MODULE 3 chronically ill, the dying and hospice care

Question 1

Age related sensory changes:

Answer 1

Diminished hearing ◦ Impaired vision

Walang speech!

Question 2

Age-related neurologic changes:

Answer 2

Reduced reaction time ◦ Cognitive Impairment

Question 3

Difficulty in Communication with the Older Person may be due to

Answer 3

Age related sensory changes
Age-related neurologic changes
Hidden Psychosocial Issues
Medical Illnesses having Psychotic Features

Question 4

Site the origin of impairment 
hearing loss for pure tones 
problems with difficult speech 
language problems
problems in binaural listening
hearing loss for speech
problems localizing sounds

Answer 4

Site the origin of impairment
hearing loss for pure tones - Peripheral
problems with difficult speech - cortical
language problems - cortical
problems in binaural listening - brainstem
hearing loss for speech - peripheral
problems localizing sounds - brainstem

Question 5

AGING is accompanied by a decline of

Answer 5

◦ the auditory threshold
◦ sound frequency discrimination
◦ localization of higher frequency sounds
◦ discrimination of high-frequency consonants

Question 6

 Ageing is accompanied by an increased sensitivity to

Answer 6

◦ background noise ◦ Loudness ◦ recruitmentll

Question 7

Doctor Shopping

Answer 7

Shock and Denial:

Question 8

concept of care whose goal is to maximize the quality of a patient’s life when the quantity of that life can no longer be increased

Answer 8

Hospice

Question 9

the application of palliative care to the patient who is felt to have a terminal illness ‘’

Answer 9

Hospice

Question 10

The degree to which denial is adaptive or maladaptive appears to depend whether a patient continues to obtain treatment while denying the prognosis.

Answer 10

Shock and Denial

Question 11

negotiation

Answer 11

Bargaining

Question 12

Affirms life and neither hastens nor postpones death

Answer 12

Hospice

Question 13

withdrawal, psychomotor retardation, sleep disturbance, hopelessness, and suicidal ideation

Answer 13

Depression

Question 14

Admission Criteria for hospice care

Answer 14

• Life-limiting illness, prognosis is 6 months or less if disease takes normal course • Live in service area • Consent to accept services

Question 15

Recognizes dying as part of the normal process of living

Answer 15

Hospice

Question 16

Patient become frustrated, irritable, and angry at being ill

Answer 16

Anger

Question 17

expands traditional diseasemodel medical treatments to include the goals of enhancing quality of life for patients and family, optimizing function, helping with decision-making and providing opportunities for personal growth

Answer 17

Palliative care

Question 18

Focuses on quality of life for individuals and their family caregivers

Answer 18

Hospice

Question 19

Treatment that enhances comfort and improves the quality of an individual’s life during the last phase of life

Answer 19

Palliative Care

Question 20

May represent patients’ desire for control in a situation in which they feel completely out of control

Answer 20

Anger

Question 21

True or false.

All hospice patients receive palliative care, but not all palliative care patients are enrolled in hospice

Answer 21

True

Question 22

Caused by activity in neural pathways in response to potentially tissue-damaging stimuli

Answer 22

Nociceptive Pain (Inflammatory)

Question 23

Initiated or caused by primary lesion or dysfunction in the nervous system

Answer 23

Neuropathic Pain

Question 24

The expected outcome is relief from distressing symptoms, the easing of pain, and/or enhancing the quality of life

Answer 24

Palliative Care

Question 25

True or false

Oral administration is the most convenient and cost-effective route

Answer 25

True

Question 26

applicable early in the course of illness, in conjunction with other therapies intended to prolong life.

Answer 26

Palliative Care

Question 27

Rectal administration provides slower absorption but with little first-pass effect

Answer 27

True

Question 28

patient and family centered care

Answer 28

Palliative care

Question 29

Drugs that were renally cleared

Answer 29

Morphine and hydromorphone

Question 30

Most commonly used opioid in terminal illness.

Answer 30

MORPHINE

Adverse effects: nausea, sedation, confusion, constipation

Question 31

appropriate for all patients with serious illness

Answer 31

Palliative care

Question 32

Preferred drug In patients with addiction history

Answer 32

Methadone

Question 33

 Help the pt eat even while anorexic by:

Answer 33

a) Knowing the pt’s preference b) Serving the food that the pt wants c) Offering small portions on a small plate d) Serving hot soup, ice cream and fruits e) Allowing someone to eat with the pt f) Giving supplemental vitamins and minerals

Question 34

Only opioid administered topically via patch which releases opioid steadily for 72 hours

Answer 34

FENTANYL

Can cause confusion and delirium

Question 35

Drug that is useful for nausea

Answer 35

Metoclopromide

Question 36

What Causes Caregiver Burnout?

Answer 36

 Role confusion  Unrealistic expectations  Lack of control  Unreasonable demands

Question 37

The goal of palliative care

Answer 37

to enhance quality of life through assiduous symptom management and attention to psychological, social and spiritual needs of the patient and family

Question 38

Mmse grading

Answer 38

25-30 normal
21-24 mild
10-20 moderate
<10 severe

Question 39

Focuses on quality of life and death, and views death as a natural part of life

Answer 39

Palliative care

Question 40

• Focuses on quantity of life and prolonging of life

Answer 40

Curative care