cancer
Definition
radiation, surgery (lumpectomy, mastectomy), chemotherapy, hormone therapy
Term
Prevention for breast cancer
Definition
health behavior choices and some medications for those with high-risk factors
Term
Five year survival rate of cancer localized in the breast
Definition
98%
Term
Five year survival rate of cancer also in adjacent tissues
Definition
80%
Term
Five year survival rate metastasizes to other parts of the body
Definition
26%
Term
Health Behaviors that can help reduce the risk of breast cancer
Definition
low fat diet, weight reduction, low alcohol intake and an active lifestyle
Term
Almost all diagnosed prostate cancer cases (97%) occur in men aged
Definition
50 and older
Term
Prostate cancer can be ____ growing and is the _____ leading cause of cancer death in men
Definition
slow, second
Term
Those diagnosed with prostate cancer can have surgery to _______ or engage in _______
Definition
remove the prostate, watchful waiting
Term
How many men die per year from prostate cancer?
Definition
30,000
Term
How many new cases of prostate cancer are men 65+
Definition
two thirds of a quarter of a million
Term
Death rates from prostate cancer are twice as high in
Definition
blacks as in whites
Term
Many men die with prostate cancer rather than
Definition
from it
Term
Cancer spread outside prostate is more deadly and is managed by
Definition
hormonal therapy or removal of testes
Term
More than ____ of colorectal cancer cases are diagnosed after age 50
Definition
90%
Term
Symptoms of colorectal cancer
Definition
rectal bleeding, constipation, diarrhea or weight loss
Term
Colorectal cancer is more prevalent in American than
Definition
Japan or china
Term
Colorectal cancer may be diagnosed through what three ways
Definition
rectal exam, testing the stool for occult blood, or looking at the colon with a “scope”.
Term
Treatment for colorectal cancer
Definition
surgery
Term
Colorectal cancer is strongly related to
Definition
age
Term
What five things may be contributing to colorectal cancer
Definition
High fat, low fruits and vegs and fiber and alcohol and cigs
Term
Many require ______ after surgery to remove colorectal cancer.
Definition
radiation/chemo
Term
Stroke is like a
Definition
heart attack in the brain
Term
Two types of stroke
Definition
ischemic, hemorrhagic
Term
ischemic stroke
Definition
when a blood clot or clump of cholesterol travels through the bloodstream to the brain blocking the blood supply to brain cell
Term
hemorrhagic stroke
Definition
bleeding in the brain caused by a broken or leaking blood vessel
Term
About ____ of stroke victims are over 65
Definition
2/3
Term
Main risk factor for stroke
Definition
high blood pressure
Term
What is the third leading cause of death
Definition
stroke
Term
Like in a heart attack, in a stroke
Definition
brain cells are deprived of oxygen and they die.
Term
__% of strokes are Ischemic.
Definition
90
Term
Major warning signs of an impending stroke
Definition
mini strokes (TIA)
Term
______ ________ can be given at the hospital during a stroke to help the patient
Definition
blood thinners
Term
After a stroke, patients are prescribed (3)
Definition
medication, daily aspirin therapy and lifestyle modifications
Term
Effects of a stroke are variable depending on
Definition
the portion of the brain effected and length of the stroke
Term
Stroke normally ______ the qaulity of life
Definition
dimenishes
Term
Other than physical, what other effects may also take place after a stroke?
Definition
emotional and psychological
Term
What treatment is started almost immediately after a stroke?
Definition
rehab
Term
What may mini strokes result in
Definition
motor weakness, black outs, speech disturbances or personality changes.
Term
What does TIA stand for
Definition
transient ischemic attack
Term
Medications can help ________ and reduce impact of stroke.
Definition
breakdown clots
Term
Emotional effects of a stroke include
Definition
depression, frustration, and anxiety.
Term
Physical effects of a stroke
Definition
weakness/paralysis, speech, lose vision and lack of coordination.
