Death and dying Flashcards
Palliative care
Any stage, transition between late life and end of life, supplement to current treatments, paid for by insurance, comfort care, offer a higher quality of life, helps patients and loved one’s cope
Hospice care
End of life physical/mental cues
weakness, fatigue, anorexia, changes in bowel and bladder pattern, changes in LOC
End of life respiratory cues
changes in breathing pattern, shallow and rapid breathing, Cheyne-stokes respirations (apnea alternating w/periods of rapid breathing)
Cardiovascular
Poor tissue perfusion, BP decreases, HR rapid and irregular
Pain nursing interventions
opioid and non-opioid analgesics, long-acting oral opioids cannot be crushed, switch to shorter acting sublingual opioids, rectal forms as well
Weakness nursing interventions
stay in bed to avoid falls and injuries, foley catheter, aspiration precautions, provide mouth care
Breathlessness and dyspnea nursing interventions
pharmacological interventions early on, some may benefit from oxygen, limit exertion, inserting long-term foley, position patient w/head of bed up, apply wet cloths to face, encourage imagery and deep breathing
Nausea and vomiting nursing interventions
if nausea from constipation enema or mineral oil, antiemetics, remove sources of odor, aromatherapy
Agitation and delirium interventions
assess for pain/urinary retention/constipation/other cause, delirium if no cause found, antipsychotic agents, music therapy or aromatherapy
Seizure nursing interventions
around the clock benzos, barbiturates, rectally or sublingually
Refractory symptoms of distress interventions
nurses must follow guidelines, but palliative sedation may be needed
Advance directive
written document prepared by competent person to specify what extraordinary actions they want when no longer able to make decisions about personal health care
Patient self-determination act
right to determine medical care wanted if incapacitated
POLST
Document additional instructions in case of cardiac or pulmonary arrest
