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HEA 300 > Death and Dying > Flashcards

Death and Dying Flashcards

1
Q

True or False: modern medicine has enabled people to survive illnesses that once caused death

A

true

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2
Q

Ventilators and feeding tubes allow medical practitioners to do what for patients?

A

sustain their life from weeks, months even years after traditional standards would say they’re dead.

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3
Q

21 y/o admitted to NJ, suffered cardiopulmonary arrest, placed on ventilator, tracheotomy, nasogastric tube, comatose, permanently vegetative, EEG was absnormal, brain scan was within normal limits

A

Karen Ann Quinlan Case

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4
Q

How many months was Karen Ann Quinlan comatose while her body deteriorated?

A

9 months

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5
Q

True or False: Loss of heartbeat, body color, and stiffness (rigor mortis) are considered criteria for death

A

true: debate over using cardiac definition or brain oriented definition of death.

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6
Q

Cardiac Death

A

heart stops functioning, legal death, irreversible loss of cardiac function

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7
Q

True or False: patients who are clinically dead may not be resuscitated with CPR

A

false, they can (dnr?)

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8
Q

caridiac death causes problems with what?

A

organ transplants ( heart needs to be beating)

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9
Q

When can cessation of pulse and breathing be reversable?

A

drug overdose, hypothermia

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10
Q

brain oriented death

A

irriversible cessation of all brain function

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11
Q

brain is dead the person is considered

A

deceased, dead

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12
Q

An irreversible brain condition where the patient is in a deep state of unconsciousness is called…

A

Persistent Vegetative State (PVS)

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13
Q

What are the three Harvard Criteria for irreversible coma ?

A

Patient is unreceptive and unresponsive, unaware of external stimuli, no spontaneous movements of breathing, no reflexes, fixed dilated pupils, lack of eye movement, lack of dep tendon reflexes.

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14
Q

Irreversible coma is also known as

A

brain death

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15
Q

Before the ventilator can be removed, what must be declared?

A

Brain death

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16
Q

What requires an EEG to determine absence of brain activity, then repeated again in 24 hours?

A

Harvard Criteria

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17
Q

Any individual, who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.

A

Uniform Determination of Death Act (1980)

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18
Q

Withdrawing life sustaining treatment

A

discontinues treatment after it’s been started (artificial ventilation)

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19
Q

withholding life-sustaining treatment

A

never started, harder to stop once started,

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20
Q

euthanasia

A

good death

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21
Q

right to die, aid in dying, assisted suicide

A

euthanasia

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22
Q

intentional killing of terminally ill

A

active euthanasia

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23
Q

withholding medical interventions to only serve to sustain life

A

passive euthanasia

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24
Q

dying process is neither inhibited or accelerated

A

passive euthanasia

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25
Q

Jack Kevorkian, MD

A

Active Euthanasia

26
Q

Arguments in favor of euthanasia

A

autonomy, harvesting viable organs, relief for family of patient with incurable disease, end terminal ly ill person’s suffering

27
Q

Arguments against euthanasia

A

terminally ill patients known to recover, modern tech may find a cure, people may use it to relieve financial burden, it could be used indiscriminately, not good for society to have physicians kill patients or patients to kill themselves

28
Q

Against permitting assisted suicide saying it would eventually lead to diminishing respect for life

A

slippery slope

29
Q

woman PVS for 8 years after auto accident. feeding tube, , parents fought to have it removed. died 12 days after removal

A

Nancy Cruzan (1983)

30
Q

woman PVS, medical malpractice lawsuit won, husband wanted to remove wife’s feeding tube, parents opposed, pathologists said she uttered “stop”, died 15 years and 13 days after her accident

A

Terri Schiavo Case (1990)

31
Q

Death is the result of another persons intended action or inaction

A

direct killing

32
Q

death is the result of an unintentional action of another person

A

indirect killing

33
Q

an action may have two consequences, desired and undesired

A

principle of double effect

34
Q

treatment or procedures that is morally required

A

ordinary means

35
Q

procedures and treatments that are morally expendable

A

extraordinary means

36
Q

Right to Die Legislation or Right to Refuse treatment

A

patients have the right to refuse treatment, courts have rules that patients must be mentally competent, patient’s refusal places their lives in danger, legal action sometimes results (guardian appt)

37
Q

stages of dying

A

denial, anger, bargaining, depression, acceptance

DABDA

38
Q

Who came up with the five stages of the dying process?

A

Dr. Elizabeth Kubler-Ross

39
Q

Refusal to believe dying is taking place

A

denial

40
Q

patient is angry with everyone

A

anger

41
Q

gain time by making promises, be patient

A

bargaining

42
Q

deep sadness over loss of health, independence and eventually life. sadness about leaving loved ones, withdrawn

A

depression

43
Q

sense of peace and calm, i am ready to die

A

acceptance

44
Q

These measures can assist with making healthcare decisions based on clinical factors, cost and issues that the patient believs are important

A

Quality of Life Issues

45
Q

Quality of Life Measures include (name 4)

A

general health, physical functioning, role limitations, pain, social function, vitality, mental health

46
Q

True or False: Most terminally ill patients wont live long enough to become addicted to heavy doses of narcotics

A

true, although physicians are still reluctant to do prescribe them

47
Q

True or False: dying patients often spend most of their last days in comfort

A

false, they are in moderate to severe pain

48
Q

The fundamental responsibility of physicians to relieve pain

A

HIppocratic Oath

49
Q

True or False: Few physicians believe that patients pain and suffering should be controlled with the use of adequate medications

A

False: MANY physicians believe it.

50
Q

9 million Americans live with cancer, 2/3 with advanced disease have significan pain. How much receive adequate pain control?

A

only half!

51
Q

Originated in France to keep terminally ill patients as pain free as posible

A

Hospice Care

52
Q

Hospice Care is also known as

A

death with dignity

53
Q

Focuses on comfort measures, emotional support and pain free environment

A

Hospice Care

54
Q

Hospice patients are typically there during their last few ____ of life.

A

weeks

55
Q

True or False: During hospice, patients are kept awake and alert so they can spend some of their last moments with their family members.

A

True

56
Q

Total care of patients whose disease in no longer responsive to curative therapy

A

Palliative Care

57
Q

Palliative care is meant to provide ____ of pain and suffering.

A

relief

58
Q

Allows people with terminal illness to obtain money from life insurance policies by selling them

A

Viatical Settlements

59
Q

Viatical Settlements are _% - __% percent discount on face value of patients insurance to have ___ access to money

A

20 - 50, immediate

60
Q

What are some things Viatical Settlements are used for?

A

medical and nursing care during final illness, vacation with family, experimental medical treatment that health insurance wont cover.

61
Q

Mandates that adult patients receiving either medicare or medicaid be asked if they have an advanced directive or want information on the patient self-determination directives (living will)

A

Advance Directives

The Federal Patient Self-Determination Act (1991)

62
Q

If someone attempts suicide they may be place in ________ care if the present ______ to themself or others

A

psychiatric, danger

HEA 300 (3 decks)

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