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562 > End Of Life > Flashcards

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
Q

Artificial nutrition and hydration will prolong life by days or weeks but will cause what

A

Physical and emotional damage

26
Q

What is essential in end of life care

A

Honest compassionate communication

27
Q

Guidelines in communicating about illness and death

A 
Listen 
make empathetic statements 
elicit the patients values and goals of care 
Offer information about prognosis 
discuss death explicitly 
maintain cultural sensitivity
28
Q

What should conversations about death and dying always consider

A

Pts cultural and ethnic background and spirituality

29
Q

What is called the fifth vital sign

A

Pain

30
Q

Other effects pain has

A

Physical and emotional

31
Q

Severe chronic pain cause

A

Depression anxiety fear decreased appetite impaired sleep thoughts of suicide (often disappear when pain is releived)

32
Q

What does jcaho require

A

Hospitals and other healthcare facilities regularly assess monitor and manage pain in all patients

33
Q

Pain meds should be given what

A

Freely to relieve pain with the concern of addiction

34
Q

What should define the goal of pain management

A

Patient preferences

35
Q

Who may have a higher pain threshold

A

Older pts

36
Q

Why might older pts have a higher pain tolerance

A

Age related charges in neurophysiology

37
Q

What may perception of pain be affected by

A

Cultural considerations

38
Q

Side effects of opioid therapy

A 
Drowsiness
Nassau vomitting
Dyspenea 
Constipation
Dry mouth
39
Q

What the most common fears

A

Fear of death
fear pain
of dying alone
fear of being a burden

40
Q

Depression can be caused by

A

Weak support system
Persistent negative thinking
Increased dysfunction related to the illness
Untreated or under treated pain

41
Q

What can loss consist of

A 
Physical strength
Abilities
Mental abilities
Relationships
Self esteem
Body image 
Independence
Control over life plans and lifestyle
42
Q

What is grief

A

The normal human response to loss

Is universal individual and unpredictable

43
Q

Stages of grief

A

Shocking and numbing
yearning and searching
disorganization and despair
some degree of reorganization

44
Q

What is bereavement

A

Being deprived of someone through death and the feeling of desolation that follows

45
Q

What to consider for family of the dying pt

A

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
Q

Signs that death has occured

A 
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
Q

What is pronouncement

A

Formal process of death being certified by a physician

48
Q

When should organ donation be discussed

A

When preparing advance directives

49
Q

What is palliative care

A

Refers to patient and family centered care of that optimizes quality of life by anticipating preventing and treating suffering

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