CHRONIC ILLNESS,

H E A LT H C A R E
S I T U AT I O N S
G L O B A L , N AT I O N A L
AND LOCAL
 CHRONIC
ILLNESSES
• Chronic illnesses are defined as illnesses that are
either ongoing or recurring over a course of
several months to year require ongoing medical
attention or limit activities of daily living or both.
• Chronic illnesses are prolonged and rarely
completely cured. The most common types
include:
C A R D I O VA S C U L A R
DISEASES

A type of disease that affects the heart or blood

vessels. The risk of certain cardiovascular diseases
may be increased by smoking, high blood pressure,
high cholesterol /it damages the lining of the arteries,
making them more susceptible to the buildup of
plaque, which narrows the arteries leading to the heart
and brain.
C A R D I O VA S C U L A R
DISEASES
• include coronary heart disease, cerebrovascular
disease, rheumatic heart disease and other conditions.
• Cessation of tobacco use, reduction of salt in the diet,
eating more fruit and vegetables, regular physical
activity and avoiding harmful use of alcohol have been
shown to reduce the risk of cardiovascular disease.
 R H E U M AT O I D A R T H R I T I S
• Rheumatoid arthritis (RA) is an inflammatory disorder of unknown origin that
primarily involves the synovial membrane of the joints. Phagocytosis
produces enzymes within the joint.
• The
Rheumatoid enzymes
arthritis (RA) is anbreak downdisorder
inflammatory collagen, causing
of unknown edema,
origin proliferation
that primarily ofsynovial
involves the the membrane of the
synovial
joints. Phagocytosis membrane,
produces and ultimately
enzymes within the joint. pannus formation.
• Pannus destroys cartilage and erodes the bone.
• The consequence is loss of articular surfaces and joint motion.
• Muscle fibers undergo degenerative changes.
• Tendon and ligament elasticity and contractile power are lost.
• RA affects 1% of the population worldwide, affecting women two to four
times more often than men.
 R H E U M AT O I D A R T H R I T I S
Clinical Manifestations

• Clinical features are determined by the stage and severity of the disease.
Joint pain, swelling, warmth, erythema, and lack of function are classic symptoms.
Palpation of joints reveals spongy or boggy tissue. Fluid can usually be aspirated from the
Clinical Manifestations
Clinicalinflamed joint.
features are determined by the stage and severity of the disease.
Joint pain, swelling, warmth, erythema, and lack of function are classic symptoms.
Palpation of joints
Nursing reveals spongy or boggy tissue.
Management
Fluid can usually bea aspirated
• Provide variety offrom the inflamed
comfort joint.(eg, application of heat or cold; massage, position changes,
measures
rest; foam mattress, supportive pillow, splints; relaxation techniques, diversional activities). It
takes time to find the right foam mattress and supportive pillows, but after looking at lots of
reviews such as leesa reviews, you will find one perfect for your needs.
• Administer anti-inflammatory, analgesic, and slow-acting antirheumatic medications as prescribed.
• Encourage verbalization of feelings about pain and chronicity of disease.
 R H E U M AT O I D A R T H R I T I S
Nursing Management
• Teach pathophysiology of pain and rheumatic disease, and assist patient to
recognize that pain often leads to unproven treatment methods.
• Assist in identification of pain that leads to use of unproven methods of treatment.
Clinical Manifestations
Clinical features are determined by the stage and severity of the disease.
• Assesswarmth,
Joint pain, swelling, for subjective changes
erythema, and in pain.are classic symptoms.
lack of function
Palpation of joints reveals spongy or boggy tissue.
Fluid can usually be aspirated from the inflamed joint.
DIABETES MELLITUS
• Diabetes mellitus (DM) is a chronic metabolic disorder caused by an absolute or relative
deficiency of insulin, an anabolic hormone.
• Type 1 diabetes or (also known as insulin-
dependent diabetes mellitus (IDDM) and juvenile diabetes melliuts) is a chronic illness
characterized by the body’s inability to produce insulin due to the autoimmune destruction of
the beta cells in the pancreas.
• Insulin is produced by the beta cells of the islets of Langerhans located in the pancreas, and the
absence, destruction, or other loss of these cells results in type 1 diabetes (insulin-
dependent diabetes mellitus [IDDM]).
• Diabetes mellitus is often considered an adult disease, but at least 5% of cases begin in
childhood, usually at about 6 years of age or around the time of puberty.
DIABETES MELLITUS
• Diabetes mellitus (DM) is a chronic metabolic disorder caused by an absolute or relative
deficiency of insulin, an anabolic hormone.
• Type 1 diabetes or (also known as insulin-
dependent diabetes mellitus (IDDM) and juvenile diabetes melliuts) is a chronic illness
characterized by the body’s inability to produce insulin due to the autoimmune destruction of
the beta cells in the pancreas.
• Insulin is produced by the beta cells of the islets of Langerhans located in the pancreas, and the
absence, destruction, or other loss of these cells results in type 1 diabetes (insulin-
dependent diabetes mellitus [IDDM]).
• Diabetes mellitus is often considered an adult disease, but at least 5% of cases begin in
childhood, usually at about 6 years of age or around the time of puberty.
Medical Management
Management of type 1 diabetes in children includes insulin therapy and a meal and exercise plan.

