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IM3 > End Of Life Care > Flashcards

End Of Life Care Flashcards

1
Q

What is the definition of end of life care

A

Term used for issues and services related to death and dying

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2
Q

What doe palliative care do for pt’s

A

Reducing severity of disease symps
Improve QOL
Decrease economic costs of health care
Alleviate burden of caregivers
Pain control

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3
Q

What is hospice care

A

A concept that helps a pt die pain free and with dignity

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4
Q

A physician decides to place a pt on hospice care when they feel that the pt has how many months to live

A

6 months

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5
Q

When a pt is on hospice are they allowed to try new cures or survives for their illness

A

No

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6
Q

If a pt chooses to seek a cure while they are on hospice, what happens

A

The pt will be discharged from hospice and able to go seek treatment

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7
Q

Can a pt join or leave hospice at any point

A

Yes they can

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8
Q

If a pt on hospice goes to the ER and chooses to be admitted to the hospital, what happens to their hospice

A

they are discharged from hospice but can come back after being discharged from the hospital

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9
Q

Hospice wants to provide the best

A

Best quality of life

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10
Q

What settings can hospice care be done

A

Home
Inpatient settings
acute and long-term care facilities
Rehabilitation centers

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11
Q

What are the four levels of hospice care

A

Routine home care
Inpatient respite care
Continuous care
General pt care

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12
Q

What defines routine home care

A

Med admin
Daily baths
Hospice pays for meds and DMEs
Full care at home

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13
Q

What is inpatient respite care

A

It is where the family can choose to put pt in a facility for 5 days to take a break and get rest

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14
Q

What is continuous care

A

Caregiver stays all day or goes multiple times a day

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15
Q

When giving pain meds to hospice pts are we worried about respiratory distress with those pain meds

A

No because hospice pts are in lots of pain and need these meds

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16
Q

Why do we want to do a spiritual assessment of pt and family

A

Want to know these beliefs for comfort

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17
Q

Why should we assess and manage family needs

A

We always worry about the family and want them to be comfortable along with the pt

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18
Q

We need to teach the family about what management in general

A

Pain management

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19
Q

What are the four awareness contexts

A

Closed awareness
Suspected awareness
Mutual pretense awareness
Open awareness

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20
Q

What is the definition of closed awareness

A

Everyone in family knows pt is dying but do not want the pt to know
So hospice cannot say they are from hospice

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21
Q

What is the definition of suspected awareness

A

Pt suspects something is going on but the family hasn’t told them anything about what is going one

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22
Q

What is the definition of mutual pretense awareness

A

Pt and family are aware of pt dying but no one is talking about what’s happening

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23
Q

What is the definition of open awareness

A

Everyone knows what’s going on (pt and family)

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24
Q

What two DNRs do hospice pts need

A

In hospital and out of hospital DNRs

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25
Q

What two advanced directives should hospice pts have

A

A living will
Power of Attorney

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26
Q

What is a living will

A

This is what pt wants done in case something happens to them

27
Q

What is a power of attorney

A

In case pt is incapacitated this distinguishes a person to make medical decisions on their behalf

28
Q

What is assisted suicide

A

Where you are given meds to kill yourself but you get to choose when and where. A medical professional does not give you these drugs

29
Q

Is assisted suicide legal

A

Yes, but only in some states

30
Q

What is euthanasia

A

A medical professional hooks you up to iv and runs the meds that will kill you

31
Q

Is euthanasia legal

A

No it is not

32
Q

For assisted suicide you must have proof of what

A

Proof of terminal illness

33
Q

As hospice nurses we need to ask what a pt wants done, like?

