Chapter 24 Palliative & End-of-life Care Flashcards
adjuvant drugs
medication used along with analgesics to increase the effectiveness of the drugs to treat pain and associated symptoms
advance directives
documents signed by a person indicating his or her choice or wishes for medical treatment or naming of another to make choices if the person is unable to
bereavement
peroid of time or state of mind where feelings of loss, grief, or mourning are expected by the survivor after the death of a loved one
breakthrough pain
pain that is experienced despite the fact that a person is receiving scheduled pain relief medication
comfort measures only
a plan of care that specifies nursing intervention designed not to treat disease but to improve pain function or quality of life
grief
feelings of despair, sadness, and remorse in response to the loss of a loved one
healthcare proxy
a person designated to make healthcare designs for another in the event that he or she is unable to make such decisions beacuse of illness or disability
hospice care
care of persons and families who have 6 months or less to live in what they consider their home
mourning
the outward social expressions of loss often dictated by cultural norms, customs, rituals and tradition
palliative care
interdisciplinary team-based care for persons and family members experiencing life threateing illness or injury that addresses their physical, emotional, social, and spiritual needs
post mortum care
care provided by nurses to the body after death
hospice and palliative nurses acknowledge and accept
death as a natural process
10 components of quality in hospice care
patient and family centered care
ethical behavior and consumer rights
clinical excellence and safety
inclusion access
organizational excellence
workforce
standnards
compliance with laws and regulations
stewardship and accountability
performance measurment
hospice tiem peroid
less than 6 mo
stages of dying
denial
anger
bargaining
acceptance
will a dying person exhibit all stages of death
no
they may move quickly though a stage only to return to a later time
palliative care
relief of suffering for persons with serious illness
3 people that are competent expert and evidence based care
florence wald
dame Cicely saunders
Jeanne quint benoliel
common fears and concerns of the dying
death itself
thoughts of a long or painful deaht
facing death alone
dying in a nursing home, hospital, or rest home
loss of body control
community nurse acts
autonomously
neuropathic pain
nerves has been damaged
- burning, electrical, tingling
difficult to relieve with pain meds
nociceptive
resolves when injury heals
- acetaminophen
- NSAID
nonpharm pain management
glass of water
back rub
change of position
music
TV
model of pain
WHO
stepwise approach for pain treatment on the basis of the presence of mild, moderate, and severe or unrelenting pain
neuropathic pain or mild (1-3)
adjuvant drugs
moderate pain
low does opioid
nonopiod
adjuvant
severe pain
high opioid dose
persons with severe pain should receive what doses intially
severeh
how should pain meds be administered
routinely
PRN pain meds are used for
breakthrough
constipation
profphyaltic bowel regimen
if you have constipation what should we avoid
buling agents (psyllium) to avoid impaction
myoclonus
jerking
- change opoids
pruritus
common with morphine
- Benadryl
we should avoid what so they do not irritate mucosal
alcohol, perfume lemon or glycerin
watch for thrush
are anorexia and dehydration common and normal at the end of life
yes
should we have catheters in
no because it is distressing an dpainful
buildup of what
saliva and oropharyngeal secretions
changes in what pattern
resp
skin appernce
dusky or grey
cold or clammy
eyes
discolored, deeper set or bruised
greif
emotion felt after the loss
mourning
recovery form the loss
numb shock
cannot believe
shock
emotional dullness
emotional turmoil or depression
alarm or panic type reactions
reorganization or resolution
coping strategies
