hospice Flashcards
hospice is all about
comfort
painless death
not trying to cure the disease
if a dying client is having difficulty swallowing oral med, what do you do?
crush med in applesauce
or
ask provider to discontinue or substitute the med
pt might not be able to swallow at all. best ans is ask doc if it can be discontinue or substituted.
if not then applesauce
therapeutic communication
focus on open ended questions: ex: tell me more about that
don’t use “why”
don’t tell them how to feel
don’t give false reassurance
don’t pass the buck to someone else, if you can do/say something right now
rule out other answers
common in hospice
they might refuse to eat or drinks, offer ice chips. next best thing is favorite foods (but that’s in a normal pt, not dying patient, but that is the next best answer. IV hydration is not the best for IV patient.
on the nclex, if they ask about na DYING patient, that is code for “we’re not going to resuscitate them”, let them die comfortably
we take action if they moan for ex (might be in pain)
but if they’re apneic, anorexic(normal in a dying pt), cool extremities (common in dying clients)
what to do if a dying client is agitated and Foley shows 100ml in past 3hrs and last bowel mvt is yesterday evening, what’s wrong?
lots of dying patient can’t talk. agitation might be signs of pain, they can’t talk and say they’re in pain
would you assess for impaction? no b/c they had a bowel mvt yesterday
check foley? no, normal urine output is 30-60ml/hr
administer analgesic, pain med
client is receiving high dose of opiods but still in pain, what else would you do?
classical music? deep massage? short, light massage? more pain meds?
no more pain meds
touch does help people by interrupting the pain. b/c they feel the touch more than they feel the pain.
so light touch (short, light massage) is the answer
classical music is a distraction but the touch is better
deep massage: not recmmonded
more pain med: no, its already high dose
goal of a dying palliative care patient
avoiding symptoms of client distress?
meeting all of clients needs: too extreme, we can’t expect to meet all clients needs. try to avoid extremes on the exam. unless absolutely necessary
facilitating a peaceful death: even if you might think it is hospice, hospice pt can have both hospice and palliative care, and besides pt is dying.
on the NCLEX, waiting is usually not the best ans
if client is unresponsive, family wants you to remove all IV lines and end this, what would you do?
have a meeting w/ family and healthcare team
wait to obtain the clients advance directives
and is meeting w/ fam. if you wait, that means you’re doing anything for the fam. you could facilitate that meeting, while waiting on the advance directives. you don’t have to leave them hanging.
and the client is still connected while you’re having the meeting so nothing wrong with that