A

Organ & tissue donations
Advanced directive
Resuscitation
Mechanical ventilation
Tube feeding placement

34
Q

What are barriers to end of life care

A

Cures for disease
Financial criteria, reimbursement issues
Cultural, social issues
Discomfort with death (family, pt, and med staff)
Psychological, coping responses to death, dying denial

35
Q

What do hospice pts have to be on in order to have care

A

Insurance or Medicaid/Medicare

36
Q

When communicating with a hospice pt we should

A

Reflect on pwn experiences
Use lay terms, not medical jargon
Respect cultural background
Be fully present in convo
Silence is okay
Allow pt, family to set agenda regarding depth of convo
Allow pt and family time to reflect
Avoid distractions
Avoid impulse to give advice
Avoid canned responses
Ask q’s
Address your and pt’s understanding

37
Q

We should give culturally competent care by owing what

A

Understand cultures may have different processes about death
Assess nonverbal cues

38
Q

Is spiritual care synonymous with religion

A

No

39
Q

Does spirituality include religion

A

Yes

40
Q

As hospice nurses we must assess the spirituality because

A

It’s an important care of a dying pt

41
Q

What physical care do hospice nurses do

A

Symptom management and comfort
Priority is to meet physiologic and safety needs
Deserve and require same care as people who are expected to recover

42
Q

As end of life care nurses we should help treat these 5 symptoms

A

Pain
Dyspnea
Nausea
Weakness
Anxiety

43
Q

What are signs of approaching death

A

Refusal of foods/fluids
Urinary output decreases
Weakness, sleep, confusion, restlessness
Impaired vision/hearing-hallucinations
Thick secretions
Cheyenne-Stokes Reparations
CV changes
Integumentary changes - develop mottling, Kennedy terminal ulcer
Third-spacing

44
Q

As death approaches we need to monitor for

A

System failure

45
Q

If pt is alert we need to review body systems to detect

A

S/S

46
Q

If patient is alert we need to also asses for what four things

A

Discomfort
Pain
Nausea
Dyspnea

47
Q

We need to asses what abilities of pts and family

A

Coping

48
Q

We need to pay attention to subtle ___ changes

A

Physical

49
Q

We need to advocate for our pt’s what when they are passing

A

Needs

50
Q

We need to make sure pt’s psychosocial needs are met like (7)

A

Anxiety
Depression
Anger
Hopelessness
Powerlessness
Fear
Communication

51
Q

Pts may have a fears such as (5)

A

Pain
SOB
Loneliness
Abandonment Meaninglessness

52
Q

We need to have these four parts of communication

A

Empathy
Active listening
Silence
Respect cultural differences

53
Q

What physical care do we do for end of life care

A

Oxygen
Nutrition
Pain relief
Mobility
Elimination
Skin care
Postmortem care

54
Q

What concepts go into postmortem care

A

Pronouncement of death
Allow privacy & as much time as family needs with deceased
When to call medical examiner
Security takes body to morgue
Security releases the body to the morgue

55
Q

When do we need to call medical examiner

A

Death upon arrival or death occurs w/in 24 hrs of admission
Death was result of homicide or unnatural means
Absence of a witness
Suicide or suspected suicide
Dies w/o being seen by a licensed provider
Child younger than 6 when death is not expected

56
Q

What should we document when a pt passes in our care

A

What time vitals ceases
Who pronounced death at what time
What postmortem care was done
Where are pts clothing and valuables and who did we give them too. If there is not family give belongings to security
What time and who came to pick them up for the morgue
Name of funeral home
Is there going to be an autopsy
Across the dismissal form write deceased

57
Q

What is bereavement (grief)

A

3 days after death

58
Q

Grief is a

A

Reaction to loss

59
Q

What is anticipatory grief

A

Know death is coming. Grieving at diagnoses and then grieving again once family member has passed

60
Q

What is adaptive grief

A

Acceptance of the person passing and moving on with life

61
Q

What is prolonged grief disorder

A

Family stops living and grieves
Do not live for themselves anymore

62
Q

What are the 5 stages of grief according to the Kubler-Ross model

A

Denial
Anger
Bargaining
Depression
Acceptance

63
Q

What comprises the grief wheel model

A

Shock
Protest
Disorganization
Reorganization

IM3 (47 decks)

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