Death and Dying Flashcards
What is hospice care?
Comfort care for people with terminal illnesses and their families
Describe the purpose of Advance Care Planning (ACP) in end-of-life care.
Planning future medical care so your wishes are known
Explain the significance of a Do Not Resuscitate (DNR) order.
A request to not perform CPR if the heart stop
Define what an Advance Directive is and its importance.
A legal paper stating your healthcare wishes if you can’t speak for yourself.
How does a personal directive differ from an advance directive in Alberta?
Same as Advance Directive. Names someone to make decisions for you
Do you need a lawyer to witness an Advance Directive?
“No lawyer needed. Just signed, dated, and witnessed
What are some considerations clients and families face during terminal illness?
Decisions about CPR, ICU, and treatment options.
Explain the role of the healthcare team in Advance Care Planning.
Help patients and families understand options and make informed choices
Describe the purpose of a Power of Attorney (POA).
“Someone to make legal/financial decisions if you can’t
Explain the eligibility criteria for organ and tissue donation in Canada.
16+, competent, and usually on life support for organ donation
Define Advance Care Planning (ACP) in the context of medical assistance in dying.
ACP includes the option to request medical assistance in dying (MAID)
How does the enduring power of attorney document function in legal terms?
Legal document for someone to manage finances if you become unable
What are the requirements for completing an enduring power of attorney document?
Written, dated, signed by you and a witness, states when it starts
Explain the significance of Bill 205 regarding organ donation in Canada.
Requires documenting organ donation wishes in medical records
Describe the primary diagnosis of individuals who received Medical Assistance in Dying (MAiD) in Canada.
Most common: Cancer
Describe the five phases of MAID.
Thinking, learning, requesting, action, support
Explain the focus of nursing management in end-of-life care.
Focus on comfort, dignity, and managing symptoms, not curing.
How should anxiety and grief be managed in end-of-life care?
“Use medicine and support to help with feelings
Define the role of the nurse in addressing fear during end-of-life care.
Help patients cope with fears, manage pain, and provide comfort
Do patients have a say in their end-of-life care decisions?
Yes, patients should help make decisions
Explain the importance of managing anger in end-of-life care.
Nurses must understand anger to provide good care.
What are common emotional challenges faced by patients in the end-of-life period?
Sadness, fear, feeling helpless
Describe the key aspects of post-mortem care.
Clean and prepare the body, give family privacy
Explain the difference between pronouncement of death and certification of death.
Pronouncing: saying death occurred. Certifying: legal cause of death.
How should healthcare providers communicate with patients nearing the end of life?
Talk with respect, focus on comfort
Define what a death certificate is.
Legal document stating someone is dead
What should be discontinued during end-of-life care?
Stop unnecessary treatments
Explain the importance of allowing family privacy after a death.
Give family time to grieve
Describe the considerations for preparing a body for viewing or release to a funeral home.
Follow rules, clean the body, give family privacy
Describe the importance of personal interventions for nurses.
Hobbies, rest, and support help nurses
Explain the emotional challenges nurses face when caring for dying clients.
Sadness, guilt, feeling helpless
Define palliative sedation and its purpose.
Last resort to relieve severe symptoms
How does grief affect nurses personally?
Nurses also feel grief
What are common end-of-life medications used in palliative care?
Pain meds, calming meds
Do nurses need informed consent for palliative sedation?
Yes, you need consent
Explain the significance of prioritizing sleep, exercise, and diet for nurses.
“Sleep, exercise, and diet help nurses
Describe the pharmacological class of morphine.
Morphine belongs to the pharmacological class of opioid receptor agonists.
Explain the mechanism of action of morphine.
Morphine acts as a mu-receptor agonist, providing pain relief by binding to opioid receptors in the brain and spinal cord.
Identify the common routes of administration for morphine.
Morphine can be administered through various routes, including intravenous, intramuscular, subcutaneous, and oral.
Define the indications for using morphine in patient care.
Morphine is indicated for the management of moderate to severe pain, as well as for treating dyspnea and diarrhea.
How does morphine affect patients in end-of-life care regarding addiction concerns?
In end-of-life care, addiction and dependence are not commonly concerns when morphine is used for pain management.
List some common side effects associated with morphine use.
Common side effects of morphine include constipation, sedation, nausea, and respiratory depression.
What nursing considerations should be taken into account when administering morphine?
Watch breathing, check pain, teach about side effects
Describe the pharmacological class of midazolam.
Midazolam belongs to the benzodiazepine pharmacological class.
Explain the mechanism of action of GABA in the brain.
GABA acts as an inhibitory neurotransmitter, inhibiting dopamine activity, which is excitatory.
What is the focus of palliative care?
Improve comfort and quality of life.
What are signs of imminent death?
Signs may include altered breathing, decreased responsiveness, and lower body temperature.
What is the role of nurses in end-of-life care?
Nurses provide physical, emotional, and spiritual support, manage symptoms, and facilitate communication.
What are key considerations for home end-of-life care?
Consider proper beds, supplies, pain management, and skin care.
What is the grief process?
Grief involves emotional responses to loss, including sadness, anger, and the need for support.
What are common medications in end-of-life care?
Common medications include morphine, midazolam, and scopolamine.
What is the goal of Canada’s HPC?
The goal is to improve life quality for patients and families by preventing and relieving suffering.
What are the principles of HPC?
Principles include symptom relief, affirming life, holistic care, and family support.
