ch 13 palliative and end of life care NOT ON EXAM 1 Flashcards
autonomy
self determination, the right to make choices
bereavement
the period in when mourning takes place
grief
feels about actual or anticipate
hospice
services provided for pt or families for terminal illnesses with less than 6 months to live
interdisciplinary collaboration
includes physician, family, pt, nurses, different therapies, pharmacy/ communication and cooperation amongst various disciplines coordinating care
medicare hospice benefit
included in medicare part A
palliative care
pt family center approached/ primary focus is quality of life
palliative sedation
controlled or monitored administration of sedatives or opioids to reduce pain or level of consciousness
mourning
the expression of grief
contemporary definition of nursing
the diagnosis and treatment of human responses, and advocacy in the care of individuals, families, groups, communities and population
palliative care defintion
interdisciplinary model or care/ focuses on pts with serious life- limiting illnesses (who focus is to improve quality of life)
hospice is a type of what care
palliative care/ focuses on relief of symptoms only, pain management, life review, bereavement support
4 major setting for palliative care and end of life care
institution-based, outpatient-based, community-based, hospice
communication in palliative care: nurses need to develop skills in
assessing pt family responses, planning interventions, comfort in communicating with seriously ill pt, identify own values & beliefs, need patience empathy and honesty, therapeutic commnication, open ended questions, emotions (NURSE)
what does the acronym NURSE mean in communication of palliative care
N: name the emotion
U: understand the emotion
R: respect or praise the pt
S: support the pt
E: exploring the emotion
advanced care planning
engage pas and families in goals of care
living will is
the document of end of life preferences (don’t want put on a ventilator but okay with oxygen)
health care power of attorney
known as the durable power of attorney, makes decision for the pt in the time of event when they are unable to talk for themselves
patient self determination act 1991
requires health care settings that receive medicare and medicaid ask pts about advanced directives, if they don’t have one we provide them with information
DNR-CC
do not resuscitate- comfort care (only pain meds/ able to breath easier) (no antibiotics, vitamins, BP meds)
DNR-CCA
do not resuscitate- comfort care anything (pt can have anything they want up to the point their heart stops and they stop breathing, once that happens you stop all treatment) they can have antibiotics, BP meds, vitamins
types of grief
anticipatory, uncomplicated, complicated or prolonged, disenfranchised, unresolved
complicated or prolonged grief
when the family member can no longer get out of bed, can not perform normal ADLs, can’t eat
disenfranchised grief
grief that occurs when there is mistress involved or homosexual couple
unresolved grief
can not get over it, keeps bringing it up
if reaching end of life, the pt will become
dehydrated, constipated, dry mouth, don’t respond to artificial nutrition
expected physiologic changes when. close to death
organs begin to fail, circulation starts to fail (pulls fluids toward main organs, leaving the other limb/ organs to die)
death vigil is
imminent death, within 48 hours, can be seen when difference sin RR, HR changes, change in skin color, weakened pulses, extremities become cold, pt becomes lethargic
determination of death is the
auscultation of absence of breathing and heart sounds
changes in body at death
skin color (blue), skin temperature (cool), evacuation of bowel and bladder (incontinent)
to prepare the body
where the body is to be taken, polices on removing tubes
