Chronic illnesses

What is the status of the underlying medical condition Has the syndrome resolved, such as in the case of a delirium, the anxious anticipatory response to a procedure, or steroid boost for organ rejection or is the medical illness chronic (e.g., HIV or diabetes mellitus) ... 

Kieseier BC, Dalakas MC, Hai tung HP (2002a) Immune mechanisms ill chronic inflammatory demyeliiiadiig iieuropadiy. Neurology 59 S7-S12. 

Concomitant illness chronic liver, cardiac, pulmonary or kidney disease diabetes mellitus etc. 

Commission on Chronic Illness Chronic Illness in the United States. Vol. I Prevention of Chronic Illness Harvard University Press Cambridge, Massachusetts, 1957. 

Selenium, as selenocysteine, is incorporated into glutathione peroxidase (antioxidant), iodothyronine deiodinase (thyroid hormone regulation), and selenoprotein P (vitamin C metabolism). Prematurity, acute illness, chronic GI losses, and long-term selenium-free parenteral nutrition are associated with low serum selenium concentrations and decreased glutathione peroxidase activity. " The... 

Home Health Care is the provision of services, such as intravenous treatment, feeding, diagnostic testing, and other medical therapies at home, by licensed health care workers. Over ten million individuals in the US, who suffer from acute illness, chronic health conditions, permanent disability, and terminal diseases, receive care from home health providers. Home health care was judged to rank highest in terms of outcomes and cost effectiveness for patients who have undergone hip or knee replacements. 

Cardiovascular System. Dingwall-Fordyce and Lane [17] found marked increase in cerebrovascular mortality among heavily exposed workers. These exposures were in the first quarter of this century, a time of poor working conditions. A similar increase was not found in the mortality of unemployed males. Other studies have concluded that there was excess mortality associated with only two illnesses, chronic nephritis and hypertension. It is unclear whether vascular effects of lead in man are direct effects on blood vessels or if the effects are secondary to renal effects [73). 

Workers who produce or use lead should be aware of possible ha2ards. Symptoms of chronic lead poisoning include fatigue, headache, constipation, uneasy stomach, irritabiHty, poor appetite, metallic taste, weight loss, and loss of sleep. Most of these same symptoms also occur in many common illnesses, such as the flu, thus a physician must rely on tests, such as blood lead analysis, to determine chronic lead poisoning. 

Asthma affects 3—5% of the population and is one of the most common chronic illnesses (7—9). Both the frequency and severity of asthma appear to be increasing (10—13). Acute, severe asthma has the potential to be fatal. The disease may first appear ia childhood and iadividuals so affected can suffer recurrent episodes throughout their Hves or they may "outgrow" the condition at puberty. On the other hand, there is also adult-onset asthma. These people show no symptoms as children or as young adults, but suddenly develop symptoms later ia life. There have been many reports of bronchial infections preceding the appearance of asthma. However it is not known whether these infections contributed to the development of the disease or whether iadividuals who are already predisposed to asthma ate more likely to experience bronchospasms as a result of a bronchial infection (14). 

In nonindustrial settings, MCS substances are the cause of indoor air pollution and are the contaminants in air and water. Many of the chemicals which trigger MCS symptoms are known to be irritants or toxic to the nervous system. As an example, volatile organic compounds readily evaporate into the air at room temperature. Permitted airborne levels of such contaminants can still make ordinary people sick. When the human body is assaulted with levels of toxic chemicals that it cannot safely process, it is likely that at some point an individual will become ill. For some, the outcome could be cancer or reproductive damage. Others may become hypersensitive to these chemicals or develop other chronic disorders, while some people may not experience any noticeable health effects. Even where high levels of exposure occur, generally only a small percentage of people become chemically sensitive. 

Development of subchronic RfDs parallels the development of chronic reference doses in concept the distinction is one of e.xposurc duration. Appropriate studies are evaluated and a subchronic NOAEL is identified. The RfD is derived from the NOAEL by the application of the UFs and MF, as outlined above. When experimental data arc available only for shorter e.xposurc durations than desired, an additional uncertainly factor is applied. This is similar to the application of the uncertainly factor for duration differences when a chronic RfD is estimated from subchronic animal data. On the other hand, if subchronic data are missing and a chronic oral RfD derived from chronic data exists, the chronic oral RfD is adopted as the subchronic oral RfD. Ill this instance, there is no application of an uncertainly factor to account for differences in exposure duration. 

The relevance of clinical conditions with chronic low blood pressure or hypotension has been questioned, with the exception of a few rare clinical syndromes. Temporary increases or decreases of blood pressure are often seen in clinical medicine in the context of acute illnesses or interventions. 

Extended therapy for chronic illness causes patient to become discouraged... 

Pain can be defined as an unpleasant sensory and emotional experience that is associated with actual or potential tissue damage. Pain is subjective, and the patient s report of pain should always be taken seriously. Pain management in acute and chronic illness is an important responsibility of the nurse Many nurses consider pain as the fifth vital sign and assessment of pain just as important as the assessment of temperature, pulse, respirations, and blood pressure Accurate assessment of pain is necessary if pain management is to be effective Fhtients with pain are often undertreated. 

Observations for fluid and electrolyte disturbances are particularly important in the aged or chronically ill patient in whom severe dehydration may develop in a short time. The nurse must immediately report symptoms of dehydration, such as dry mucous membranes decreased urinary output, concentrated urine, restlessness or confusion in the older adult. 

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