Chapter 3

Question 1

Holistic care

Answer 1

Caring for the whole person- the mind as well as the body.

Caring for a person holistically is part of providing person-centered care promotes their individual preferences, choices, dignity and interests.

Example: taking the time to talk with residents while helping them bathe

Question 2

Changes in residents that need to be reported to the charge nurse

Answer 2

Signs of depression
Suicidal thoughts
Loss of ability to think logically
Poor nutrition
Shortness of breath
Incontinence

Question 3

Guidelines to caring for a resident with an intellectual disability

Answer 3

Treat them as adults

Praise and encourage often, especially positive behavior

Help teach activities of daily living by dividing a task into smaller units

Promote independence. Assist residents with activities and motor functions that are difficult

Encourage social interaction

Repeat what you say to make sure they understand

Be patient

Question 4

Schizophrenia

Answer 4

A psychotic disorder that affects a person’s ability to think and communicate clearly. It also affects the ability to manage emotions, make decisions and understand reality. Affects the person’s ability to interact with others. Symptoms include hallucinations and delusions

Question 5

Observing and reporting mental health disorders

Answer 5

Note:

Changes in ability

Positive or negative mood changes, especially withdrawal

Comments, even jokes about hurting oneself or others

Failure to take medicine or proper use of medicine

Real or imagined physical symptoms

Events, situations or people that seem to upset or excite residents

Question 6

Advanced directives

Answer 6

Legal documents that allow people to decide what kind of medical care they wish to have if they are unable to make those decisions themselves.

Question 7

Living will

Answer 7

Outlines the medical care a person wants, or does not want, in case they become unable to make those decisions

Question 8

Durable power of attorney for healthcare

Answer 8

(Sometimes called healthcare proxy)

is a signed, dated and witnessed legal document that appoints someone else to make medical decisions for a person in the event that they become unable to do so. This can include instructions about medical treatment that the person does not want

Question 9

Guidelines for caring for the dying resident

Question 10

Reduce glare and keep room lighting low

Answer 10

Census begin to diminish and vision May fail. Hearing is usually the last sense to leave the body. Speak in a normal tone. Tell the resident about care that is being done or what is happening in the room. Do not expect an answer. Ask You questions. Observe body language to anticipate a residents needs

Question 11

Give mouth care often

Answer 11

If the resident is unconscious, give mouth care every 2 hours. Apply lubricant, such as lip balm to the lips and nose

Question 12

Skin care

Answer 12

Give bed baths and incontinence care is needed. Dave perspiring residents often. Skin should be kept clean and dry. Change sheets and clothes for comfort. Keep sheets wrinkle free. Careful skin care to prevent pressure injuries is important.

Question 13

Pain control and comfort

Answer 13

Observe body language and watch for other signs of pain. Report them. Frequent changes of position, back massage skin care, mouth care and proper body alignment may help

Question 14

Environment

Answer 14

Put favorite objects and photographs where the resident can easily see them. Make sure the room is comfortable, appropriately lit and well ventilated.

Question 15

Emotional and spiritual support

Answer 15

Listening maybe one of the most important things you can do for a resident who is dying. Pay attention to these conversations. Report any comments about fear to the nurse. Touch can also be important. Holding the residence hand as you sit quietly can be very comforting.

Question 16

Guidelines for treating residents who are dying with dignity

Question 17

Respect the residence wishes and all possible ways

Answer 17

Communication is extremely important at this time so that everyone understands what the residents wishes are. Listen carefully for ideas and how to provide simple gestures that may be special and appreciated

Question 18

Do not isolate or avoid a resident who is dying

Answer 18

Enter the room regularly

Question 19

Be careful not to make promises that cannot or should not be kept

Question 20

Continue to involve the resident and his care and in facility activities

Answer 20

Be person centered. Do not talk with other staff members about your personal life when caring for the resident

Question 21

Listen

Answer 21

If a resident wants to talk do not offer advice. Do not make judgmental comments.

Question 22

Be professional

Answer 22

Don’t act especially cheerful or sad

Question 23

Keep the resident as comfortable as possible

Question 24

Help with the families physical comfort

Answer 24

Honor their requests to the best of your ability

Question 25

Common signs of approaching death include:

Answer 25

Blurred and failing vision

Unfocused eyes

Impaired speech

Diminished sense of touch

Loss of movement, muscle tone and feeling

Arising or below normal body temperature

Decreasing blood pressure

Weak pulse that is abnormally slow or rapid, shallow respirations, along with short periods of not breathing called Cheyne-stokes respirations

A rattling or gurgling sound as the person breathes (which does not cause discomfort for the dying person)

Cold, pale skin

Mottling (bruised appearance) spotting or blushing of skin caused by poor circulation

Perspiration

Incontinence

Disorientation or confusion

Question 26

Guidelines to postmortem care

Answer 26

Faith the body. Be gentle to avoid bruising. Place drainage pads underneath the head and perineum follow standard precautions

Do not remove any tubes or other equipment attached to the body. Leave this to the nurse

If instructed, put dentures back in the mouth. Close the mouth. If not possible place dentures in a denture cup near the residence head

Close the eyes carefully

Position the body on the back with legs straight and arms folded across the abdomen. Put a small pillow underneath the head

Final facility policy about personal items. Check to see if you should remove jewelry. Always have a witness of personal items I removed or given to a family member. Document what was given to whom.

Strip the bed after the body has been removed. Open Windows to air the room is needed. Straighten up.

Document according to your facilities policy

Question 27

Hospice care

Answer 27

Return for the special care of the dying person needs. it uses a holistic, person-centered approach. The resident is encouraged to participate in family life and decision making as long as possible

Question 28

Palliative care

Answer 28

Is given in hospice where the goals shift from person-centered care to focusing on the comfort and dignity of the resident.

Pain relief, comfort and managing symptoms, rather than teaching residents to care for themselves becomes the focus

Question 29

Hospice Care guidelines

Question 30

HCG

Be a good listener

Answer 30

Acknowledge that some will not want to confide in their caregivers. Never push someone to talk

Question 31

HCG

Respect privacy and Independence

Question 32

HCG

Be sensitive to individual needs

Answer 32

Ask family members of friends how you can help

Question 33

HCG

Be aware of your own feelings

Answer 33

Know your limits and respect them

Question 34

HCG

Recognize the stress

Answer 34

Talk with a counselor support group while keeping specific information confidential

Question 35

HCG

Administer self-care

Answer 35

Talk about an acknowledge your feelings. Take time to do things for yourself. Take a break when needed

Question 36

HCG

Answer 36

Allow yourself to grieve. You will develop close relationships with some residents. Know that is normal to feel sad, angry or lonely when residents die