• Insulin therapy. Insulin therapy is an essential part of the treatment of diabetes in children; the
dosage of insulin is adjusted according to blood glucose levels so that the levels are maintained near
normal; many children are prescribed with an insulin regimen given at two times during the day: one
before breakfast and the second before the evening meal.
• Diet. Current dietary management of diabetes emphasizes a healthy, balanced diet that is high in
carbohydrates and fiber and low in fat.
• Activity. Type 1 diabetes mellitus requires no restrictions on activity; exercise has real benefits for a
child with diabetes; current guidelines are increasingly sophisticated and allow children to compete
at the highest levels in sports.
• Continuous glucose monitoring. The American Diabetes Association’s Standards of Medical Care
in Diabetes-2018 recommend consideration of continuous glucose monitoring for children and
adolescents with type 1 diabetes, whether they are using injections or continuous subcutaneous
insulin infusion, to aid in glycemic control.
Medical Management
Management of type 1 diabetes in children includes insulin therapy and a meal and exercise plan.

• Insulin therapy. Insulin therapy is an essential part of the treatment of diabetes in children; the
dosage of insulin is adjusted according to blood glucose levels so that the levels are maintained near
normal; many children are prescribed with an insulin regimen given at two times during the day: one
before breakfast and the second before the evening meal.
• Diet. Current dietary management of diabetes emphasizes a healthy, balanced diet that is high in
carbohydrates and fiber and low in fat.
• Activity. Type 1 diabetes mellitus requires no restrictions on activity; exercise has real benefits for a
child with diabetes; current guidelines are increasingly sophisticated and allow children to compete
at the highest levels in sports.
• Continuous glucose monitoring. The American Diabetes Association’s Standards of Medical Care
in Diabetes-2018 recommend consideration of continuous glucose monitoring for children and
adolescents with type 1 diabetes, whether they are using injections or continuous subcutaneous
insulin infusion, to aid in glycemic control.
 Diabetes Mellitus Type 2

• Diabetes is a chronic, metabolic disease characterized by elevated levels of

blood glucose (or blood sugar), which leads over time to serious damage to
the heart,
Diabetes is a chronic, blood
metabolic vessels,
disease eyes, kidneys
characterized by elevatedand
levelsnerves.
of bloodThe most
glucose common
(or blood sugar), is typeleads
which 2 over time
to serious damage to the heart, blood vessels, eyes, kidneys and nerves. The most common is type 2 diabetes, usually in adults,
diabetes, usually in adults, which occurs when the body becomes resistant to
which occurs when the body becomes resistant to insulin or doesn't make enough insulin. In the past 3 decades the prevalence of
insulin or doesn't make has
type 2 diabetes enough insulin. In
risen dramatically the pastof3alldecades
in countries the prevalence of
income levels
type 2 diabetes has risen dramatically in countries of all income levels
HIV/AIDS -HIV
(HUMAN
IMMUNODEFICIENCY
VIRUS)

