Chapter 12
Chapter 12: Managing Chronic Conditions
Objectives
Learning Objectives
On completing this chapter, you will be able to:
• Explain the difference between an acute medical condition and a chronic medical condition.
• Describe the causes and effects of several inherited conditions, including Klinefelter’s syndrome,
Turner’s syndrome, cystic fibrosis, sickle-cell disease, and fragile X syndrome.
• Describe the effects and treatments for several congenital abnormalities, including cleft palate and
scoliosis.
• Describe the underlying metabolic problem that occurs in diabetes mellitus, and explain the differences
between type 1, type 2, and type 3 diabetes.
• List strategies to prevent and manage diabetes.
• Define autoimmune disorder, and give several examples of disorders that fall into the category,
including their symptoms and possible treatments.
• Discuss the causes and signs of common degenerative diseases, including Parkinson’s disease and
Alzheimer’s disease.
Terms and Definitions
acute – having a sudden onset and a prompt resolution.
Alzheimer’s disease – adult-onset form of dementia resulting from loss of acetylcholine production within
specific areas of the brain.
autoimmune disorders – disorders caused by the immune system’s failure to recognize the body as “self”;
thus the body mounts an attack against its own cells and tissues.
chronic – develops slowly and persists for an extended period of time.
cyanosis – blue coloration of the lips, skin, and nail beds caused by inadequate oxygenation of the blood.
degenerative – a slow but progressive deterioration of the body’s structure or function.
dementia – the loss of cognitive abilities, including memory and reason.
exocrine glands – glands whose secretions are released through tubes or ducts, such as sweat glands.
fistula – a fissure, break, or hole in the wall of an organ.
gene replacement therapy – an experimental therapy in which a healthy human gene is incorporated into a
harmless virus to be delivered to cells that have an abnormal version of the gene.
hyperglycemia – the condition of having an abnormally high blood glucose level.
hypoglycemia – the condition of having an abnormally low blood glucose level.
insulin – a hormone produced by the islet cells of the pancreas that is necessary for the normal utilization
of glucose.
in vitro – outside the living body, in an artificial environment.
multifactorial – requiring the interplay of many factors; refers to the cause of a disease or condition.
recessive inheritance pattern – the inheritance of traits whose expression requires that they be carried by
both biological parents.
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self-antigens – the cells and tissues that stimulate the immune system’s autoimmune response.
sex chromosomes – the X and Y chromosomes that determine sex; chromosomes other than the
autosomes.
systemic – distributed or occurring throughout the entire body system.
xenotransplant – a transplant of tissue from an animal, such as a pig, to a human recipient.
Lecture Outline
I. Chronic Disease Prevention

We do not yet understand the causes of many chronic diseases.
II. Genetic/Inherited Conditions

Scanty recordkeeping means that many chronic diseases probably are underreported.
A. Abnormal Number of Sex Chromosomes

A normal child has 44 chromosomes and two sex chromosomes for a total of 46.
1.
Klinefelter’s Syndrome

2.
In this condition, a Y sex chromosome combines with two X chromosomes.
Turner’s Syndrome

This occurs in females when one of two X chromosomes is missing.
B. Inherited Genetic Mutations
1.
Cystic Fibrosis

2.
This potentially fatal disease occurs in about 1 of every 2,000 live births.
Sickle-Cell Trait and Sickle-Cell Disease

About 1.5 percent of African Americans have this disease.
C. Sex Chromosome-Linked Inherited Genetic Mutations
1.
Color Vision Deficiency

Virtually all with color blindness can see color but distinguishing between
shades can be difficult to impossible
2.
Fragile X Syndrome

Known association with autism

FMR1 gene mutation
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III. Congenital Abnormalities

These conditions result from abnormal changes during embryonic development.
A. Cleft Palate and Cleft Lip

These conditions occur in about 1 of every 800 live births.

Surgery usually is prescribed while the infant is 3 to 4 months old.
B. Patent Foramen Ovale (PFO)

A leak between heart chambers allows blood to bypass the lungs.

