End Of Life Flashcards

1
Q

What does palliative care involve

A

Addresses physical intellectual emotional social and special needs and facilitating patient autonomy access information and choice

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2
Q

Why Use palliative care

A

Relief from pain and other distressing symptoms
Affirms life and regards dying as a normal process
Intends neither to hasten nor postpone death
Offers a support system to patients and family

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3
Q

What does it integrate

A

Psychosocial and spirituals aspects of care

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4
Q

When does it begin

A

When a life threatening condition is diagnosed

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5
Q

What are the top priorities for a loved one with terminal illness

A

Someone to be sure that the patient’s wishes are honored choice among the type of services the patient can receive
pain control Taylored to the patient’s wishes
emotional support for the patient and family

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6
Q

The goal of palliative care

A

To relieve pain symptoms and stress of serious illness

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7
Q

Palliative care offered to

A

Those undergoing curative treatment even at the early stages of a serious and complex illness

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8
Q

The gold standard for end-of-life care

A

Hospice

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9
Q

What is the central belief of hospice

A

Each person is entitled to a pain-free death with dignity and that families are entitled to the support necessary to allow that to happen

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10
Q

Kind of approach is hospice based on

A

Interdisciplinary

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11
Q

What does the team for hospice develop

A

Individualized care plan to meet each patient’s needs for pain management and symptom control

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12
Q

Are Medicare covered hospice services

A
Physician  services
 nursing care 
medical equipment 
medical supplies 
drugs for symptom control 
short term care in the hospital 
short term respite care 
home health aide 
homemaker services 
PT and OT 
speech therapy 
social worker 
Dietary counseling 
Bereavement for patients families
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13
Q

What does the right to die concept include

A

Suicide or voluntary active euthanasia

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14
Q

Where is right to die legal

A

Montana Oregon and Washington

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15
Q

What can be some disparities in end of life

A

Geographic racial and ethnic and language

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16
Q

Is palliative sedation therapy

A

The lowering of patient consciousness using medications for the express purpose of limiting patients awareness of suffering that is intractable an intolerable

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17
Q

What are advanced medical directive’s

A

Documents containing patient’s oral and written expression’s other preferences about future medical care if they should become unable to speak for themselves

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18
Q

Palliative sedation therapy equated with

A

Euthanasia

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19
Q

What does federal law require

A

Hospitals to inform patient that they have the right to complete advanced directive

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20
Q

What are advanced medical directive’s usually in the form of

A

A living will or medical power of attorney

21
Q

What was a do not attempt resuscitation order formerly

A

Do not resuscitate

22
Q

Where should A do not attempt resuscitation order to be placed

A

Head or foot of bed refrigerator

23
Q

How to many older patients choose to end their lives

A

Refusing food and liquids

24
Q

When does death occur in refusing food and liquid

A

Within 15 days
Little pain and suffering
No hunger or thirst experienced

25
Artificial nutrition and hydration will prolong life by days or weeks but will cause what
Physical and emotional damage
26
What is essential in end of life care
Honest compassionate communication
27
Guidelines in communicating about illness and death
``` Listen make empathetic statements elicit the patients values and goals of care Offer information about prognosis discuss death explicitly maintain cultural sensitivity ```
28
What should conversations about death and dying always consider
Pts cultural and ethnic background and spirituality
29
What is called the fifth vital sign
Pain
30
Other effects pain has
Physical and emotional
31
Severe chronic pain cause
Depression anxiety fear decreased appetite impaired sleep thoughts of suicide (often disappear when pain is releived)
32
What does jcaho require
Hospitals and other healthcare facilities regularly assess monitor and manage pain in all patients
33
Pain meds should be given what
Freely to relieve pain with the concern of addiction
34
What should define the goal of pain management
Patient preferences
35
Who may have a higher pain threshold
Older pts
36
Why might older pts have a higher pain tolerance
Age related charges in neurophysiology
37
What may perception of pain be affected by
Cultural considerations
38
Side effects of opioid therapy
``` Drowsiness Nassau vomitting Dyspenea Constipation Dry mouth ```
39
What the most common fears
Fear of death fear pain of dying alone fear of being a burden
40
Depression can be caused by
Weak support system Persistent negative thinking Increased dysfunction related to the illness Untreated or under treated pain
41
What can loss consist of
``` Physical strength Abilities Mental abilities Relationships Self esteem Body image Independence Control over life plans and lifestyle ```
42
What is grief
The normal human response to loss | Is universal individual and unpredictable
43
Stages of grief
Shocking and numbing yearning and searching disorganization and despair some degree of reorganization
44
What is bereavement
Being deprived of someone through death and the feeling of desolation that follows
45
What to consider for family of the dying pt
Time and logistics (24/7 care) Physical tasks - risk for injury Financial Caregiver emotional burden and mental health Physical health risks for caregiver (respite care)
46
Signs that death has occured
``` No respiration or pulse Eyes open but don't move or blink Jaw relaxed and mouth slightly open Bowel and bladder expelled Don't respond to touch or speech ```
47
What is pronouncement
Formal process of death being certified by a physician
48
When should organ donation be discussed
When preparing advance directives
49
What is palliative care
Refers to patient and family centered care of that optimizes quality of life by anticipating preventing and treating suffering