elnec

Question 1

serious illness

Answer 1

high risk mortality and either negatively impacts daily function, quality life, or strain caregiver

Question 2

sharing prognosis

Answer 2

must do this to ensure the pt is able to take the opportunity to achieve life closure

Question 3

serious illness

Answer 3

need to focus on pain and symptom management more to ensure the pt is cared for and not just trying new technology to cure

Question 4

palliative care

**not end of life care

Answer 4

focuses on expert assessment and management of pain, other s/s, caregiver needs, and coord care. attends physical, functional, psych, practical, and spiritual conseq of serious illness
what’s important to pt, family, and caregivers and congruent w/goals and care tx

**must advocate for the pt

Question 5

social workers

Answer 5

psychosocial assessments, counselors, family care

adult- varies stage life, grief and loss of children

Question 6

np

Answer 6

consult for pt and families
symptom, pain, anxiety management
goals of care
needs of families and needs of pts

Question 7

chaplain

Answer 7

spiritual needs pt, families, staff

Question 8

physician

Answer 8

clinician, educator, directing cirriculum

Question 9

rn role

Answer 9

presence - compassion
care coordination
comm skills - listening
evidence-based practice

Question 10

quality of life model

Answer 10

physical
social
psychological
spiritual

Question 11

continuum of care

Answer 11

disease-modifying tx and palliative care
hospice care - 6 mo or less
death and bereavement support - prove to family 12 mo or longer if needed

Question 12

hospice

Answer 12

spec palliative care with life expectancy measured in months, not years

Question 13

how do people die

Answer 13

sudden death
steady decline
chronic illness
progressive deterioration

Question 14

hospice team

Answer 14

homemakers and hospice aids
nurses
physicians
chaplains
social workers
bereavement counselors
speech, OT/PT
volunteers

Question 15

hospice vs palliative care

Answer 15

palliative care = serious illness and in any setting, can receive disease-modifying tx, different financial payments and circumstances

hospice last 6 mo life and usually at home, specific financial option with medicare (medicare hospice benefit)

Question 16

8 domains of palliative care

Answer 16

structure and process of care
physical aspects of care
psychological and psychiatric aspects of care
social aspects of care
spirit, relig, existential aspects of care
cultural asp care
care pt nearing end of life
ethical and legal aspe of care

Question 17

barriers to communication

Answer 17

1. fears surrounding death - avoidance, not knowing answers, expressing emotions leads to avoidance of tough topics
2. lack of personal experience w/death
3. HCP insensitivity
4. provider sense of guilt over failure to pt
5. desire to support
6. disagreement w/ pt and family decisions
7. lack of knowledge and understanding of pt culture
8. personal grief hcp experiencing
9. ethical concerns

Question 18

culture

cultural considerations super important - pull up chair and ask whats important to pt and family

Answer 18

cultural humility - acknowledge own biases and value may interfere w pt values

Question 19

pain

Answer 19

whatever the pt says it is - subjective
barriers
- HCP
- healthcare system
- pt, families, society

unable?

• pain ass in advanced dementia (PAINAD)
• pediatric - face, legs, activity, crying, consolidation (FLACC)

Question 20

tx n/v

Answer 20

anticholinergic - tx motion sickness
antihistamine- intestinal obstruction, incr intracranial pressure,
steriods- cytotoxic-induced emesis
prokinetic agents- gastric stasis or ileus
benzos- nausea w/anxiety
5-HT3 receptor agonists post op n/v

Question 21

med cause constipation

Answer 21

opiates
antidepressants
antacids
chemo
 serotonin antagonist antiemetics

Question 22

bereavement

Answer 22

period grief and mourning that occurs after loss

Question 23

mourning

Answer 23

outward, social expression of loss

affects survivors physically, psychologically, socially, and spiritually

Question 24

types grief

Answer 24

anticipatory- before loss
acute- 
normal
disenfranchised- loss not validated or recognized
complicated