Treatment is unnecessary in mild cases.
C. Scoliosis

Uncorrected severe curvature can compress the heart, lungs, and related structures.

Curvatures greater than 30 degrees generally require treatment.
IV. Metabolic Disorders

In these disorders, the body is unable to properly regulate the buildup and tearing down of tissues.
A. Diabetes Mellitus
1.
2.
3.
Type 2 Diabetes

Body cells become increasingly less sensitive to the presence of insulin.

For many, weight loss and diet modification is the only treatment needed.
Type 1 Diabetes

In this disease, the body produces no insulin at all.

Delivery of insulin from an outside source is required.
Double-Diabetes or Type 3 Diabetes

B.
Person has both Diabetes 1 and 2.
Hypoglycemia

This condition results when blood sugar is excessively reduced by taking too much
insulin, exercising too little, or other causes.

Consuming frequent small meals can maintain a more proper level of blood glucose.
V. Autoimmune/Hypersensitivity Disorders
A. Fibromyalgia
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
Approximately 2 percent of the adult population is believed to have fibromyalgia.

Reduce stress, avoid infections, and maintain strong overall health to help prevent this
disease. Treatment centers on improving sleep and reducing pain.
B. Asthma

A genetic predisposition is suspected as a primary cause.

Most important is maintaining a high level of health through a sound diet, exercise, and
stress management.
C. Irritable Bowel Syndrome (IBS) and Inflammatory Bowel Disease (IBD)

IBS is characterized by uncomfortable episodes of spasticity-based pain, diarrhea, or
constipation

IBD involves changes to the GI tract
D. Systemic Lupus Erythematosus (SLE)

In this autoimmune disorder, the body attacks its own fibrous connective tissue.

Long-term drug therapy is used to treat lupus.
E. Multiple Sclerosis (MS)

In MS, myelin-producing cells are destroyed, and thus underlying nerves are badly
damaged.

Researchers are focusing on immune system-related medications.
VI. Degenerative Diseases

These diseases result from structural and functional degeneration over time.
A. Parkinson’s Disease

This disease results from progressive loss of dopamine production in specific areas of the
brain.

Several medications are used to affect dopamine production.
B. Alzheimer’s Disease (AD)

Genetic mutations are a possible cause.

New imaging technology can nearly confirm the presence of Alzheimer’s.
VII. Chronic Conditions and a Sense of Well-Being
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Supplemental Resources: Activities, Assignments, and
Discussion Material
For your convenience listed below are some of the available supplemental assets for this chapter. For the
most up-to-date supplement information, please refer to the textbook website
(http://www.mhhe.com/payne11e).
Online Learning Center
Personal Assessments
Are You Managing Your Asthma Effectively? *
*also found in the text
Web Activities
Resources for Managing Your Asthma
Focus On
Chronic Illness and the Demands of Caregiving
Activities
Core Textbook Activities: Talking Points
1. You learn that two young women who are your coworkers have recently been diagnosed with lupus and
Crohn’s disease, respectively. How can you be supportive of them? What would you say to them about
their conditions, particularly on days when it is obvious that they are not feeling well? (p. 341)
2. Your grandmother seems increasingly frustrated by your grandfather’s “clumsiness” and has
complained that he is becoming increasingly unsteady and nervous. What might you say to her about his
condition? What would you suggest she say to him? (p. 345)
Individual Activities
1.
Interview someone who has diabetes and write a short report about this disease from the patient’s
perspective.
2.
Research and write a paper on the latest developments in one of the chronic conditions presented in the
text.
3.
Interview a person who has a family member with Alzheimer’s. Write a summary of the disease from
the family’s perspective.
Community Activities
1.
Visit a nursing home and observe the activities that are planned and conducted for an Alzheimer’s
resident. Discuss the objectives of these programs with the activity director.
2.
Volunteer with the Special Olympics for the winter or summer games in your area.
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