Term
Aspirin daily after a stroke is up to
Definition
the doctor
Term
Who are more susceptible to chronic lung diseases
Definition
elders
Term
Why are elders more susceptible to chronic lung diseases
Definition
Been smoking longer/exposed to environmental factors longer
decline reducing pulmonary function
Term
Chronic lung disease
Definition
An obstruction of air flow in the bronchi of the lungs that worsens over time
Term
Umbrella term for most lung conditions
Definition
COPD
Term
What three things can help chronic lung diseases
Definition
Supplemental oxygen, corticosteroids, bronchodilators
Term
Chronic lung disease increases risk for
Definition
diabetes, flu, and other chronic conditions
Term
Obstruction n the lungs that is debilitating and causes
Definition
breathlessness, cough and weakness
Term
Chronic lung diseases affect which gender more?
Definition
men
Term
Why do chronic lung diseases affect men more then women?
Definition
men tend to smoke more
Term
Bronchodilators
Definition
relax the muscles surrounding the airways
Term
Corticosteriods
Definition
reduce inflammation making it easier to breathe. Many possible negative side effects
Term
Chronic bronchitis is common among
Definition
smokers
Term
Chronic bronchitis has a chronic
Definition
cough for at least 3 months a year for 2 years
Term
In chronic bronchitis irritation of the respiratory tract increase the ______ _____ further decreasing the airways ability to clear itself
Definition
mucus production
Term
Emphysema
Definition
Irreversible deterioration of the alveoli
Term
Early symptoms of emphysema
Definition
chronic mild cough, fatigue and loss of appetite.
Term
Later symptoms of emphysema
Definition
include shortness of breath
Term
Symptoms of emphysema are not often seen until
Definition
the lungs have been greatly damaged.
Term
deterioration of the alveoli
Definition
inhale oxygen into lung and exhale carbon dioxide.
Term
Two medications for emphysema
Definition
such as bronchodilators (to relax muscles) and corticosteroids (reduces inflammation).
Term
Asthma
Definition
The bronchi of the lungs are hyperactive and constrict causing reduction of air flow
Term
Some asthma patients may only have symptoms when they are
Definition
stressed, around allergens, or during exercise
Term
What may reduce symptoms of allergies
Definition
Steroids, bronchodilators or allergy medicine
Term
Diabetes
Definition
A metabolic disorder -difficulty in regulating the production or use of insulin
Term
By age 60, ____ of Americans have diabetes
Definition
27%
Term
What three ethnic groups are most at risk for diabetes?
Definition
African American, Hispanic American, and Native Americans
Term
what type of diabetes develops gradually and first appears in middle age
Definition
type 2
Term
In type 2 diabetes
Definition
The pancreas produces sufficient insulin but the body cells become resistant to it
Term
Type 1 diabetes is also known as
Definition
juvenile
Term
Type 1 diabetes
Definition
pancreas stops producing insulin so they have high blood sugar levels and no insulin to help sugar enter cells where needed. Can be deadly.
Can use injections, pump and inhaled
Term
Risk factors for diabetes
Definition
obesity and family history
Term
Diabetes cannot be cured, but can be _______
Definition
controlled
Term
Two things diabetics need to do to reduce ther disease
Definition
eat well and lose weight
Term
Three parts of a diabetc diet
Definition
vegetables, whole grain, and low-fat protein
Term
Medications to help diabetics
Definition
Medications, oral and injectable including insulin, can be prescribed
Term
Diabetics need to measure
Definition
their blood sugar several times a day
Term
Diabetes is associated with complications in
Definition
almost every body system
Term
The 7th leading cause of death for elders
Definition
diabetes
Term
Why is diabetes the 7th leading cause of death in elders
Definition
increases the death rate for other conditions such as heart disease, stroke and kidney disease
Term
What is the most costly chronic disease?
Definition
diabetes
Term
Estimated that __ in __ Medicare
dollars is spent on people with
diabetes
Definition
1 in 4
Term
Leading causes of blindness and impotency.
Definition
diabetes
Term
Diabetes is most costly because of increased
Definition
incidence of complications, regular monitoring, drugs, and high use of the health care system.
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