ch 13 palliative and end of life care NOT ON EXAM 1

Question 1

autonomy

Answer 1

self determination, the right to make choices

Question 2

bereavement

Answer 2

the period in when mourning takes place

Question 3

grief

Answer 3

feels about actual or anticipate

Question 4

hospice

Answer 4

services provided for pt or families for terminal illnesses with less than 6 months to live

Question 5

interdisciplinary collaboration

Answer 5

includes physician, family, pt, nurses, different therapies, pharmacy/ communication and cooperation amongst various disciplines coordinating care

Question 6

medicare hospice benefit

Answer 6

included in medicare part A

Question 7

palliative care

Answer 7

pt family center approached/ primary focus is quality of life

Question 8

palliative sedation

Answer 8

controlled or monitored administration of sedatives or opioids to reduce pain or level of consciousness

Question 9

mourning

Answer 9

the expression of grief

Question 10

contemporary definition of nursing

Answer 10

the diagnosis and treatment of human responses, and advocacy in the care of individuals, families, groups, communities and population

Question 11

palliative care defintion

Answer 11

interdisciplinary model or care/ focuses on pts with serious life- limiting illnesses (who focus is to improve quality of life)

Question 12

hospice is a type of what care

Answer 12

palliative care/ focuses on relief of symptoms only, pain management, life review, bereavement support

Question 13

4 major setting for palliative care and end of life care

Answer 13

institution-based, outpatient-based, community-based, hospice

Question 14

communication in palliative care: nurses need to develop skills in

Answer 14

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)

Question 15

what does the acronym NURSE mean in communication of palliative care

Answer 15

N: name the emotion
U: understand the emotion
R: respect or praise the pt
S: support the pt
E: exploring the emotion

Question 16

advanced care planning

Answer 16

engage pas and families in goals of care

Question 17

living will is

Answer 17

the document of end of life preferences (don’t want put on a ventilator but okay with oxygen)

Question 18

health care power of attorney

Answer 18

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

Question 19

patient self determination act 1991

Answer 19

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

Question 20

DNR-CC

Answer 20

do not resuscitate- comfort care (only pain meds/ able to breath easier) (no antibiotics, vitamins, BP meds)

Question 21

DNR-CCA

Answer 21

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

Question 22

types of grief

Answer 22

anticipatory, uncomplicated, complicated or prolonged, disenfranchised, unresolved

Question 23

complicated or prolonged grief

Answer 23

when the family member can no longer get out of bed, can not perform normal ADLs, can’t eat

Question 24

disenfranchised grief

Answer 24

grief that occurs when there is mistress involved or homosexual couple

Question 25

unresolved grief

Answer 25

can not get over it, keeps bringing it up

Question 26

if reaching end of life, the pt will become

Answer 26

dehydrated, constipated, dry mouth, don’t respond to artificial nutrition

Question 27

expected physiologic changes when. close to death

Answer 27

organs begin to fail, circulation starts to fail (pulls fluids toward main organs, leaving the other limb/ organs to die)

Question 28

death vigil is

Answer 28

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

Question 29

determination of death is the

Answer 29

auscultation of absence of breathing and heart sounds

Question 30

changes in body at death

Answer 30

skin color (blue), skin temperature (cool), evacuation of bowel and bladder (incontinent)

Question 31

to prepare the body

Answer 31

where the body is to be taken, polices on removing tubes