end of life care Flashcards
occurs when all vital organs and systems cease to function. there will be irreversible cessation f circulatory and respiratory function. the body gradually slows down until all function end
death
what is the first to go?
respirations
what is the last to go?
hearing and touch
occurs when the cerebral cortex stops functioning or is irreversibly destroyed
brain death
what are the stages of grief and bereavement according to kubler-ross
denial
anger/bargaining
depression
acceptance
what are the stages of grief and bereavement according to bowlby
numbness
yearning and searching
disorganization and support
reorganization
what are wordens four tasks of mourning?
accepting the reality of loss
working though the pain of grief
adjusting to an environment without the deceased
emotionally relocating the deceased and moving on with life
is the emotional and behavioral response to loss. is an individual experience and can be manifested in many way. a complex process in which an individual attempts to make sense of the loss
grief
a term used to describe an individuals response to the loss of a significant other. may begin prior to death.
bereavement
refers to unhealthy or ineffective grief reactions
unresolved grief
refers to prolonged grief disorder
dysfunctional grief
children at this age will percieve that the family is very upset and sad even though they do not understand why
infants and toddlers
children at this stage are familiar with the term death, but they see it as going away or possibly as sleep. they take statements literally
preschoolers
for these childre, death is only temporary and is personified by figures such as the bogeyman or the devil. the child may think that death can be avoided by being good.
school aged children
normally respond with appropriate grief and react to death with an almost adult understanding
adolescence
may not regulate to death unless forced to. individuals in this age group typically expect to have a long life ahead of them
young adults
report more fear of death. they may perhaps be caring for both children and older parents. they may feel anxiety about learning them to care for themselves
middle adulthood
give information about future health care and treatments and personal care
specifies whether the client would like to die without heroic or extraordinary measures
advanced directives
is supportive care or treatment that relieves or reduces the severity of symptoms rather than providing a cure
palliative care
an infrequent and extraordinary intervention that requires interprofessional expertise. to control unmanageable symptoms and suffering
palliative sedation
may be a major symptom associated with terminal illness
can be chronic or acute
pain
characterized by confusion, disorientation, restlessness, clouding of consciousness, incoherence, fear, anxiety, excitement, and often hallucinations
delirum
may occur as death approaches and cerebral metabolism slows
anxiety or restlessness
may occur because of extreme weakness and changes in level of consciousness
difficult swallowing
aspiration
dysphagia
may occur during the last days of life, but hunger and thirst are rare
dehydration
this is a subjective symptom, often accompanied by anxiety and the fear of suffocation
underlying disease process can exacerbate this
dyspnea
coughing and expelling of secretions become difficult
pooling of secretions
this is mild to severe jerking or twitching, which is sometimes associated with the use of large doses of opioids
myoclonus
white, cottage cheese like oral plaques
candidiasis
