End of Life Care Flashcards
When is a person actually dead?
when lungs and heart cease to function
Define clinical death
The short interval after cessation of heartbeat and breathing when no evidence of brain function is present
What are 4 causes of death?
natural aging, emergencies (trauma, cardiac arrest), MODS (multiple organ system failure), disease related (cancer, aids)
What are some goals for end-of-life care?
control symptoms, identify client needs, promote meaningful interactions between the client and significant others, and facilitate a peaceful death
A holistic approach that does not hasten or postpone death, but provides relief of symptoms experienced by the dying client while providing emotional and spiritual support to improve the quality of care at the end of life is defined as what?
Palliative Care
True or False, An interdisciplinary approach facilitates both quality of life and a good death for clients who are nearing the end of their lives is defined as Palliative Care.
False, Hospice Care
What are some common symptoms of a patient at End-of-Life?
pain, dyspnea, agitation, nausea, vomiting, fatigue, weakness, constipation, anorexia, delirium
A patient comes into the ER cold, mottled, and cyanotic skin. What would you expect his BP, HR, and RR to be? Increased or decreased?
Decreased
As a nurse caring for a patient on comfort care, what are our main goals?
keep patient clean, dry, and odor free. Manage acute symptoms causing most problems
Your patient on end-of-life care reports that feels extremely fatigued, what nursing care would you implement?
aspiration precautions, mouth care & moisture for lips, altered routes of medication
What rational do you use for altering routes of medication for fatigued patients?
choose least invasive route of medication administration with the most effective treatment
True or False, loss of their independence if the symptom that dying patients fear most?
False, Pain is the correct answer.
Greg, your patient on palliative care is complaining of dyspnea. What are possible interventions you could implement?
treat primary cause and relieve the psychological distress that accompanies the symptoms, administer medications, administer oxygen, elevate the head of the bed or position patient on the side, and suction fluids from airway prn
What are typical medication orders that may be given if a patient complains of dyspnea>
morphine sulfate, diuretics, bronchodilators, antibiotics, anticholinergics, sedatives, oxygen
You are a student nurse taking care of a patient on comfort care. Your patient appears restless and agitated. Your nurse instructs you to figure out the underlying cause, administer an antimetic & a sedative, and consult with a spiritual/bereavement counselor. What treatment do you question?
antimetic
A major part of caring for patients during the end-of-life is the psychosocial component. What are the 4 components of a psychosocial assessment?
Assess for fear, anxiety, cultural considerations & bereavement, and feelings of client & significant others
True or False, grief is an unnatural process to death and dying
False. It is a NATURAL process
What are the 5 stages of grief?
Denial, anger, bargaining, depression, and acceptance
What is the difference between grief and mourning?
Mourning is external expressions of grief. Grief is internal sorrow.
You are the nurse teaching the UAP about physical and emotional support. What are some key points you should make?
Be realistic about the facts of death and dying, encourage reminiscence of client’s life memories and stories, promote spirituality (including religion), foster hope, avoid explanation of loss, provide referrals to bereavement specialists, and communicate with client
What are your nursing postmortem care responsibilities as the nurse?
legal considerations (death cert), determination of the need for an autopsy, and transfer of the body, notify MD, get death confirmation, and document your findings
During the post-mortem period, what needs to be documented?
patient’s condition just prior to death, presence/absence of advanced directive, who pronounced the death, when was the family notified, and if donor services or autopsy referral made
Your patient Miles just died, the family would like to view him, how do you prep the body before viewing?
Close eyes, put dentures in, clean up area, position in resting position, and gather valuables.
Miles’ family has just left after viewing his body, what are your next actions?
shroud kit, lines and tubes removed, get body transferred to morgue.
