Delivering Bad News

Question 1

What are the seven steps of delivering bad news?

Answer 1

1. Know yourself
2. Create a plan
3. What does the patient know
4. How much does the patient want to know?
5. Sharing the information
6. Responding to patient, family’s feelings
7. Planning and follow up!

Question 2

what are the physiologic changes during the dying process?

Answer 2

• increased weakness, fatigue
• decreased appetite/fluid intake
• decreasing blood perfusion
• neurologic dysfunction
• loss of ability to close eyes
• pain

Question 3

During the process of active dying, state the time frame of when each of these is likely to happen:

a. Death rattle
b. respiration with mandibular movement
c. Cyanosis of extremities
d. lack of radial pulse

Answer 3

a. 24-60 hours
b. 2-5.8 hours
c. 1-5 hours
d. 1-3 hours.

Question 4

Which of the following route of medication administration should you almost never impose on a dying patient? 
A. Oral
B. Rectal
C. Subcutaneous 
D. IV
E. Intramuscular

Answer 4

E. intramuscular.

Always choose the less invasive route of administration first.