Fundamentals · chapter 42 · Caring for Patients with Disability and Chronic Illness
Chronic Disease and Chronic Illness
The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 6 practice questions with the reasoning.
Key points
Nursing chronic care focus
Nurses must understand the subtle differences between chronic disease and chronic illness to provide compassionate and individualized care.
Health illness continuum
Health and illness exist on a continuum, with many factors playing a role in an individual's experience of illness or health.
Shared chronic condition causes
Chronic disease and chronic illness can be grouped together as a collection of chronic conditions that have overlapping causes as well as treatments.
Daily activity impact
Although disease presentations and circumstances vary widely between individuals, most chronic diseases require ongoing medical treatment and intervention and may affect a person’s ability to perform daily activities (CDC, 2022a).
Common chronic diseases
Common chronic diseases in the United States include heart disease, hypertension (HTN), epilepsy, stroke, mood disorders, cancer, diabetes, asthma, chronic obstructive pulmonary disease (COPD), arthritis, dementia, psoriasis, osteoporosis, obesity, autoimmune disorders, and chronic pain.
Delayed symptom development
Chronic diseases typically develop over a prolonged period, sometimes without overt symptoms.
Treatment modification limits
Chronic diseases typically are not cured by medical treatment but may be modified to an extent to create a remission, reduction, or disappearance of symptoms of a disease.
Chronic illness expression
The outward expression of chronic illness is seen in the way individuals live and cope with chronic disease and the disruptions it causes in their daily activities.
Chronic illness symptoms
Symptoms may include fatigue, weakness, pain, headaches, negative self-image, social withdrawal, inability to work, decreased physical function, stress, mood disorders, anxiety, sleep disturbance, and cognitive changes.
Adult chronic disease prevalence
The CDC (2022b) reports that up to 60 percent of adults have one chronic disease.
Lifestyle risk factors
Many chronic conditions arise from a few detrimental lifestyle factors, including tobacco use, secondhand smoke exposure, improper nutrition, sedentary lifestyle, and substance use disorders (CDC, 2022b).
Family history risk
A family history of specific disorders puts an individual at a higher risk for these same chronic conditions.
Multiple chronic conditions prevalence
The CDC (2022b) reports that up to 40 percent of adults in the United States have two or more co-occurring chronic conditions.
Multisystem treatment effects
However, many chronic conditions affect multiple organ systems directly or indirectly. Treatments and interventions for one condition may negatively affect another chronic condition or create problems in associated organ systems.
Terms to know
- disease
- The terms disease (a disorder within the body that is identifiable as a medical condition) and illness (the perceived experience of a disorder within the body) are often used interchangeably.
- illness
- The terms disease (a disorder within the body that is identifiable as a medical condition) and illness (the perceived experience of a disorder within the body) are often used interchangeably.
- chronic disease
- Long-standing definitions describe chronic disease as a state of being that includes a biomedical disease (Martin, 2007).
- chronic illness
- In contrast to chronic disease, chronic illness describes an individual’s experience with a chronic condition.
- comorbid medical conditions
- The interaction between multiple disorders is responsible for many interrelated symptoms and comorbid medical conditions (multiple medical conditions that are simultaneously present).
- immunodeficiency disorder
- An immunodeficiency disorder is a condition or disease that is caused by a weakened immune system that impairs the body’s ability to fight off disease or infection.
- overactive immune disorder
- An overactive immune disorder occurs when the immune system develops a hyperresponse to normally harmless environmental substances.
- autoimmune disorder
- An autoimmune disorder, or a rheumatological condition, arises from the body’s immune system attacking and damaging its cells and organs.
Practice questions
Stuck on select-all-that-apply? How to take them one option at a time.
The graded version needs JavaScript. Every question is below anyway, with the answer and why.
Every question here, with the answer
A patient with a long-term medical diagnosis tells the nurse, “I still feel healthy because I have strong support, good coping strategies, and I can do most of what matters to me.” Which response by the nurse best reflects the section’s concept of health?
- “A person with a chronic disease cannot experience overall health.”
