Natural History of Disease – Flashcards
Unlock all answers in this set
Unlock answersquestion
Natural History of Disease
answer
Referred to the course of the disease over time, unaffected by treatment. DISEASE IS AN EVOLVING PROCESS Stages 1. Stage of Susceptibility 2. Stage of Pre-Symptomatic Disease 3. Stage of Clinical Disease 4. Stage of Disability
question
Stage of Susceptibility
answer
- Disease has not developed -Risk factors promote development (poor diet, lack of exercise, stress, high cholestorol level,etc.)
question
Risk Factors
answer
Factors that will favor the disease's development Two types: Modifiable and Non-modifiable
question
Modifiable Risk factors
answer
Changeable factors Lifestyle: Centenarians (exercise, diet rich in fruits and vegetables, friends, purpose in life) Obesity: Weight Smoking: lung cancer: 2nd most common cancer
question
Non-modifiable factors
answer
Factors that cannot be changed Premature babies: at risk for mental retardation disability, chronic lung disease and learning disabilities Age and genetics: Heart disease, Parkinson's disease, Alzheimer's disease Race: -Black Americans have higher incidence for HTN, diabetes and coronary heart disease: risk for stroke -Mexicans have high incidence of diabetes (higher mortality) -Native Americans have higher incidence of alcoholism, lower incidence of heart disease Genetics
question
Stage of Pre-Symptomatic Disease
answer
- No manifestations (clinical signs and symptoms) of the disease -Pathological changes have started to occur Examples: -High Cholesterol: plaque formation -High Stress Level: develop pre-hypertension -Pre-cancerous mole: atypical cells -Pre-diabetes: chronic elevation of blood glucose levels
question
Stage of Clinical Disease
answer
-Organ changes have occured (now there are recognizeable signs and symptoms of the disease) -Subdivided into 3 stages (Morphological, Functional or Therapeutic)
question
Morphological
answer
Involves the CELLULAR level -Most often used with CANCER -Measures extent of disease (Ex: tumor staging) -Allows for prognosis Tumors placed into categories Localized Regional Metastasis Metastasis
question
Localized
answer
1 single lymph node or organ is involved
question
Regional Metastasis
answer
Group of lymph nodes near organ on SAME SIDE of diaphragm
question
Metastasis
answer
Involves BOTH SIDES of diaphragm
question
Functional
answer
Involves the stages or types of disease -Based on extent of disease Examples -Types of Diabetes (Insulin vs Non-Insulin dependent) -Stages of Alzheimers (7 stages) -Stages of Hypertension
question
Therapuetic
answer
Involves the TREATMENT -Based on restrictions Examples -Heart disease (Restriction of activity, dietary restrictions) -Diabetes (Dietary or caloric restriction)
question
The Importance of Staging
answer
Is for epidemiologic studies in research Reduces variability in -evaluation of the effect of treatments -clinical trials -management of clients
question
Stage of Disability
answer
Any temporary or long term reduction of a person's activities, including his psychosocial role as parent, wage earner and member of his community Emphasis is on LOSS OF FUNCTION, not the structural defect Examples -Diabetes leads to blindness, amputation, renal failure or cardiac disease -Hypertension leads to stroke and paralysis -COPD and heart disease leads to impairment of activity
question
Levels of Prevention
answer
Leavell and Clark (1965) Disease EVOLVES over time. Pathological changes may or may not become fixed and irreversible. The aim of prevention is to DETECT and INTERVENE at the RISK FACTORS. Basis of all prevention programs
question
3 Levels of Prevention
answer
Primay Prevention Secondary Prevention Tertiary Prevention
question
Primary Prevention
answer
-Focuses on health promotion and protection -Occurs in the stage of SUSCEPTIBILITY
question
Secondary Prevention
answer
-Identifying a health problem and its intervention -Occurs in the stage of PRE-CLINICAL and CLINICAL
question
Tertiary Prevention
answer
-Focuses on restoration and rehabilitation -Occurs in the stage of DISABILITY
question
Primary Prevention (2)
answer
Health Promotion -AVOIDANCE of disease -Motivated by personal approach to wellness -WELLNESS focused Protection against specific health problems -Behaviors to actively avoid illness (immunizations, taking vitamins, handwashing) -Health promotion programs (exercise programs, nutrition programs, fire safety, D.A.R.E program)
question
Secondary Prevention (2)
answer
-Early identification of health problems (Goal -> identify people in early stages of disease and limit disability -Interventions to alleviate health problems (ex: screenings, physical exam, dental checks, assessment of growth and development) Examples: -Annual pap smear -Mammogram -Self-breast exam -Self-testicular exam -Falls risk -ROM -Turn patients Q 2
question
Tertiary Prevention
answer
-Begins after an illness or disability (is fixed and stabalized) -Helps rehabilitate or restore client to optimal level of health within the constraints of the disability Examples: -Physical therapy -Cardiac rehab -Support group after cholestomy -Teaching diabetic how to prevent complications
question
Schematic Representation of Natural History of Disease and Levels of Prevention (Chart)
answer
Pg 133
question
Theories Used in Health Promotion
answer
Needs Theory Developmental Theory Theoretical Frameworks
question
Needs Theory
answer
Maslow (See pg. 134)
question
Needs Theory (Richard Kalish)
answer
-Adapted Maslow's theory (6 Levels) -Included category between physiological and safety needs (STIMULATION NEEDS)
question
Developmental Stage Theory: Piaget, Erickson
answer
-Describes characteristics of people in a certain group Usefulness in Nursing: -Describes a typical behavior within a certain group -Predicts behavior in a given circumstance -Used in clinical education
question
Healthy People 2010 (Purpose)
answer
Provided framework for national health promotion, health protection and prevention
question
Healthy People 2010 (Goals)
answer
-Increase quality and years of life -Eliminate health disparities
question
Health (Tradition definition)
answer
The presense or abscense of disease
question
Health (WHO definition)
answer
A state of complete physical, mental and social well-being and not merely the abscense of disease and infirmity
question
Wellness
answer
State of well-being
question
5 Models of Wellness
answer
Clinical model Role Performance model Adaptive Model Eudemonistic model Agent-host envrironmental model
question
Clinical model
answer
-PHYSIOLOGICAL aspect of health -absence of signs and symptoms -Disease is narrow model
question
Role performance model
answer
Ability to fullfil societal's needs
question
Adaptive model
answer
-Disease is a failure in adaptation -Aim of treatment is to restore the ability to adapt
question
Eudemonistic model
answer
-Based on self-actualization (Maslow's Theory) -Health is seen as self-actualization -Illness prevents actualization (client potential)
question
Agent-host environmental model
answer
-Considers multiple causes of disease -Used to predict illness -Identifies risk factors which result from agent, host and environment
question
Health Illness Continua
answer
Consists of grids or graduated scales -Used to measure a client's perceived level of health and illness are on opposite ends Dunn's High Level of Wellness Grid (See Pg. 137) Travis' Illness Wellness Continuum (See Pg. 138)
