End of Life Flashcards
Death occurs when
the lungs and heart cease to function, MODS (multiple organ dysfunction syndrome)
The short interval after the cessation of heartbeat and breathing when no evidence of brain function is present
clinical death
What are some causes of death?
natural aging, emergencies (trauma, cardiac arrest), MODS, disease related (cancer, AIDS)
What are the goals for end of life care?
Control symptoms
Identify client needs, promote meaningful interactions between the client and significant others, facilitate a peaceful death
This kind of care is a philosophy that provides a compassionate and supportive approach to clients and families who are living with life-threatening illnesses, a holistic approach that does not hasten or postpone death, but provides relief of symptoms experienced by the dying client while providing emotional and spiritual support to improve the quality of care at the end of life
palliative care
What is hospice care?
An interdisciplinary approach facilitates both quality of life and a “good” death for clients who are nearing the end of their lives. Hospice programs are often affiliated with home care agencies, providing services to families at home or in an extended care facility.
What are the sx of distress at end of life?
Pain, dyspnea, agitation, N/V, fatigue, weakness, constipation, anorexia and delirium
What are some of the clinical manifestations of end of life?
Lethargy with long periods of sleep, difficulty in communication, distress, constipation, cold, mottled, cyanotic skin, decreased BP, heart rate, respiratory rate
Name the difference in treating patients for comfort care
Similar to palliative; keep the pt clean, dry, odor free, manage acute symptoms causing sx
Aspiration precautions
Mouth care and moisture for lips, altered routes of medication administration if needed—choose the least invasive route of medication administration with the most effective treatment are management for
Fatigue
What is feared most by patients at the end of life?
pain
Pain medications should be scheduled to prevent any recurrence of pain? True or False
True
A nurse should consider alternative route of pain medication administration as needed . True or False
True
What and how would you do as the nurse to manage dyspnea?
Treatment of the primary cause and relieve the psychological distress that accompanies the symptom, meds: Morphine sulfate, diuretics, bronchodilators, antibiotics, anticholinergics
What would you do as the nurse to manage n/v?
Antiemetic agents, especially evident in persons with AIDS or breast, stomach, or gynecologic causes
Treat the underlying cause, administer sedatives, consult with a spiritual and/or bereavement counselor are management for
Restlessness and agitation
Psychosocial assessment includes
Fear, anxiety, cultural considerations and bereavement, feelings of client and significant others
Describe grief
Grief is a natural process to death and
dying.It is not pathological in nature, but
rather, is a necessary response to helping
heal from the overwhelming sense of loss
when a loved one dies.
Denial, anger, bargaining, depression, acceptance are stages in
Grief
In providing emotional and physical support, as the nurse you would
Be realistic about the facts of death and dying, encourage reminiscence of client’s life memories and stories of events, promote spirituality including religion, foster hope for clients and their families, avoid explanations of the loss, communicate with the client, provide eferrals to bereavement specialists
What are some nursing behaviors?
Reliving the event, dreams, increased tobacco use, eating more/less, withdrawal, doubting performance
Legal considerations, such as death certificate, determination of the need for an autopsy, transfer of the body are part of
postmortem care
During post mortem, as the nurse you would
Notify MD, pronouncement, confirm death, document your findings, be sure to include the patient’s condition just prior to death, the presence—or absence—of an advanced directive, who pronounced the death, when the family was notified, and whether donor services were called or an autopsy referral was made.
To prep the body before viewing, you would
Close eyes, mouth( put in dentures), clean up area, position in resting position, valuables
Shroud kit, lines and tubes, transfer to morgue are part of
after viewing
Advanced directives, pronouncement, code or no code, death certificate are part of what issues?
Legal
A document prepared by a competent individual specifying what, if any, extraordinary actions the person would want when no longer capable of decisions about personal health care
Advanced directive
What is a DPOA?
a legal document assigning decision-making power to another
Written instructions for end-of-life care is called
Living will