- “Chronic disease and chronic illness always mean the same thing.”
- “Health is more than simply not having a disease.”
- “Your health status depends only on whether symptoms are present.”
Answer: “Health is more than simply not having a disease.”
The section explains that health includes well-being and is more than the absence of disease. A person living with chronic disease may still experience emotional, social, physical, or overall health; the other options ignore the health-illness continuum or collapse distinct concepts.
A nurse is planning prevention teaching for adults at risk for chronic conditions. Which factors should the nurse include as detrimental lifestyle factors associated with many chronic conditions? Select all that apply.
- Family history of a specific disorder
- Secondhand smoke exposure
- Sedentary lifestyle
- Genes associated with breast and ovarian cancers
- Improper nutrition
Answer: Secondhand smoke exposure, Sedentary lifestyle, Improper nutrition
The section identifies secondhand smoke exposure, sedentary lifestyle, and improper nutrition as detrimental lifestyle factors. Family history and specific genes can increase risk, but they are genetic or hereditary factors, not lifestyle factors.
An adult with obesity and type 2 diabetes asks why the provider is monitoring kidney function. Which explanation by the nurse is most appropriate?
- “Kidney damage occurs only when diabetes is caused by infection.”
- “Diabetes can increase the risk for progressive kidney damage and chronic kidney disease.”
- “Obesity prevents diabetes from affecting other organ systems.”
- “Monitoring kidney function is unnecessary unless diabetes symptoms disappear.”
Answer: “Diabetes can increase the risk for progressive kidney damage and chronic kidney disease.”
The section describes overlap among chronic conditions and gives diabetes as an example of a condition associated with progressive kidney damage and chronic kidney disease. The other options contradict the section’s discussion of multiple chronic conditions and organ-system overlap.
A nurse is caring for a patient with cardiovascular disease and associated risk factors. Which nursing actions are consistent with the section’s evidence-based practice guidance? Select all that apply.
- Monitor for progressive changes in serum lipid tests and blood pressure.
- Provide lifestyle-modification education using evidence-based data.
- Rely primarily on clinical opinion-based reports for patient teaching.
- Use the same depth of teaching regardless of patient motivation or health literacy.
- Assess for edema and subtle chest pain.
Answer: Monitor for progressive changes in serum lipid tests and blood pressure., Provide lifestyle-modification education using evidence-based data., Assess for edema and subtle chest pain.
The section states that nurses can monitor biomarkers such as lipid tests, blood pressure, edema, and subtle chest pain, and can support lifestyle change with evidence-based education. It also emphasizes distinguishing evidence from opinion and adjusting teaching to patient motivation and health literacy.
A patient reports recurrent breathing symptoms, skin reactions, and nasal congestion after exposure to normally harmless environmental substances. Which category of immune disorder should the nurse suspect based on this description?
- Immunodeficiency disorder
- Chronic cognitive disorder
- Overactive immune disorder
- Autoimmune disorder
Answer: Overactive immune disorder
The section defines an overactive immune disorder as a hyperresponse to normally harmless environmental substances and links it with breathing disorders, skin reactions, and nasal congestion. Immunodeficiency involves impaired ability to fight infection, autoimmune disease involves the body attacking its own cells and organs, and cognitive disorders affect thinking and memory.
A nurse is assessing how a patient is living with and coping with a chronic disease. Which findings may reflect chronic illness as described in the section? Select all that apply.
- Sleep disturbance
- Fatigue
- Social withdrawal
- Negative self-image
- Improved physical function
Answer: Sleep disturbance, Fatigue, Social withdrawal, Negative self-image
Chronic illness describes the individual’s experience of a chronic condition, including disruptions in daily life. The section lists fatigue, negative self-image, social withdrawal, and sleep disturbance among possible symptoms; improved physical function is not listed as a symptom of chronic illness.
Where every quote comes from
Section 42.3 Chronic Disease and Chronic Illness of Fundamentals of Nursing by Christy Bowen, Lindsay Draper, Heather Moore, OpenStax, 2024. Read the whole section free at openstax.org.
The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.