Week 1 - Long Term Conditions Flashcards
Define what a long term condition is
- A condition than can be treated and managed, however NOT cured
- A condition that is ‘non-communicable disease’ meaning you can’t catch it
Name some long term conditions
- Autoimmune conditions like diabetes, rheumatoid arthritis
- Chrons disease - not autoimmune however does affect the immune system - inflammatory
bowel condition - Cardiovascular disease
- Cancers
- Respiratory disease
- Mental Illness
- Chronic Pain
- Chronic Kidney disease
- Dementia
- COPD (Chronic Obstructive Pulmonary Disease)
- Chrons disease - not autoimmune however does affect the immune system - inflammatory
What is the difference between a Long Term Condition and an acute illness?
Therefore Long term conditions are conditions that cannot be cured, however can be managed. An acute illness if treated correctly can be cured. Patients with Long Term conditions can still be admitted to hospital with acute exacerbations of their long term condition. For example Chronic Obstructive Pulmonary Disease (COPD) - acute exacerbation (change in cough or sputum), or heart failure - acute exacerbation
What can empowering patient self-management of their long-term condition do for patients?
- Reduce disease progression - improve their quality of life (QOL)
- Increase the patients understanding of their ‘triggers’ - when they need to get medical help
and from where - Reduce readmission to hospital-reduce costs to health system
Why is it important to understand long term conditions?
- “Chronic illness is the leading cause of morbidity, mortality and inequitable health outcomes in NZ”
- “Reducing the impact of long term conditions is a priority of the NZ health system. Service funders and providers need to be more flexible, innovative and able to measure the difference they are making for their populations. This high-level approach is people/whānau focused, not disease specific.”
What is COPD?
Progressive, chronic disease characterised by irreversible airway obstruction, hindering expiratory flow
Umbrella term encompassing emphysema, chronic bronchitis and other conditions
Each has their own pathophysiology but all contribute to airway inflammation initiated by a noxious irritant
What is Emphysema?
Lung disease which makes it harder for clients to breathe out. The Alveoli are damaged making it harder for effective gas exchange to occur as the air sacs enlarge, Emphysema causes big baggy alveoli (increased volume) so pressure drops – this makes it hard for CO2 to be expelled
What are the 4 major causes/risk factors for COPD cited by WHO
- Tobacco smoking (Cigarettes, pipes, cannabis, second hand smoke)
- Indoor pollutants (Biomass fuel used for cooking and heating (wood and coal) most common in developing countries)
- Outdoor pollutants (Occupational dusts/chemicals, Particulate matter, ozone, sulpha dioxide, nitrogen dioxide, carbon monoxide, and lead (industrialised areas) forest bush fires, agricultural burning, transport
- Genetics, history of respiratory infections
What is Pursed lip Breathing?
It is a ventilatory strategy frequently adopted spontaneously for patients with COPD to relieve dyspnoea (difficultly breathing): it helps to counteract gas trapping. It generates an increased pressure in the airways to allow for expiration (airflow will move from an area of high to low pressure)
How does Pursed Lip Breathing help?
Pursed lip breathing works by moving oxygen into your lungs and carbon dioxide out of your lungs. This technique helps to keep airways open longer so that you can remove the air that is trapped in your lungs by slowing down your breathing rate and relieving shortness of breath
Emphysema causes big baggy alveoli (increased volume) so pressure drops – this makes it hard for CO2 to be expelled. Pursed lip breathing generates increased pressure so that intraluminal pressure exceeds atmospheric pressure and the breath can flow out of the lungs more easily. It is to aid expiration and decrease WOB (work of breathing).
What is Rheumatic Fever and why is it important to discuss?
Rheumatic fever may develop if strep throat or scarlet fever infections are not treated properly or after strep skin infections. Rheumatic fever is thought to be caused by a response of the body’s immune system. The immune system responds to the earlier strep throat or scarlet fever infection and causes a generalised inflammatory response.Strep throat is caused by the bacteria Group A Streptococcus.
If rheumatic fever is not treated promptly, rheumatic heart disease may occur. Rheumatic heart disease weakens the valves between the chambers of the heart. Severe rheumatic heart disease can require heart surgery and result in death.
Is Rheumatic Fever a long term condition?
Rheumatic fever is not a long term condition. Getting a precise diagnosis soon after symptoms show up can prevent the disease from causing permanent damage and can develop into rheumatic heart disease
- Rheumatic Heart Disease is a long term condition
What populations does rheumatic fever impact on more than others?
Although anyone can get Rheumatic fever, It is more common in school aged children (age 5-15), Māori and Pacific children. Rheumatic fever is very rare in children younger than 3 years old and adults. Infectious illnesses, including group A strep, tend to spread wherever large groups of people gather. Crowded conditions can increase the risk of getting strep throat or scarlet fever, and thus rheumatic fever if they are not treated properly. These settings include:
- Schools - Day-care centres - Military training facilities
Someone who had rheumatic fever in the past is more likely to get rheumatic fever again if they get strep throat or scarlet fever again
What are the three steps health professions can do for long term condition?
- Primary Prevention
- Reduce disease progression
- Empower patients/whānau
What happens during primary prevention?
Screening - like cardiovascular disease risk assessment, Smear, Well man check, Mammography, vaccinations. Importance of education for primary prevention
