Symptoms Management: Unit 13

- find ways to reduce fatigue
- assist the client in managing the effecgts of fatigue

- pain
- fever
- infection
- diarrhea
- bedrest
- extreme stress
- disturbed sleep
- anxiety
- depression

Physical functioning:
- self-care
- food preparation - may lead to issues of malnutrition
- withdrawal from normal lifestyle
Changing roles/relationships:
- self-esteem, mood, self-motivation
- relationships with others and role changes - unable to perform roles
Social Isolation:
- NRG required for communication
- NRG required for group activities
Sexual Functioning

- pacing
- priority setting
- NRG conservation
- exercise program: Flexibility, ROM, stretching, strength, endurance, balance
- Nutrition
- Pain management

A mental condition marked by ongoing feelings of sadness, despair, loss of energy, and difficulty dealing with normal daily life.

Depression

- It is estimated that up to 1/3rd of individuals with a serious medical condition experience sxs of depression.
- common conditions: MI, CAD, Parkinson's, MS, stroke, cancer, DM, chronic pain sydrome.
- Clients and others often overlook sxs of depression assuming that feeling sad is normal for someone struggling with disease.
- Sxs of depression may be masked by other medical problems, resulting in tx for the sxs, but not the underlying depression.
- When both chronic illnesses and depression are present, it is important to treat both at the same time.
- Early dx and tx of depression and reduce distress, as well as the risk of complications and suicide for those with chronic illness and depression.
- In many, depression tx can produce an improvement in the person's overall medical condition, a better QOL, and a greater likelihood of sticking to the plan of care.

- depressed mood or loss of interest in pleasure in daily activities.
- significant weight loss or weight gain
- sleep disturbances - too much or not able to sleep
- problems with concentration
- Apathy (lack of feeling or emotion)
- feeling hopelessness and helplessness
- feeling of worthlessness or guild - self loathing
- fatigue or loss of NRG
- repated thoughts of death or suicide

- psychotherapy
- antidepressants
- coping mechanisms such as: relaxation techniques, rest, exercise, and sleep, health diet, manage stress, cultivate supportive relationships, clear communication with health team.
- recovery is often more rapid and complete when both antidepressant medication and psychotherapy are combined.
- the success of therapy can't be gauranteed, but the majority of individuals treated for depression will recover.
- specific interventions and treatments are discussed in reading assignment.

A lack of appetite, lack of desire or interest in food.

An involuntary weight loss of 10% of premorbid weight and is associated with muscle wasting and hypoproteinemia: Gastric dysmotility leads to anorexia and early satiety.

- history
- physical exam
- lab tests

- Tx of reversible causes: anxiety, N/V, constipation, depression, dysphagia, pain.
- Aggressive nutritional support: enteral nutriotion through a tube, nose, stomach, small intestine. Parenteral nutrition IV, salt, glucose, amino acids, lipids, and vitamins
- medications: megestrol acetate (megace), medroxyprogesterone acetate (depo-provera), corticosteroids, dronabinol (marinol), metoclopramide (regland) for reflux
- Nutritional counseling: high calorie meals of small portions.