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NURSING 232- Exam 1 > End of Life Care > Flashcards

End of Life Care Flashcards

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1
Q

Kübler-Ross’s stages of grief in order.

A
  • Denial
  • Anger
  • Bargaining
  • Depression
  • Acceptance
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2
Q

How is death defined?

A

Cessation of integrated tissue and organ function

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3
Q

How is death manifested?

A 
*Cessation of heartbeat
or
*Absence of spontaneous respirations
or
*Irreversible cessation of brain function
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4
Q

leading cause of death in the united states (besides covid)?

A

Heart disease

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5
Q

Document that designates a person to make health care decisions?

A
  • Healthcare proxy

* Also known as- Durable power of attorney FOR HEALTH/HEALTH CARE

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6
Q

Document that Designates person to make financial transactions.

A

*Durable power of attorney

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7
Q

document that Specifies desired medical treatment

A

*Living will

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8
Q

an advance directive document created by a nonprofit organization that is available online. What does it cover?

A
  • 5 wishes

* Personal, legal, spiritual, and medical wishes

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9
Q

Define palliative care.

A
  • A philosophy of care to prevent and relieve suffering for people with a life threatening illness.
  • anticipating, preventing and treating suffering
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10
Q

Define Hospice care? Where is this done?

A

A philosophy and a concept of care using an interdisciplinary approach for patients and families to facilitate quality of life and a peaceful death
*Usually at home or in special facilities

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11
Q

What does hospice emphasize?

A
  • Emphasizes palliative over curative treatment

* Quality rather than quantity

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12
Q

communication and cooperation among the various disciplines, with each member of the team contributing to a single integrated care plan that addresses the needs of the patient and the family.

A

Interdisciplinary collaboration

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13
Q

hospice care is an application of ________delivered at the _______.

A
  • Palliative care

* End of life

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14
Q

To care for others in the dying process, the nurse must explore what?

A

his or her own feelings about mortality and death and dying.

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15
Q

refers to the personal feelings that accompany an anticipated or actual loss

A

Grief

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16
Q

refers to individual, family, group, and cultural expressions of grief and associated behaviors

A

Mourning

17
Q

refers to the period of time during which mourning for a loss takes place

A

Bereavement

18
Q

Name the stage of grief:

Feelings of isolation. May search for another health care professional who will give a more favorable opinion. May seek unproven therapies.

A

Denial

19
Q

name the stage of grief:

“Why me?” Feelings of rage, resentment, or envy directed at God, health care professionals, family, others.

A

Anger

20
Q

name the stage of grief

“I just want to see my grandchild’s birth, then I’ll be ready….” Patient and/or family plead for more time to reach an important goal. Promises are sometimes made with God.

A

Bargaining

21
Q

name the stage of grief

“I just don’t know how my kids are going to get along after I’m gone.” Sadness, grief, mourning for impending losses.

A

Depression

22
Q

Name the stage of grief

“I’ve lived a good life, and I have no regrets.” Patient and/or family are neither angry nor depressed.

A

Acceptance

23
Q

Four levels of hospice care?

A
  • Respite - 5 day care to relieve caregivers
  • Continuous - continuous nursing care to deal w/ medical crisis, returns to routine once resolved
  • Routine - General hospice homecare
  • In-patient - inpatient care for symptoms that cannot be managed at home.
24
Q

What is seen 1 to 3 months prior to death

A

*Withdrawal- eating, sleeping, lack of communication

25
Q

What is seen 1 to 2 weeks prior to death

A
  • Disorientation
  • Decreased BP/Pulse changes
  • Skin changes - color/increased perspiration/temp changes
  • Respiration irregularities - cheynne-stokes
  • Death rattle - Congestion/secretions
  • Limited fluid/food intake
26
Q

What is seen days to hours before death?

A
  • Symptoms from 1 to 2 weeks intensify
  • Sudden burst of energy
  • Glassy eyes
  • Weak pulse
27
Q

What is seen minutes before death?

A
  • Fish out of water/gasping/lips puff out

* Cannot be awakened

28
Q

Common Meds in hospice kit?

A
  • Compazine - N/V
  • Roxanol (Morphine) - Pain/dyspnea
  • Hyoscamine - dries oral secretions
  • Haldol - Agitation/delirium/vomiting
  • Ativan - anxiety/dyspnea
  • Tylenol supp-mild pain/fever
29
Q

Whats in a seizure kit?

A

depakote 250/500mg supp

Ativan 2mg

30
Q

What is in a cardiac comfort kit

A

Medications addressing edema and chest pain - Nitroglycerin, aspirin, furosemide

31
Q

4 Signs that death has occured

A
  • Cessation of respiratory, cardiac, circulatory function upon auscultation
  • Pupils fixed, dilated, no blinking
  • Body pale and cool
  • Muscles/sphincter relaxed (urine/stool may be released)
32
Q

Post Mortem care?

A
  • Check vitals, pronounce death, sign death certificate
  • Allow family to be alone with client/perform rituals
  • Remove soiled garments/wash client with family assitance
  • If no autopsy planned - cut tubes and lines
33
Q

If client death occurred at home, what does the nurse do?

A
  • Contact funeral director and PCP

* Dispose of hospice meds - do not flush down toilet

34
Q

Medications given to client receiving end of life care for constipation?

A
  • Sennosides

* Milk of magnesia

35
Q

Medications given to client receiving end of life care for diarrhea?

A
  • Loperamide

* Diphenoxylate/atropine

NURSING 232- Exam 1 (5 decks)

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