End of Life / Palliative

Question 1

end-of-life care

Answer 1

supportive & compassionate care
- comfort
- QOL
- respect for personal health care treatment decisions
- support for the family
- psychological, cultural and spiritual concerns

Question 2

goals of care
– advanced directive

Answer 2

MOST
representation agreement
enduring POA
living will

Question 3

goals of care
– end of life plan

Answer 3

• plan for living
• where
• plan around: meds, supports (who)

Question 4

goals of care
– MAiD

Answer 4

legal in Canada June 2016

Question 5

chronic disease management

Answer 5

pain management
self-care support
flare up plan

common chronic diseases:
- arthritis
- heart failure
- COPD
- diabetes

Question 6

managing physical symptoms
– fatigue

Answer 6

• assess and treat cause
• energy conservation
• corticosteroids

Question 7

managing physical symptoms
– constipation

Answer 7

• assess and treat cause
• bowel protocol

Question 8

managing physical symptoms
– dyspnea

Answer 8

• assess and treat cause
• comfort measures
  pharmaceuticals:
  morphine/hydromorphone
  anxiolytics (anxiety)
  corticosteroids

Question 9

managing physical symptoms
– nausea & vomiting

Answer 9

• assess and treat cause

Question 10

managing physical symptoms
– dehydration

Answer 10

assess
good oral hygeine

Question 11

managing physical symptoms
– anorexia/cachexia

Answer 11

comfort measures

Question 12

signs and symptoms at the end of life

Answer 12

Altered Breathing Patterns:
- more shallow
- cheyne-stroke
- noisy breathing
Changing Circulation:
- limbs/ears/nose become cold and/or mottled
- decreased BP, weak P
- diaphoresis
- no/minimal urine output
Decreased Muscle Tone:
- relaxed facial muscles
- decr. / loss of gag reflex
- difficulty swallowing
- abdominal distention
- decreased GI activity
- urinary fecal incontinence
Decreased Senses:
- reduced LOC
- hearing continues