• HIV/AIDS -HIV (human immunodeficiency virus) is a virus

that attacks the body's immune system. If HIV is not treated,
it can lead to AIDS (acquired immunodeficiency syndrome).
There is currently no effective cure. Once people get HIV,
they have it for life.
• (in countries with effective treatment), certain forms of
cancer, and mental-health problems such as depression.
Syndromes of uncertain aetiology like chronic fatigue or
fibromyalgia can also have long-standing and disabling
effects .
H E A LT H
S I T U AT I O N S
GLOBAL HEALTH ISSUES
• Global health issues transcend borders Include Infectious
diseases that travel between counties, as well as
noncommunicable diseased and conditions that affect many
populations around the world.
• The spread of a disease doesn't stop at a county's borders
more people living in crowded cities traveling to other
counties,its easier For germs to spread we have here
examples of global health situations
1.COVID-19 (coronavirus disease 2019) is a disease caused by a virus named SARS-
CoV-2. It can be very contagious and spreads quickly. Over one million people have
died from COVID-19 in the United States. COVID-19 most often causes respiratory
symptoms that can feel much like a cold, the flu, or pneumonia.
2.MENTAL HEALTH
Mental health includes our emotional, psychological, and social well-being. It affects
how we think, feel, and act. It also helps determine how we handle stress, relate to
others, and make healthy choices. 1. Mental health is important at every stage of life,
from childhood and adolescence through adulthood.
3.IMPACT OF CLIMATE CHANGE
• Climate change has caused increased heat, drought, and insect outbreaks. In
turn, these changes have made wildfires more numerous and severe. The
warming climate has also caused a decline in water supplies, reduced
agricultural yields, and triggered heat-related health impacts in cities.
• 4.CARDIOVASCULAR DISEASE
• A type of disease that affects the heart or blood vessels. The risk of certain cardiovascular diseases may be
increased by smoking, high blood pressure, high cholesterol /it damages the lining of the arteries, making them
more susceptible to the buildup of plaque, which narrows the arteries leading to the heart and brain.
• 5.EPILEPSY
• Is the disorder of the brain characterized by repeated seizures is usually defined as a sudden alteration of
behavior due to a temporary change in the electrical functioning of the brain medicines called anti-epileptic drugs
(AEDs) surgery to remove a small part of the brain that’s causing the seizures. A procedure to put a small
electrical device inside the body that can help control seizures. A special diet (ketogenic diet) that can help
control seizures.
• .6.POVERTY'S ROLE IN HEALTH
• Poverty affects health by limiting access to proper nutrition and healthy foods; shelter; safe neighborhoods to
learn, live, and work; clean air and water; utilities; and other elements that define an individual’s standard of
living.
7. DIABETES
• Is a chronic, metabolic disease characterized by elevated levels of blood glucose (blood sugar) which
lead to overtime to serious damage to the heart blood vessels, eyes kidneys and nerves
8. Alzheimer’s disease (AD)
is Alzheimer’s disease (AD) is a progressive and irreversible, degenerative, fatal disease and is the most
common form of dementia among older people. Dementia is a brain disorder that seriously affects a
person’s ability to carry out daily activities. It usually begins after age 60, and the risk goes up as you
get older. Risk is also higher if a family member has the disease.
Nursing Interventions and Actions
Improving Cognitive Function
• Improving cognitive function in patients with Alzheimer’s disease (AD) is a significant challenge as
this progressive neurological disorder leads to the deterioration of memory, thinking skills, and
overall cognitive abilities.
9.CHRONIC PULMONARY DISEASE ( COPD)
• Chronic Obstructive Pulmonary Disease (COPD) is a common, preventable, and treatable disease that is
characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar
abnormalities, usually caused by significant exposure to noxious particles or gases.
• It leads to narrowing of the airways and changes in lung parenchyma and pulmonary vasculature. In the
airways, there are increased mucus production, thickening of the airway wall, and overall narrowing. In the lung
parenchyma, alveolar wall destruction and loss of elastic recoil occur.
Nursing Problem Priorities
• The following are the nursing priorities for patients with COPD:
• Maintain airway patency.
• Assist with measures to facilitate gas exchange.
• Enhance nutritional intake.
• Prevent complications, slow progression of condition.
• Provide information about disease process/prognosis and treatment regimen.
10. ROAD INJURY / ACCIDENT
• Sprains, strains, bruising, and other damage to muscles, tendons, and ligaments (soft tissue
injuries) are very common in automobile accidents. This type of injury can be painful and long-lasting
 N AT I O N A L
1. HYPERTENSIONI
• Hypertension is the term used to describe high blood pressure.
Hypertension is repeatedly elevated blood pressure exceeding 140 over
90 mmHg. It is categorized as primary or essential (approximately 90%
of all cases) or secondary due to an identifiable, sometimes correctable
pathological condition, such as renal disease or primary aldosteronism.
Nursing Problem Priorities
• The following are the nursing priorities for patients with hypertension:
• Prevent complications and death through aggressive hypertension
management.
• Weight reduction and lifestyle & dietary modifications.
• Promoting adherence to therapeutic regimen.
.2. UTI

