EOL

Question 1

What are the 4 goals of Pallative care

Answer 1

• Focus on reducing the severity of disease symptoms
• improve quality of life
• Decrease economic costs of health care
  -Alleviate burden of caregivers

Question 2

Where can Hospice Care happen? (4)

Answer 2

-Home
-Inpatient settings
-acute and LTC facilities
-Rehab Centers

Question 3

What are the four levels of hospice care?

Answer 3

• Routine home care
  -Inpatient respite care
  -Continuous care
  -General inpatient care

Question 4

What is closed awareness?

Answer 4

Everyone but the patient knows that the patient is on hospice

Question 5

What is suspected awareness?

Answer 5

The patient suspects something in on with hospice?

Question 6

What is mutual pretense awareness?

Answer 6

Everyone and the patient knows about hospice, but no one wants to talk about it

Question 7

What is open awareness?

Answer 7

Everyone knows what is going on and talks about it

Question 8

When can organ and tissue donation happen?

Answer 8

When there is brain death

Question 9

How does assisted suicide work?

Answer 9

The doctor gives the patient the med, but the patient decides that take it to end their life

Question 10

What can the patient decide they want regarding their EOL care? (5)

Answer 10

-Organ and tissue donation
-Advance directives
-Resuscitation
-Mechanical Ventilation
-Tube feeding placement

Question 11

What are the five barriers to EOL care?

Answer 11

-cure
- financial
-cultural, social
-addressing issues of death, HCP
-coping with death

Question 12

What symptoms are a nurses priorities with EOL? (5)

Answer 12

Pain
Dyspena
Nausea
Weakness
Anxiety

Question 13

What are 9 signs of approaching death?

Answer 13

-Refusal of food and fluids
-Urinary output decrease- may have incontinence
-Weakness, sleep, confusion, restlessness
-Impaired vision/Hallucinations
-Thick secretions- esp in throat
-Cheyenne- stokes respirations
-CV changes
-Integumentary changes- develop mottling, Kennedy terminal ulcer
-Third- spacing

Question 14

As death approaches, which systems begin to fail? (3)

Answer 14

Renal
Respiratory
Cardiac

Question 15

What can patients fear at the end of their life? (4)
Besides fear of death

Answer 15

Fear of pain
Fear of SOB
Fear of loneliness and abandonment
Fear of meaninglessness

Question 16

What in a part of physical care in EOL? (7)

Answer 16

Oxygen
Nutrition
Pain Relief
Mobility
Elimination
Skin Care
Postmortem care

Question 17

What is anticipatory grief?

Answer 17

Grief before the death

Question 18

What is Adaptive grief?

Answer 18

Acceptance of death/ grief

Question 19

What is prolonged grief disorder

Question 20

What are the 5 stages of grief? Küber- Ross model

Answer 20

1. Denial
2. Anger
3. Bargaining
4. Depression
5. Accpetance

Question 21

What are the 4 parts of the grief wheel?

Answer 21

1. Shock
2. Protest
3. Disorganization
4. Reorganization

Question 22

What situations are do the ME need to be called? (7)

Answer 22

1. DOA
2. If death occurs within 24hrs of admission
3. Result of homicide or unnatural means
4. Absence of a witness
5. Suicide or suspected suicide
6. Died without being seen by licensed provider
7. A child younger than 6 or unsuspected