End Of Life

Question 1

End of life

Answer 1

Is when there is no cure for a persons disease and the focus is on comfort care and dignity

Question 2

Palliation

Answer 2

Relief of suffering when a cure is impossible

Question 3

Terminal phase

Answer 3

Is a phase within end of life when the patient is actively dying

Question 4

End of life 2

Answer 4

The process of dying is an individualised one, unique because of a person’s life experiences and belief

Question 5

Goals for end of life

Answer 5

Respect of patient and family wishes
Patient and family feel a sense of control over the situation
Patient is physically comfortable
Patient has spiritual support according to their wishes

Question 6

Psychological needs

Answer 6

Denial
Anger
Bargaining 
Depression 
Acceptance

Question 7

Communication

Answer 7

Communication is through presence, compassion, touch, promoting autonomy and honesty

Nurses may facilitate patients being able to express their needs by being open, honest, direct and empathic in their communication

Question 8

Spiritual needs

Answer 8

Meaningful existence
Ability to find meaning in daily experience
Ability to transcend physical discomfort and prepare for death
Respect for religious beliefs and rituals

Question 9

Physical needs

Answer 9

Pain
Respiratory distress 
Constipation
Poor nutrition intake
Anorexia 
Dehydration 
Decreased muscle tone

Question 10

Nausea and vomiting causes

Answer 10

Bowel obstruction
Medication
Ear infection
Kidney/liver failure
Increased intracranial pressure
Offensive odours
Anxiety

Question 11

Non pharmacological treatment nausea

Answer 11

Review diet
Small frequent mela
Reduce environmental odours
Good oral care
Good bowel management 
Review meds

Question 12

Pain non-pharma

Answer 12

Hot/cold packs
Positioning
Relaxation
Distraction therapy

Question 13

Dyspnoea

Answer 13

Upright position
Open windows
Oxygen therapy dries the nasal mucosa and may create more distress
Fan

Question 14

Constipation non pharma

Answer 14

Encourage fluids
Gentle exercise
Gentle abdominal massage

Question 15

Insomnia (non-pharma)

Answer 15

Encourage good routines
Address concerning issues
Refer to social worker

Question 16

Signs of imminent death

Answer 16

Decline in bp
Weak pulse
Dyspnea and periods of apnea
Reduced pupil response to light
Profuse perspiration 
Cold extremities
Faecal or urinary incontinence
Pallor
Reduced level of consciousness 
No urine 
Dependent oedema
Blurred vision

Question 17

Decision making

Answer 17

Advanced care planning that is supported by good communication and promotes patient autonomy in regards to paitentwishes is the cornerstone for providing effective for patients transitioning into the end of life stage

Question 18

Decision making parts

Answer 18

The person must be competent and have the capacity to participate in the decision making process

Process are in place that protect the individuals autonomy when they can no longer explicitly express their wishes

Advanced care directive
Proxy directive

Question 19

Advanced care directives

Answer 19

Living will

Question 20

Proxy directive

Answer 20

Enduring power of attorney

Question 21

Decisions are made regarding end of life

Answer 21

Environment
Funeral
Care options
Medical treatment

Question 22

Practical assistance from the nurse

Answer 22

Aggressive treatment pf any distressing symptoms

Open and honest communication

Ongoing discussion of patient’s goals

Psychological and spiritual support

Interdisciplinary approach to provide for holistic care

Support pf bereaved families