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Adult Health 2 > End of Life Care > Flashcards

End of Life Care Flashcards

1
Q

care that focuses on reducing severity of symptoms for patients with life-limiting illness

A

palliative care

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2
Q

characteristics of palliative care

A
  • prevent and relieve suffering (pain, other physical sxs, psychological and emotional distress)
  • support for patients until death
  • support for families (coping w/ pt’s illness and bereavement)
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3
Q

Where does palliative care take place?

A
  • hospital
  • home
  • long-term care
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4
Q

T/F: Patients getting palliative care can also receive curative care if applicable

A

True

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5
Q

care to provide support and comfort during last stages of a terminal illness

A

hospice care

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6
Q

characteristics of hospice care

A
  • part of palliative care
  • pt does not receive curative care to treat illness
  • support for patient and family
  • services available 24 hours a day
  • interdisciplinary health care team
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7
Q

criteria for hospice care

A

2 physicians certify that the pt is terminal with estimate of less than 6 months to live (one physician can recertify after 6 months if needed)

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8
Q

physical manifestations of end of life

A
  • decreased vision, taste, smell
  • decreased pain and touch perception
  • decreased BP, HR, and weak irregular pulse
  • Cheyne-stokes respirations (alternating apnea and deep breathing) and congested breathing
  • decreased urine output and bowel/bladder incontinence
  • slowing or cessation of GI tract (due to opioids)
  • difficulty speaking and swallowing
  • mottling, cold clammy skin, and cyanosis
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9
Q

What is the last of the 5 senses to disappear?

A

hearing

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10
Q

psychological manifestations of end of life

A
  • anxiety, fear, and helplessness
  • life review, peacefulness
  • restlessness
  • decreased socialization and withdrawal
  • vision-like experiences
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11
Q

period of grief and mourning after death of loved one

A

bereavement

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12
Q

psychological and physiologic response to a loss

A

grief

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13
Q

manifestations of grief

A
  • anger
  • depression/despair
  • guilt
  • anxiety
  • insomnia
  • physical problems
  • changes in appetite
  • illness
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14
Q

5 stages of grief (Kubler-Ross model)

A
  • denial
  • anger
  • bargaining
  • depression
  • acceptance
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15
Q

T/F: everyone goes through the stages of grief in the same order

A

False

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16
Q

spiritual needs with end of life care

A
  • belief in higher power but may question spirituality at end of life (spiritual crisis)
  • respect the patient and family preferences in regard to pastoral care services
  • spirituality and faith may provide a sense of peace and decreased despair to some
17
Q

general term for documents regarding instructions about care and treatment and who can make decisions for them

A

advanced directive

18
Q

document w/ specific interventions to be used or withheld

A

directive to physicians

19
Q

physician’s order not to do CPR; need to indicate specific interventions to be used or withheld

A

do not resuscitate (DNR)

20
Q

replaces DNR with comfort measures only

A

allow natural death

21
Q

nursing management at end of life

A
  • pain management
  • suction as needed
  • O2 as needed
  • position for comfort and optimal breathing
  • provide frequent rest periods and assistance w/ activity
  • may experience myoclonus
  • skin breakdown prevention and wound care
  • adequate fluid an fiber intake if appropriate
  • perineal care and urinary catheters
  • provide favorite foods in small portions
22
Q

care for dry mouth in end of life

A
  • lip balm
  • oral care (swabs and toothettes)
  • don’t force patient to eat or drink
23
Q

medications administered at end of life

A
  • pain meds
  • stool softeners, laxatives, and enemas if needed
  • antiemetics before meals
24
Q

psych care for end of life

A
  • reorient patient as needed if delirium present

- encourage patient to verbalize feelings

25
Q

post mortem care

A
  • prepare body for viewing by family (if not present when death occurs)
  • remove tubes and dressings (unless autopsy is to be performed) -> same w/ non-hospice care
  • create quiet, welcoming space for family
  • allow family as much time as they need w/ pt
  • contact nursing supervisor
  • get funeral home info from family
  • care of body after family leaves

Adult Health 2 (8 decks)

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