Nursing 109

N109: Foundations in Nursing Practice Study Guide

©2018 of 154 Physical Condition As patients deal with chronic illness, their general physical condition may have a profound effect on their ability to adapt. If the individual is experiencing chronic pain or fatigue, the ability to deal with the illness or condition may be diminished. Deconditioning will occur for individuals on bedrest as muscle mass and strength diminish quickly from inactivity. If the individual is unable to take care of himself, he may develop depression and a feeling of powerlessness. The nurse must understand the effects of the individual’s loss of abilities and plan interventions around these losses. Role Changes As one member of a family develops a chronic condition, roles may begin to shift. If the husband becomes disabled and he was the primary income earner, the wife may have to work more to make up for the loss of income. Parents may have continued to support and help their children into adulthood, but if a parent develops a chronic illness, the son or daughter may be the one caring for the parent. These role changes can cause ambiguity, conflict, and a strain in relationships. Stigma An individual with a chronic illness that causes disability may experience secondary gain, such as disability benefits, relinquishment from responsibilities, and increased attention. However, these individuals may also be devalued and disregarded, leaving them feeling isolated and alone. Cultural and Spiritual Beliefs Family cohesiveness, including the cultural and spiritual values, may have a profound effect on chronic illness and the treatments that are sought for chronic conditions. The nurse must be aware of the patient’s religion and culture and any healthcare beliefs associated with them, particularly in the use of alternative types of healthcare and herbs. It is also important to allow room for the patient and family’s spiritual needs to be met whenever possible, as this will add to their overall well-being and coping. Socioeconomic Factors Individuals without the economic means to obtain healthcare may delay treatment for chronic illness. As the illness progresses, the individual may not be able to continue to work and income may be further decreased. The nurse must assess the individual’s ability to afford the needed equipment, supplies, and medications and must actively intervene to consult social services to help with financial and social needs. The individual with a chronic illness who is unable to get needed social and economic help may begin to feel isolated and may withdraw from society. Environmental Factors Physical barriers and transportation issues will have an effect on the individual’s response to his chronic illness. A home assessment can uncover issues that should be corrected to make the environment safe for the chronically ill, particularly if the illness involves mobility or sensory impairments. Occupational hazards should also be assessed. Achieve Page 51