What is End-of-Life (EOL) Care?
EOL Care focuses on comfort and quality of life during the final stages of a life-limiting illness.
What is the Bow Tie Model in palliative care?
The Bow Tie Model emphasizes early integration of palliative care, treating death as a normal process.
Can palliative care patients seek curative treatments?
Yes, palliative care patients can pursue curative treatments, unlike hospice care.
What is the role of the Quality End of Life Care Coalition of Canada?
It serves as the national voice for hospice and palliative care, focusing on policy and education.
What support is available for caregivers?
Caregiver benefits help financially support those providing end-of-life care.
Why is self-awareness important in caregiving?
Self-awareness helps caregivers recognize their beliefs and focus on patient-centered care.
Who is Cicely Saunders?
Cicely Saunders was a nurse and physician who significantly advanced palliative care.
What are common illness trajectories in terminal conditions?
Trajectories include prolonged dying, sudden death, and prolonged frailty.
How do illness trajectories assist in care planning?
They help caregivers anticipate patient needs and improve support during dying.
What are therapeutic boundaries in caregiving?
Therapeutic boundaries maintain professional relationships, focusing on patient needs.
Why is living until the end important in palliative care?
Palliative care emphasizes living meaningfully until death, addressing physical and emotional needs.
What percentage of individuals experience sudden death?
About 10% die suddenly, often from cardiac arrest or strokes.
What are clinical standards indicating death?
Standards include absence of pulse, breath sounds, and fixed pupils after 2-5 minutes.
Explain the difference between brain death and cardiac death.
Brain death is defined as the irreversible cessation of all functions of the entire brain, including the brain stem, while cardiac death occurs when all vital organs and systems cease to function.
How does the experience of death vary across different cultures?
Different cultures have different rituals
Identify the physical manifestations of death related to the cardiovascular system.
Changes in heart rate, weak pulse, low blood pressure
Discuss the sensory changes that occur as death approaches.
Hearing lasts, vision blurs, less feeling
What is self-awareness and how can it be described?
Knowing your own feelings and beliefs.
Explain the implications of altered metabolism during the dying process.
“Body systems slow down
Describe the physical manifestations that may occur as a person approaches death.
Mottling on hands, feet, arms, and legs; cold, clammy skin; cyanosis on the nose, nail beds, and knees; ‘waxlike’ skin when very near death; flattening or drooping of nasolabial folds.
Explain the changes in urinary function that may be observed in a dying person.
Decreased urinary output, incontinence of urine, and inability to urinate.
Define the gastrointestinal changes that can occur during the dying process.
No appetite, slow digestion, nausea, loss of bowel control
How does the nursing role support a dying patient?
Pain relief, comfort, and basic care
Explain the concept of somatic death and its characteristics.
Breathing and circulation stop, body cools.
Describe the process of rigor mortis and its timeline after death.
Rigor mortis is the muscle stiffening that is completed within 12 to 24 hours after death.
Differentiate between neurological death and cardiac death.
Neurological death involves the irreversible cessation of brain function, confirmed by testing for brainstem reflexes and certain cranial nerves, while cardiac death refers to the cessation of heart function.
Describe the psychosocial manifestations that may occur at the end of life.
Fear, sadness, reviewing life, saying goodbye
Explain the role of a nurse in supporting patients at the end of life.
Comfort, information, emotional support.
How can a nurse provide emotional support to a dying patient?
Comfort, information, emotional support
Define the importance of therapeutic touch in nursing care for dying patients.
Shows care and comfort
Do nurses need to consider family dynamics when caring for a dying patient?
Yes, nurses should consider family dynamics as the approaching death of a loved one can be a stressful time for family members, who may experience a range of emotions including sadness and fatigue.
Explain how a nurse can support the family of a dying patient.
Emotional support, information, listening
What are some common fears experienced by patients at the end of life?
Common fears include fear of loneliness, fear of pain, fear of meaninglessness, and anxiety about unfinished business.
Describe the concept of bereavement.
Bereavement refers to the state of loss or death, and the duration of bereavement is individual to each person.
Define grief and its potential manifestations.
Response to loss, affects sleep, appetite, health
How do the Five Stages of Grief function in the grieving process?
Denial, anger, bargain, sad, accept. Not always in order
What is anticipatory grief?
Grief before death
Explain the difference between ‘feelers’ and ‘thinkers/doers’ in the context of grief.
Feelers: strong emotions. Thinkers: problem-solving.
Discuss the awareness of health in relation to grief and loss.
The enigma of health is often recognized only in its absence, and experiences of death, loss, or grief bring this awareness into sharp focus.
Describe the significance of spiritual care in healthcare settings.
Helps with meaning and purpose, reduces hopelessness
Explain the role of the nurse in providing palliative care.
The nurse’s role in palliative care includes direct Care, teamwork, patient support
How do patients generally feel about their spiritual needs being addressed by healthcare teams?
Research indicates that 41-94% of patients desire their spiritual needs to be addressed by their healthcare team.
Define the two most commonly mentioned needs during end-of-life care.
The two most mentioned needs during end-of-life care are making peace with God and pain control.
What is a key consideration when assessing a patient’s spiritual needs?
Important to understand the patient’s needs.
Do healthcare providers need to respect clients’ wishes regarding spiritual care?
Yes, and refer to spiritual care
Explain how personal values can impact the provision of spiritual care.
Be aware of your own beliefs to give respectful care
