End of life care

Question 1

What is hospice care

Answer 1

Provision of medical and psychosocial care to support clients who have a terminal illness so as to allow them to live the last days of their life as best as they can

Question 2

Admission criteria for hospice care

Answer 2

Diagnosis of a life expectancy of 6 months
1. Hospice provider and primary care provider officially state pt is terminally ill
2. Pt must agree to palliative care
3. Pt is required to sign a statement that they are choosing hospice care

Question 3

Focus of hospice care

Answer 3

Comfort, dignity, and personal growth

Question 4

What is respite care

Answer 4

a service or agency that provides primary caregivers with a short-term break from the responsibilities of client care

Question 5

Benefits of respite care

Answer 5

Allows caregivers to rest while knowing that their loved one is in the safe hands of professionals

Question 6

What is palliative care

Answer 6

Holistic care provided for clients throughout the lifespan who are experiencing a severe medical illness
Concentrated on lessening the client’s distress

Question 7

Goal of palliative care

Answer 7

Improve client’s quality of life, reduce time in the hospital, and improve pt satisfaction

Question 8

Difference between palliative and hospice care

Answer 8

Can be provided while the client is still receiving curative treatments
Any client with a life-limiting disease, regardless of projected life expectancy or prognosis, is eligible to receive this care

Question 9

Breathing and respirations for someone dying

Answer 9

Dyspnea
Death rattle: retentions of secretions in respiratory tract which causes congestion and a rattling sound
Cheyne-Stokes Respirations

Question 10

Nursing interventions for breathing and respirations

Answer 10

Dyspnea: opioids, O2 therapy, positioning, using a fan, anxiolytics
Death rattle: turning client’s head to side or rolling client on side, medications, moist washcloth and oral suctioning
Cheynestokes: positioning fan (typical and expected)

Question 11

3 step ladder for administering pain management

Answer 11

NSAIDs→codeine or tramadol → morphine

Question 12

what is mottling

Answer 12

Upper and lower extremities become cold to the touch accompanied by purple or reddish marbling of the skin

Question 13

Causes of mottling

Answer 13

heart’s inability to pump blood effectively = decreased blood perfusion
Begins in feet and moves up the legs

Question 14

Interventions of mottling

Answer 14

warm blankets

Question 15

Vision and hearing near the end of death

Answer 15

Experience hallucinations

Question 16

Nursing intervention for vision and hearing

Answer 16

don’t deny hallucinations = aggravation and distress. Provide reassurance

Question 17

End of life goals

Answer 17

Preventing social isolation
Managing client manifestations
Maintaining spirituality and dignity
“Good death”

Question 18

What is postmortem care

Answer 18

physical care performed after a client has died to prepare the client’s body for viewing, autopsy, or release to a funeral home

Question 19

Nursing interventions of post mortem care

Answer 19

washing the body, making sure possessions are accounted for, and placing identification tags

Question 20

Documentation of post mortem care

Answer 20

Documents date and time of death, name of anyone notified, location of client’s belongings, and where the client’s body is moved

Question 21

Physical manifestations of a grieving nurse

Answer 21

feeling of tightness in the chest or the inability to breathe, muscle discomfort, headaches, agitation, sleep disturbances, gastrointestinal problems, and heart palpitations.

Question 22

Psychological manifestations of a grieving nurse

Answer 22

anger, irritation, unhappiness, sleeplessness, exhaustion, difficulty staying focused, and altered eating patterns.

Question 23

Coping mechanisms for the grieving nurse

Answer 23

self-care activities: exercise, eating well-balanced meals, setting boundaries, and taking time for oneself