Questions: Which stage in the trajectory of illness will the nurse classify an older adult with a chronic illness to be in based on the following information? Medical History: Hypertension, diabetes, myocardial infarction, heart failure Surgical History: Coronary artery bypass grafts x 3 Vital Signs: BP 110 / 58 mm Hg; HR 101 beats/minute; respiratory rate 22 breaths/minute; temperature 97.2° F(36.2° C); pulse oximetry 88% Imaging: Chest x-ray: pulmonary edema Dying Crisis Onset Stable

The answer is Crisis.

The "Dying" stage typically involves end-of-life care where the focus is on comfort and palliative measures. While the patient's condition is serious, there is no explicit indication that they are in the dying phase based on the information provided.

The "Crisis" stage in the trajectory of illness refers to a period where the patient's condition is acutely exacerbated, requiring immediate and intensive medical intervention. The patient's vital signs and imaging results indicate significant instability: low blood pressure, high heart rate, respiratory distress, and low oxygen saturation, along with pulmonary edema. These factors suggest an acute exacerbation of their chronic conditions, placing them in a crisis stage.

The "Onset" stage refers to the initial appearance of symptoms or diagnosis of a chronic illness. Given the patient's extensive medical and surgical history, they are well beyond the onset stage.

The "Stable" stage is characterized by the management of chronic conditions with no acute exacerbations. The patient's current vital signs and imaging results indicate instability, not a stable condition.