NSG6440 Week4 Discussion:Chronic-Diseases
This week’s content addressed common chronic diseases. Please review the case study below and answer the following questions:
A sixty-year-old baker presents to your clinic, complaining of increasing shortness of breath and nonproductive cough over the last month. She feels like she can’t do as much activity as she used to do without becoming tired.NSG6440 Week4 Discussion:Chronic-Diseases She even has to sleep upright in her recliner at night to be able to breathe comfortably. She denies any chest pain, nausea, or sweating. Her past medical history is significant for high blood pressure and coronary artery disease. She had a hysterectomy in her 40s for heavy vaginal bleeding. She is married and is retiring from the local bakery soon. She denies any tobacco, alcohol, or drug use. Her mother died of a stroke, and her father died from prostate cancer. She denies any recent upper respiratory illness, and she has had no other symptoms. On examination, she is in no acute distress. Her blood pressure is 160/100, and her pulse is 100. She is afebrile, and her respiratory rate is 16. With auscultation, she has distant air sounds and she has late inspiratory crackles in both lower lobes. On cardiac examination, the S1 and S2 are distant and an S3 is heard over the apex.NSG6440 Week4 Discussion:Chronic-Diseases
What is the chief complaint?
Based on the subjective and objective information provided what are your 3 top differential diagnosis listing the presumptive final diagnosis first?
What treatment plan would you consider utilizing current evidence based practice guidelines?
Submission Details:
Post your response to the Discussion Area by the due date assigned. Respond to atleast two posts by the end of the week.
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Living with a chronic illness is perhaps the most difficult challenge that people can face in their life. Any disease is usually a hard psychological blow for a person, not mentioning all the physical inconveniences and pain that the disease might cause. However, when the disease can be cured, it gives hope to a person and the light at the end of the tunnel. The person knows why he or she takes medicines and goes for treatment. The result of the treatment is waited and the wish to get cured becomes the guiding force of a patient. However, if we remove any possibility to get cured, what is left for sick people? Do they have any stimulus to undergo a cure? That is why, first of all, chronic illness is a trial for the psychology of ill people and their environment.
Chronic illnesses might have different characteristics and different course, they might cause constant pain or just discomfort from time to time, and they might have different stages. All these factors influence the psychological and physical state of a person and the possibility to alleviate patient’s sufferings. However, if to take a general approach to a chronic illness as a physical and psychological problem, it is possible to characterize the way it influences on a person and find out the methods of struggle with it.
Certainly, having learned about the chronic disease, people get depressed. The perspective of being ill for an indefinite period and to be dependent from medicines dispirits. It adversely affects people’s communication with others. They might be nervous and aggressive, reject any help or on the contrary pretend absolutely helpless.NSG6440 Week4 Discussion:Chronic-Diseases
Anyway, if chronically ill people yield to the disease and lose heart they become a burden to their family. Family members feel that they should support the person but the more they feel sorry the more the person becomes depressed and overburdened with his or her problem. Certainly, people, who are physically-challenged because of their chronic illness, need help and support, but they should be treated as normal people and members of society.
Chronically ill people are usually painfully sensible of their inferiority to others and try to avoid companies. Thus, they become more isolated and reserved, which contribute to the worsening of depression. �Social relationships are frequently disrupted and usually disintegrate under the stress of chronic illness and its management because chronic illnesses often involve disfigurement, limitations in mobility, the need for additional rest, loss of control of some body functions, and an inability to maintain steady employment�� (Royer, 66).
Unfortunately, the desire to cut oneself from the society is often provoked by the society itself. Others’ people attitude to physically-challenged people might be different and not always positive. They might be treated as inferior people or even discriminated. Obviously, such attitude results in aggression and desire for isolation. Thus, we see that chronic illnesses usually have negative effect on ill people themselves, on their environment and on their relations with the society. However, these negative consequences might be mitigated due to another approach to the problem.NSG6440 Week4 Discussion:Chronic-Diseases
In her book After the Diagnosis Joann Lemaistre calls it the Pollyanna approach, basing on the novel about a girl Pollyanna, who tried to find something positive in all her troubles and to adjust to difficulties. Ill people should try to find inner harmony and to become confident of themselves. �To be psychologically well while physically sick involves the belief that your personal worth transcends physical limitations; you need positive self-esteem for true adaptation.
This belief in your self-worth rarely emerges until what you have lost and grieved for stands second in importance to precious moments of inner peace and joy�� (Lemaistre, 25).
Chronically ill people should master their disease and continue struggle with it. They should not be afraid of being among healthy people, and then they could change attitude to them. It is very important to follow examples of those people who managed to find their place in society despite any illness. Therefore, there are different associations which have united those people who have recently learned about their disease and those who managed to win it.NSG6440 Week4 Discussion:Chronic-Diseases
There chronically ill people might derive strength and hope, learn more details about the disease and find more friends. It is important not to be afraid of learning the information about the illness, its types, its stages and the ways of its treatment. Knowledge becomes one of the most important arm in the struggle with any disease. Such diseases as cancer are often associated with soon death, while there are many people who managed to cure it and to continue full-fledged life. Recognition of this fact will help people to struggle with their illness.
To make a conclusion, chronic illness has a serious impact on people’s state of mind and their relations with the society. In the very beginning the shock might be so strong that a person might lose heart and postpone the treatment because of the fear and unwillingness to believe that this disease has affected him or her. The support of friends and relatives is essential for ill people. They should feel that they are not alone in their struggle with the disease.NSG6440 Week4 Discussion:Chronic-Diseases