Death and Dying & Pt Education Flashcards
What are the 5 stages of Kubler Ross stages of grief ?
- denial
- anger
- bargaining
- depression
- acceptance
What is denial ?
cannot accept the fact of the loss
- form of protection from loss they cannot yet bear
What is anger ?
expresses resistance or anger at God, other people, the situation
What is bargaining ?
postpones awareness of the loss by trying to prevent it from happening
What is depression ?
realizes the full impact of the loss
What is acceptance ?
incorporates the loss into their life
What is palliative care ?
pt experiencing severe medical illness particularly for pt’s approaching end of life
- can receive palliative care with also curative treatments
What is the goal of palliative care?
help pt’s and families achieve best possible quality of life
What is the focus of hospice care ?
providing comfort, dignity, and personal growth
What is hospice care ?
for pt’s that usually have less than 6 months to live
- available in home, hospital, extended care, or nursing home settings
How does hospice care involve the family towards the end of life of the patient ?
the hospice team provides intensive support to the pt and family
What is something you need to be eligible for hospice care ?
for home hospice services
- pt must have family caregiver to provide care when patient is no longer able to function alone
- to help for hygienic needs
- RN coordinates and manages symptoms relief
What are some pain relief measures for the skin ?
- provide skin care
- apply lotion to skin
- dry clean linens
What are some pain relief measures for the mucous membrane discomfort ?
- provide oral care (include tongue) q 2-4 hrs
- apply lip balm
- apply topical analgesics to oral lesions
- cause: mouth breathing or dehydration leads to dry MM, tongue or lips become dry or chapped
What are some pain relief measures for corneal irritation ?
- apply artificial tears to reduce corneal drying
- cause: blinking reflexes diminish near death which cause drying of the cornea
What are some pain relief measures for altered LOC ?
- keep calm, comfortable, safe
- don’t try to reorient to space since it can only confuse them further
What are some pain relief measures for nausea ?
- give antiemetics
- discontinue med or food that cause nausea
- provide oral care q2-4 hrs
- offer clear liquid diet and ice chips
- avoid acid foods
- cause: decreased intestinal blood flow with impending death, meds, or pain
What are some pain relief measures for constipation ?
- use stimulant laxative with opioids
- dietary alterations as preferred
- increase fluid intake
- cause: opioids, meds, and immobility slow peristalsis
What are some pain relief measures for diarrhea ?
- assess for fecal impaction
- confer with HCP to change meds
- protect skin with moisture barrier
What are some pain relief measures for altered perfusion ?
- keep comfy temp
- normally do not check VS very often
- cause: coolness and color changes in extremities, nose, fingers
What are some pain relief measures for ineffective breathing patterns (dyspnea, SOB) ?
- position for comfort
- provide O2
- use fan for air movement
- cause: anxiety, pain, increased O2 demand, disease process, anemia
What are some pain relief measures for noisy breathing “death rattle” ?
- HOB up
- turn from side to side
- stop PO intake
- avoid suctioning because of discomfort and ineffectiveness
- anticholinergics meds can be useful
What is the cause of noisy breathing “death rattle” ?
sound of secretions moving in the airway during inspiratory and expiratory phases caused by thick secretions, decreased muscle tone, swallow and cough
What are some pain relief measures for dehydration ?
- give mouth care q2-4 hrs
- keep lips and tongue moist
- cause: pt less willing to maintain PO intake
What are Cheyne Stokes respirations ?
irregular respiratory rate
- fluctuations in several quick breaths to periods of apnea
What should the priority be with patient that are experiencing hallucations ?
reorientation at this time is little benefit if they are actively dying
- focus should be on pt safety, and preventing pt injury
What are guidelines for body after death ?
- elevate HOB (prevent discoloration of face)
- ask family if they want to participate in any special requests
- remove all equipment, tubes, indwelling lines (unless autopsy)
- cleanse body
- cover with clean sheet, head on pillow, close eyes, leave dentures in, cover signs of trauma
What are the 6 stages of cognitive learning ?
- knowledge
- comprehension
- application
- analysis
- synthesis
- evaluation
What is cognitive learning ?
thinking domain
What is affective domain ?
based on emotions and involves the pt’s feelings
- pt evaluate their values, beliefs, and attitudes to process educational material
What is psychomotor domain ?
use of fine and gross motor skills in learning
- stoma care
What are examples of cognitive teaching strategies ?
- lecture
- question and answer
- discussion
What are some examples of affective teaching strategies ?
- discussion
- role play
What are some examples of psychomotor teaching strategies ?
- demonstration
- return demonstration
- games
What are the steps of the nursing process ?
- assessment
- diagnosis/pt problem
- planning
- implementation
- evaluation
