Care of Chronic Illness Flashcards

An RPN is conducting a home care visit for a client with chronic heart failure (CHF). The client reports a weight gain of 2 kg in the past two days and feeling more short of breath than usual. What is the RPN's priority action?

Answer: Recognize the signs of fluid retention and notify the primary care provider or case manager immediately.

A rapid weight gain of 2 kg (4.4 lbs) over two days is a significant indicator of fluid retention and worsening heart failure. This, combined with increased shortness of breath, requires immediate medical attention to adjust medications (like diuretics) and prevent hospitalization. While dietary advice is important, the immediate priority is to report these critical findings.

When providing foot care education to a client with type 2 diabetes, which of the following instructions is most crucial for the RPN to emphasize?

Answer: Visually inspect the entire surface of both feet every day.

Due to the risk of peripheral neuropathy, a client with diabetes may not feel minor injuries to their feet. Daily visual inspection is the most critical preventative measure to detect cuts, blisters, or signs of infection early. Soaking feet can cause skin to dry and crack, lotion between toes can lead to fungal infections, and nails should be trimmed straight across.

A client with advanced Chronic Obstructive Pulmonary Disease (COPD) is being introduced to a palliative approach to care. Which statement by the RPN best describes the primary goal of this approach?

Answer: "Our main goal is to improve your quality of life by managing symptoms like breathlessness and fatigue."

Palliative care focuses on improving the quality of life for clients and their families by managing distressing symptoms and providing psychosocial and spiritual support. It can be provided at any stage of a serious illness, alongside curative or life-prolonging treatments, and is not exclusively for end-of-life care.

The RPN's role in supporting self-management for a client with a chronic illness, such as arthritis, primarily involves which of the following activities?

Answer: Collaborating with the client to set realistic goals and provide health teaching.

Self-management support empowers the client to take an active role in their health. The nurse's role is to act as a partner, collaborating with the client to set achievable goals, providing education on their condition, and helping them develop problem-solving skills to manage their illness effectively.

An RPN is caring for a client with stable COPD who suddenly reports increased dyspnea, increased sputum production, and a change in sputum color from clear to yellow. The RPN should recognize these signs as indicative of what condition?

Answer: An acute exacerbation of COPD.

The three cardinal symptoms of a COPD exacerbation are worsening dyspnea, an increase in sputum volume, and an increase in sputum purulence (color change). The presence of these signs requires prompt assessment and communication with the primary care provider for timely treatment to prevent further deterioration.

An RPN is reinforcing teaching with an older adult client who has osteoarthritis and reports chronic knee pain. Which non-pharmacological pain management strategy is most appropriate for the RPN to suggest?

Answer: Applying a warm compress to the affected knee.

Applying superficial heat, such as a warm compress or heating pad, can help relax muscles and soothe stiff, painful joints associated with osteoarthritis. Complete bed rest can worsen stiffness, high-impact exercise can damage the joint, and vigorous massage over an inflamed joint is contraindicated. Low-impact exercise is recommended, but heat application is a direct comfort measure.