l OM oARc PSD|99 28 8 71
l OM oARc PSD|99 28 8 71
Med-Surg Exam 1 - Summary Brunner and Suddarth's Textbook o
Medical-Surgical Nursing
MED-SURG. EXAM 1 STUDY GUIDE
CHAPTER 9 - Chronic Illness and Disability
Delegation RNs
• Don’t delegate assessment, teaching, evaluation to LPN, UAP, Nursing Aide
• Delegate STABLE patient with EXPECTED outcomes
• TIP: 24hr post-op patient is considered stable
• Delegate tasks that involve STANDARD UNCHANGING tasks. Ex: bath, feeding, and bed making.
Prioritization
• Deciding which needs or problems require immediate action and which ones could tolerate a delay in response
until a later time because they are not urgent.
Four P’s of Prioritization
● Purpose - What is the patient’s outcome for care?
● Picture - What does the patient look like now/what will his outcome or result be?
● Plan - What are the patient’s priorities?
● Part - Who will participate in the patient’s care/what will they be responsible for?
Prioritization Criteria
● Is it life threatening or potentially life threatening if the task is not done?
● Would another patient be endangered if I do this now or leave this task for later?
● Is this task or process essential to patient or staff safety?
● Is this task or process essential to the medical or nursing plan of care?
Levels of Priority Setting
● Ensure Patient/Caregiver Safety and Infection Prevention
● First-Level Priority Problems
o ABCs plus VS concerns (high fever, hypertension, etc.)
o EXCEPTION: CPR for cardiac arrest à begin compressions stat
● Second-Level Priority Problems
o Mental status change
o Untreated medical problems requiring immediate attention
o Acute pain
o Acute urinary elimination problems
o Abnormal lab values
o Risks of infection, safety, or security (for patient or others)
● Third-Level Priority Problems
o Health problems that do not fit into the categories above (problems with lack of knowledge, activity, rest,
family coping)
, l OM oARc PSD|99 28 8 71
Levels of Priority Setting Prioritization: Maslow’s Hierarchy of Needs
Downloaded by Rehema Issa Issa ()
Chronic Illness (p. 132)
• Require therapeutic regimens
• People who develop it may react shocked, in disbelief, angry or resentful
• Symptoms often unpredictable
• Usually require long term management
• Considered to be 3 months or longer
• Examples include HTN, renal and cardiovascular
• More expensive to treat
Nursing care for patient with chronic disorder-
• Direct care – physical assessment
• Supportive care – ongoing monitoring, education, counseling, and serving as an advocate.
Disability (handicap) VS impairment (Page 140)
Disability
• Limitation in performance or function in everyday activities
• ADL’s
• Walking, jumping, hiking
• Carrying objects
• Also considered disabled if they receive federal benefits
• Considered an umbrella term for impairment
Impairment:
• A loss or abnormality in body structure or physiologic function including mental function.
• Patients on wheel chair assess for sores
• To check nutritional state (check albumin)
Chronic disorder
• Non-communicable (non-transmissible) diseases, chronic conditions, or chronic disorders
Chronic illness
• Refers to the experience of living with a chronic disease or condition. It includes the individual’s perception of the
experience of having a chronic disease or condition and the individual’s and others’ responses to it.
Acquired disabilities
• May occur as a result of an acute and sudden injury (traumatic brain injury, spinal cord injury, traumatic
amputation), acute nontraumatic disorders (stroke, myocardial infarction), or progression of a chronic disorder
(arthritis, multiple sclerosis, chronic obstructive pulmonary disease, blindness due to diabetic retinopathy)
, l OM oARc PSD|99 28 8 71
Developmental disabilities
• Those that occur any time from birth to 22 years of age and result in impairment of physical or mental health,
cognition, speech, language, or self-care.
• Examples of developmental disabilities are spina bifida, cerebral palsy, Down syndrome, and muscular dystrophy.
Age-associated disabilities
• Types of disabilities include sensory disabilities, learning disabilities, disabilities that affect the ability to speak or
communicate, and disabilities that affect the ability to work, shop, care for oneself, or access health care.
Model of disabilities
• The interface model promotes the view that people with disabilities are capable, responsible people who are able
to function effectively despite having a disability.
