Death And Dyging

Question 1

When does ‘terminal phase’ start?

Answer 1

48-72 hours before death

Question 2

Recognising dying

Answer 2

New delirium
Worsening dyspnoea
Changes in respiratory function and increased mucous

Question 3

Important needs at end of life

Answer 3

Clear communication: about their wants before and after. Important they set goals
Pain management and symptom control
Avoiding unnecessary burden (unnecessary treatment)
Medication management: may need lower doses with failing renal system

Question 4

Considerations for practice

Answer 4

Family awareness
Status of CPR resuscitation 
Necessity of treatment (review meds)
Desires before and after death both family and patient 
Religious wants 
Tissue donation status 
Single room offered if possible

Question 5

Caring for dying person

Answer 5

Mouth care, keep moist
Control symptoms especially pain
Review medications
Consider continence, maybe catheterise

Question 6

Changes in dying person

Answer 6

Lowered BP
Irregular and raid pulse 
Cold extremities 
Cyanosed nail beds and lips 
Decreased consciousness
Breathy sounds

Question 7

Complementary therapies in palliative

Answer 7

Massage
Aromatherapy
Visualisation
Mediation

Question 8

Communication PREPARED

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Answer 8

Prepare relate elicit provide acknowledge realistic encourage document 
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Prepare for the discussion 
Relate to the person 
Elicit preferences 
Provide information 
Acknowledge emotions and concerns 
Realistic hope
Encourage questions 
Documentation

Question 9

What to do when a patient dies

Answer 9

Document TOD
Notify medical team 
Notify family 
Clean body and remove drains where appropriate 
Provide referral to family

Question 10

Kubler Ross stages of grief (5)

Answer 10

Shock, Denial, anger, bargaining, depression, acceptance