• Urinary tract infections (UTIs) are caused by pathogenic microorganisms in the urinary tract (kidney, bladder, urethra).
UTI is defined as significant bacteriuria in the setting of symptoms of cystitis or pyelonephritis
• Most UTIs are caused by the bacterium Escherichia coli (E. coli), normally found in the digestive system. E.coli causes the
majority of uncomplicated cystitis cases
• UTIs are usually classified as infections involving the upper or lower urinary tract. An infection in the urethra is called
urethritis. A bladder infection is called cystitis. Bacteria may ascend to the ureters to multiply and cause infection of the
kidneys (pyelonephritis).

• Burning on urination
• Facial grimace
• Guarding behavior
• Protective decreased physical activity
• Spasms in the lower back and bladder area
3. PNEUMONIA
• Pneumonia is an inflammation of the lung parenchyma associated with alveolar edema and congestion that impair
gas exchange. Pneumonia is caused by a bacterial or viral infection spread by droplets or
• Pneumonia is categorized into four types: community-acquired pneumonia (CAP), health care–associated
pneumonia (HCAP), hospital-acquired pneumonia (HAP), and ventilator-associated pneumonia (VAP). HCAP
was introduced in 2005 to identify patients at a higher risk for multidrug-resistant pathogens compared to those with
community-acquired pneumonia. by contact and is the sixth leading cause of death in the United States.
Nursing Problem Priorities
• The following are the nursing priorities for patients with pneumonia:
• Improving airway patency
• Improving tolerance to activity
• Maintaining proper fluid volume
• Measures to prevent complications
• 3. PNEUMONIA Nursing Assessment
• Changes in rate, depth of respirations
• Abnormal breath sounds (rhonchi, bronchial lung sounds, egophony)
• Use of accessory muscles
• Dyspnea, tachypnea
• Cough, effective or ineffective; with/without sputum production
• Cyanosis
• Decreased breath sounds over affected lung areas
• Ineffective cough
• Purulent sputum
• Hypoxemia
• Infiltrates seen on chest x-ray film
• Reduced vital capacity
4. INFLUENZA