• The rehabilitation model regards disability as a deficiency that requires a rehabilitation specialist or other helping
professional to fix the problem.
l OM oARc PSD|99 28 8 71
Med-Surg Exam 1 - Summary Brunner and Suddarth's Textbook o
Medical-Surgical Nursing
MED-SURG. EXAM 1 STUDY GUIDE
CHAPTER 9 - Chronic Illness and Disability
Delegation RNs
• Don’t delegate assessment, teaching, evaluation to LPN, UAP, Nursing Aide
• Delegate STABLE patient with EXPECTED outcomes
• TIP: 24hr post-op patient is considered stable
• Delegate tasks that involve STANDARD UNCHANGING tasks. Ex: bath, feeding, and bed making.
Prioritization
• Deciding which needs or problems require immediate action and which ones could tolerate a delay in response
until a later time because they are not urgent.
Four P’s of Prioritization
● Purpose - What is the patient’s outcome for care?
● Picture - What does the patient look like now/what will his outcome or result be?
● Plan - What are the patient’s priorities?
● Part - Who will participate in the patient’s care/what will they be responsible for?
Prioritization Criteria
● Is it life threatening or potentially life threatening if the task is not done?
● Would another patient be endangered if I do this now or leave this task for later?
● Is this task or process essential to patient or staff safety?
● Is this task or process essential to the medical or nursing plan of care?
Levels of Priority Setting
● Ensure Patient/Caregiver Safety and Infection Prevention
● First-Level Priority Problems
o ABCs plus VS concerns (high fever, hypertension, etc.)
o EXCEPTION: CPR for cardiac arrest à begin compressions stat
● Second-Level Priority Problems
o Mental status change
o Untreated medical problems requiring immediate attention
o Acute pain
o Acute urinary elimination problems
o Abnormal lab values
o Risks of infection, safety, or security (for patient or others)
● Third-Level Priority Problems
o Health problems that do not fit into the categories above (problems with lack of knowledge, activity, rest,
family coping)
, l OM oARc PSD|99 28 8 71
Levels of Priority Setting Prioritization: Maslow’s Hierarchy of Needs
Downloaded by Rehema Issa Issa ()
Chronic Illness (p. 132)
• Require therapeutic regimens
• People who develop it may react shocked, in disbelief, angry or resentful
• Symptoms often unpredictable
• Usually require long term management
• Considered to be 3 months or longer
• Examples include HTN, renal and cardiovascular
• More expensive to treat
Nursing care for patient with chronic disorder-
• Direct care – physical assessment
• Supportive care – ongoing monitoring, education, counseling, and serving as an advocate.
Disability (handicap) VS impairment (Page 140)
Disability
• Limitation in performance or function in everyday activities
• ADL’s
• Walking, jumping, hiking
• Carrying objects
• Also considered disabled if they receive federal benefits
• Considered an umbrella term for impairment
Impairment:
• A loss or abnormality in body structure or physiologic function including mental function.
• Patients on wheel chair assess for sores
• To check nutritional state (check albumin)
Chronic disorder
• Non-communicable (non-transmissible) diseases, chronic conditions, or chronic disorders
Chronic illness
• Refers to the experience of living with a chronic disease or condition. It includes the individual’s perception of the
experience of having a chronic disease or condition and the individual’s and others’ responses to it.
Acquired disabilities
• May occur as a result of an acute and sudden injury (traumatic brain injury, spinal cord injury, traumatic
amputation), acute nontraumatic disorders (stroke, myocardial infarction), or progression of a chronic disorder
(arthritis, multiple sclerosis, chronic obstructive pulmonary disease, blindness due to diabetic retinopathy)
, l OM oARc PSD|99 28 8 71
Developmental disabilities
• Those that occur any time from birth to 22 years of age and result in impairment of physical or mental health,
cognition, speech, language, or self-care.
• Examples of developmental disabilities are spina bifida, cerebral palsy, Down syndrome, and muscular dystrophy.
Age-associated disabilities
• Types of disabilities include sensory disabilities, learning disabilities, disabilities that affect the ability to speak or
communicate, and disabilities that affect the ability to work, shop, care for oneself, or access health care.
Model of disabilities
• The interface model promotes the view that people with disabilities are capable, responsible people who are able
to function effectively despite having a disability.
• The rehabilitation model regards disability as a deficiency that requires a rehabilitation specialist or other helping
professional to fix the problem.
