Nursing 109

N109: Foundations in Nursing Practice Study Guide • Ability to perform activities of daily living (ADLs): Individuals with chronic illness may need assistance in performing ADLs. This assistance may be in the form of equipment or human intervention and assistance. • Progressive decline in health: By definition, chronic illness is progressive and typically results in progressive deterioration of health that may eventually interfere with performing ADLs. • Issues of quality of life: As the individual moves along the chronic illness trajectory, diminished self-esteem can become a problem as the individual becomes more impaired and less able to care for himself. As the individual’s lifestyle changes due to permanent disability or physical limitations, he may begin to enjoy life less and question the overall quality of his life. • Caregiver issues: The family dealing with chronic illness may become overwhelmed with the increased responsibilities of caring for an ill family member. In situations in which the chronically ill individual has no family capable of providing care, the nurse must intervene to provide alternative means of care. 3.6 Factors Influencing Chronic Illness Genetics The nurse should be aware of the genetic component in many chronic illnesses. A detailed family history of health problems will help pinpoint diseases and conditions to which an individual and family may be predisposed. In communities with specific ethnic populations, the nurse must be aware of the genetic disorders that are dominant for that group. Gender Because women are often the primary caregivers in the family, they may ignore their own health needs and concerns as they care for a chronically ill family member. Age An individual born with a disability or chronic illness will often have adapted to that disability better than an older person who develops a chronic illness later in life. The older person may view the chronic illness as a loss of a function he previously had. However, it must also be recognized that the older adult will typically have more resources for coping with change than a younger individual. Individual Preferences Responses to stress will influence the individual’s response to chronic illness. Previous experiences with the healthcare system will also determine how well she responds to the condition and how she adjusts to any deficits experienced. External support systems (family and significant others) may have an effect on the response to chronic illness. All should be assessed by the nurse.

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