Influenza (also known as flu, or grippe) is an acute inflammation of the nasopharynx, trachea, and
bronchioles, with congestion, edema, and the possibility of necrosis of these respiratory structures.
Influenza is a highly contagious airborne disease of the respiratory tract caused by three different types
of Myxovirus influenzae. ypical signs and symptoms include cough, fever, sore throat, myalgias,
headache, nasal discharge, weakness and severe fatigue, tachycardia, and red, watery eyes.
5. Pulmonary Tuberculosis
• An acute or chronic infection caused by Mycobacterium tuberculosis, tuberculosis is characterized
by pulmonary infiltrates, formation of granulomas with caseation, fibrosis, and
cavitation.Tuberculosis is an infectious disease that primarily affects the lung parenchyma.It also
may be transmitted to other parts of the body, including the meninges, kidneys, bones, and lymph
nodes.The primary infectious agent, M. tuberculosis, is an acid-fast aerobic rod that grows slowly
and is sensitive to heat and ultraviolet light
.
6. DIABETES

• Diabetes mellitus (DM) is a chronic disease characterized by insufficient insulin production in the
pancreas or when the body cannot efficiently use the insulin it produces. This leads to an increased
concentration of glucose in the bloodstream (hyperglycemia). It is characterized by disturbances in
carbohydrate, protein, and fat metabolism. Sustained hyperglycemia has been shown to affect almost all
tissues in the body.
• Classifications of diabetes mellitus include
• Type 1 diabetes is characterized by destruction of the pancreatic beta cells leading to absolute insulin
deficiency including latent autoimmune diabetes of adulthood.
• Types 2 diabetes is characterized by progressive loss of pancreatic beta cells and involves insulin
resistance and impaired insulin secretion.
• Specific types of diabetes due to other causes such as monogenic diabetes syndromes (neonatal diabetes
and maturity-onset diabetes of the young), diseases affecting the exocrine pancreas (cystic fibrosis and
pancreatitis), and drug- or chemical-induced diabetes (as a result of glucocorticoid use, treatment of HIV
/AIDS, or organ transplantation).
• Gestational diabetes mellitus (GDM) refers to the onset of diabetes diagnosed during the second or third
trimester of pregnancy, which was not clearly present as overt diabetes prior to conception.
7. DENGUE
• Dengue fever is an acute febrile disease caused by infection with one of the serotypes of the dengue virus. It
is a mosquito-borne disease caused by the genus Aedes.
• Dengue is also known as Breakbone Fever, Hemorrhagic Fever, Dandy Fever, Infectious Thrombocytopenic
Purpura.
• Dengue hemorrhagic fever is a fatal manifestation of the dengue virus that manifests with bleeding diathesis
and hypovolemic shock.
• These viruses are related to the viruses that cause the West Nile infection and yellow fever.

CausesThe etiologic agent and vector of dengue:

