End of Life

Question 1

Death occurs when

Answer 1

the lungs and heart cease to function, MODS (multiple organ dysfunction syndrome)

Question 2

The short interval after the cessation of heartbeat and breathing when no evidence of brain function is present

Answer 2

clinical death

Question 3

What are some causes of death?

Answer 3

natural aging, emergencies (trauma, cardiac arrest), MODS, disease related (cancer, AIDS)

Question 4

What are the goals for end of life care?

Answer 4

Control symptoms
Identify client needs, promote meaningful interactions between the client and significant others, facilitate a peaceful death

Question 5

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

Answer 5

palliative care

Question 6

What is hospice care?

Answer 6

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.

Question 7

What are the sx of distress at end of life?

Answer 7

Pain, dyspnea, agitation, N/V, fatigue, weakness, constipation, anorexia and delirium

Question 8

What are some of the clinical manifestations of end of life?

Answer 8

Lethargy with long periods of sleep, difficulty in communication, distress, constipation, cold, mottled, cyanotic skin, decreased BP, heart rate, respiratory rate

Question 9

Name the difference in treating patients for comfort care

Answer 9

Similar to palliative; keep the pt clean, dry, odor free, manage acute symptoms causing sx

Question 10

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

Answer 10

Fatigue

Question 11

What is feared most by patients at the end of life?

Answer 11

pain

Question 12

Pain medications should be scheduled to prevent any recurrence of pain? True or False

Answer 12

True

Question 13

A nurse should consider alternative route of pain medication administration as needed . True or False

Answer 13

True

Question 14

What and how would you do as the nurse to manage dyspnea?

Answer 14

Treatment of the primary cause and relieve the psychological distress that accompanies the symptom, meds: Morphine sulfate, diuretics, bronchodilators, antibiotics, anticholinergics

Question 15

What would you do as the nurse to manage n/v?

Answer 15

Antiemetic agents, especially evident in persons with AIDS or breast, stomach, or gynecologic causes

Question 16

Treat the underlying cause, administer sedatives, consult with a spiritual and/or bereavement counselor are management for

Answer 16

Restlessness and agitation

Question 17

Psychosocial assessment includes

Answer 17

Fear, anxiety, cultural considerations and bereavement, feelings of client and significant others

Question 18

Describe grief

Answer 18

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.

Question 19

Denial, anger, bargaining, depression, acceptance are stages in

Answer 19

Grief

Question 20

In providing emotional and physical support, as the nurse you would

Answer 20

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

Question 21

What are some nursing behaviors?

Answer 21

Reliving the event, dreams, increased tobacco use, eating more/less, withdrawal, doubting performance

Question 22

Legal considerations, such as death certificate, determination of the need for an autopsy, transfer of the body are part of

Answer 22

postmortem care

Question 23

During post mortem, as the nurse you would

Answer 23

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.

Question 24

To prep the body before viewing, you would

Answer 24

Close eyes, mouth( put in dentures), clean up area, position in resting position, valuables

Question 25

Shroud kit, lines and tubes, transfer to morgue are part of

Answer 25

after viewing

Question 26

Advanced directives, pronouncement, code or no code, death certificate are part of what issues?

Answer 26

Legal

Question 27

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

Answer 27

Advanced directive

Question 28

What is a DPOA?

Answer 28

a legal document assigning decision-making power to another

Question 29

Written instructions for end-of-life care is called

Answer 29

Living will