• Flavivirus. It is caused by infection of one of the four serotypes of dengue virus, which is a Flavivirus, a
genus of single-stranded nonsegmented RNA virus.
• Aedes aegypti. Dengue virus is transmitted by day-biting mosquitoes of the genus Aedes that breed in
stagnant water. It has white dots at the base of its wings, with white bands on the legs.
• Incubation period. It has an incubation period of three to ten days.
8. Cerebrovascular Accident
A cerebrovascular accident (CVA), an ischemic stroke or “brain attack,” is a sudden loss of brain function resulting from a
disruption of the blood supply to a part of the brain.
Cryptogenic strokes have no known cause, and other strokes result from causes such as illicit drug use, coagulopathies,
migraine, and spontaneous dissection of the carotid or vertebral arteries.
Classification
• Strokes can be divided into two classifications.
• Ischemic stroke. This is the loss of function in the brain as a result of a disrupted blood supply.
• Hemorrhagic stroke. Hemorrhagic strokes are caused by bleeding into the brain tissue, the ventricles, or the subarachnoid
space.
Causes
• Strokes are caused by the following:
• Large artery thrombosis. Large artery thromboses are caused by atherosclerotic plaques in the large blood vessels of the
brain.
• Small penetrating artery thrombosis. Small penetrating artery thrombosis affects one or more vessels and is the most
common type of ischemic stroke.
• Cardiogenic emboli. Cardiogenic emboli are associated with cardiac dysrhythmias, usually atrial fibrillation .
9. CANCER
• Cancer is a general term used to describe a disturbance of cellular growth and refers to a group of diseases and not a
single disease entity. Because cancer is a cellular disease, it can arise from any body tissue, with manifestations that
result from failure to control the proliferation and maturation of cells.
• There are more than 150 different types of cancer, including breast cancer, skin cancer, lung cancer, colon cancer,
prostate cancer, and lymphoma. Symptoms vary depending on the type. Cancer treatment may include chemotherapy,
radiation, and/or surgery.
•
Nursing Interventions and Actions
• Assess the patient and significant other (SO) for the stage of grief currently being experienced. Explain the process
as appropriate.
Knowledge about the grieving process reinforces the normality of feelings and reactions being experienced and can help
patients deal more effectively with them.
• Review past life experiences, role changes, and coping skills. Talk about things that interest the patient.
Opportunity to identify skills that may help individuals cope with the grief of current situation more effectively.
 LOCAL
(10 Examples of local Health situations) wow that w
1- DENGUE
• is also known as (break bone fever is a masquito born. tropical disease caused by the mosquito
bite .
2. MALARIA
• A potentially serious mosquito-borne illness caused by parasites of the plasmodium
species. Malaria can damage the kidneys or liver or cause the spleen to rupture. Any of these
conditions can be life-threatening. Anemia. Malaria may result in not having enough red blood
cells for an adequate supply of oxygen to your body’s tissues (anemia).
3. UTI CURINARY TRACT INFECTION)
• Is an Infection of the urinary system.UTIs are common infections that happen when bacteria,
often from the skin or rectum, enter the urethra, and infect the urinary tract. The infections can
affect several parts of the urinary tract, but the most common type is a bladder infection
(cystitis). Kidney infection (pyelonephritis) is another type of UTI.
• 4. HIV
• • Is a virus that attacks He body's Immune system. Human immunodeficiency virus (HIV) is an infection that
attacks the body’s immune system. Acquired immunodeficiency syndrome (AIDS) is the most advanced stage
of the disease. HIV targets the body’s white blood cells, weakening the immune system. This makes it easier to
get sick with diseases like tuberculosis, infections and some cancers.
• HIV is spread from the body fluids of an infected person, including blood, breast milk, semen and vaginal
fluids. It is not spread by kisses, hugs or sharing food. It can also spread from a mother to her baby.
• HIV can be treated and prevented with antiretroviral therapy (ART). Untreated HIV can progress to AIDS,
often after many years.
• 5. CHICKEN POX
• ► Chickenpox is an illness caused by the varicella-zoster virus. It brings on an itchy rash with small, fluid-
filled blisters. Chickenpox spreads very easily to people who haven’t had the disease or haven’t gotten the
chickenpox vaccine. Chickenpox used to be a widespread problem, but today the vaccine protects children
from it
7. Typhoid fever
Typhoid fever, also known as enteric fever, is a potentially fatal multisystemic illness caused primarily by
Salmonella enterica serotype typhi and, to a lesser extent, Salmonella enterica serotypes paratyphi A, B, and
C.
8.TUBERCULOSIS
• Tuberculosis (TB) is an infectious disease that most often affects the lungs. TB is caused by a type of
bacteria. It spreads through the air when infected people cough, sneeze or spit.
9. LEPTOSPIROSIS
• Leptospirosis is a zoonotic disease with epidemic potential, especially after a heavy rainfall, caused by a
bacterium called Leptospira. Leptospira interrogans is pathogenic to humans and animals, with more than
200 serologic variants or serovars.
• Leptospirosis is treated with antibiotics, such as doxycycline or penicillin,
10. DIABETES
• ▸ is a chronic, metabolic disorder characterized by high blood sugar levels