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FCM MODULE 3 > Module 3 Hospice Care > Flashcards

Module 3 Hospice Care Flashcards

0
Q

Sufferer’s experience of the disease

A

Illness

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1
Q

Biology; Pathophysiology

A

Disease

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2
Q

Short Period of Evident Decline

A

Cancer

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3
Q

Diminished hearing

A

Age- related sensory changes

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4
Q

Impaired vision

A

Age related sensory changes

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5
Q

Reduced reaction time

A

Age related neurologic changes

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6
Q

Cognitive Impairent

A

Age related neurologic changes

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7
Q

atrophy & disappearance of cells in the inner ear

A

auditory system aging

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8
Q

angiosclerosis in the inner ear

A

Auditory system aging

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9
Q

Degeneration of VIII cranial nerve & canal closure

A

Auditory system aging

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10
Q

Atrophy and cell loss of brainstem & cortical auditory centers

A

Auditory system aging

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11
Q

hearing loss for pure tones

A

Peripheral pathology

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12
Q

hearing loss for speech

A

Peripheral pathology

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13
Q

problems localizing sound

A

Brainstem pathology

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14
Q

problems with difficult speech

A

Cortical pathology

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15
Q

problems in binural listening

A

Brainstem pathology

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16
Q

language problems

A

Cortical pathology

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17
Q

the auditory threshold

A

Aging in hearing loss

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18
Q

sound frequency discrimination

A

Aging in hearing loss

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19
Q

localization of higher frequency sounds

A

Aging in hearing loss

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20
Q

discrimination of high-frequency consonants

A

Aging in hearing loss

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21
Q

Increased sensitivity to background noise, loudness, recruitment

A

Aging in hearing loss

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22
Q

persistent ringing or buzzing noise in the ears

A

Tinnitus

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23
Q

Decrease in pupil size

A

Aging in visual changes

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24
Q

Changes in the circumference & shape of the lens

A

Aging in visual changes

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25
Q

Decline in size of macula lutea- Macular degeneration

A

Aging in visual changes

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26
Q

Proliferation of new cells at the periphery

A

Aging in visual changes

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27
Q

Capsule becomes less thicker & less permeable

A

Aging in visual changes

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28
Q

Maturation of lens fibers

A

Aging in visual changes

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29
Q

Promoting independence in the elderly

A

Self-care

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30
Q

major health concern for older adults, affecting fifty percent of people over 85 and at least a quarter of those over 75

A

Impaire mobility

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31
Q

Electrolyte imbalance

A

Hyponatremia

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32
Q

increase risk of fracture in elderly patients because it cause subtle neurologic impairment that affects gait and attention, similar to that of moderate alcohol intake.

A

Mild hyponatremia

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33
Q

immunization, alcohol use, tobacco use, caffeine intake, sleep patterns

A

Personal habits

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34
Q

Mini-Nutrition Assessment (MNA)

A

Dietary assessment

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35
Q

emotional difficulties and adjustments, patterns of coping with stress

A

Emotional history

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36
Q

living relatives, significant others

A

Social supports

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37
Q

Pts capacity for independent living

A

Functional assessment

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38
Q

Activities of Daily Living (ADL) = DEATH (dressing, eating, ambulating, toileting, hygiene)

A

Functional assesment

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39
Q

Instrumental Activities of Daily Living (IADL) = SHAFT (shopping, housekeeping, accounting, food preparation, transportation)

A

Functional assessment

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40
Q

Geriatric depression Scale is used

A

Assessment of depression

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41
Q

living arrangements, physical layout of homes, recommendations for adaptive devices, etc

A

Environmental history

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42
Q

Vital signs

A

Physical examtination

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43
Q

General Appearance

A

PE

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44
Q

HEENT examination

A

PE

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45
Q

Systems exam

A

PE

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46
Q

Neurological and Psychiatric Examination

A

PE

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47
Q

Assessment of gait, mobility and balance

A

PE

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48
Q

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

A

Hospice care

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49
Q

Includes comprehensive pain and symptom control, spiritual care, psychosocial care, grief and bereavement support, and interdisciplinary team work

A

Hospice care

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50
Q

maximize the quality of a patients life when the quantity of that life can no longer be increased

A

Hospice care

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51
Q

Recognizes dying as part of the normal process of living

A

Hospice

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52
Q

Affirms life and neither hastens nor postpones death

A

Hospice

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53
Q

Focuses on quality of life for individuals and their family caregivers

A

Hospice

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54
Q

Providing the patient and his family with physical, social, psychological and spiritual support.

A

Hospice

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55
Q

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

A

Shock & Denial

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56
Q

Doctor Shopping

A

Shock and denial

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57
Q

Patient become frustrated, irritable, and angry at being ill.

A

Anger

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58
Q

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

A

Anger

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59
Q

negotiation

A

Bargaining

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60
Q

accepted the situation

A

Acceptance

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61
Q

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

A

Depression

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62
Q

Patient/family focused

A

Core aspects of hospice

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63
Q

Interdisciplinary

A

Core aspects of hospice

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64
Q

Develops the plan of care

A

Hospice team

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65
Q

Manages pain and symptoms

A

Hospice team

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66
Q

Attends to the emotional, psychosocial and spiritual aspects of dying and caregiving

A

Hospice team

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67
Q

Teaches the family how to provide care

A

Hospice team

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68
Q

Advocates for the patient and family

A

Hospice team

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69
Q

Provides bereavement care and counseling

A

Hospice team

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70
Q

Life-limiting illness, prognosis is 6 months or less if disease takes normal course

A

Admission criteria on Hospice care

71
Q

Live in service area

A

Admission criteria on Hospice care

72
Q

Consent to accept services

A

Admission criteria on hospice cate

73
Q

expands traditional disease-model 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.

A

Palliative care

74
Q

delivered with life-prolonging care or as the main focus of care

A

Palliative care

75
Q

delivered with life-prolonging care or as the main focus of care

A

Palliative care

76
Q

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

A

Palliative care

77
Q

Focuses on quantity of life and prolonging of life

A

Curative care

78
Q

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

A

Palliative care

79
Q

appropriate for all patients with serious illness

A

Palliative care

80
Q

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

A

Palliative care

81
Q

patient and family centered care

A

Palliative care

82
Q

philosophy of care

A

Palliative care

83
Q

a Medicare benefit available to patients who are nearing the end of life

A

Palliative care

84
Q

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

A

Hospice, palliative

85
Q

Pain, dyspnea/respi distress, nausea/vomiting, anorexia/cachexia

A

Common symptoms of palliative care

86
Q

Pruritis/dermatitis, Intractable seizures, delirium, incontinence, pressure ulcers

A

Common symptoms of palliative care

87
Q

Verbal Pain intensity scale - 0=no pain, 10=worst possible pain

A

Painassessment

88
Q

Numeric Pain Intensity Scale

A

Pain assessment

89
Q

Faces Chart

A

Pain assessment

90
Q

Visual analog scale

A

Pain assessment

91
Q

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

A

Nociceptive/ inflammatory pain

92
Q

Postoperative

pain

A

Nociceptive/ inflammatory pain

93
Q

Mechanical

low back pain

A

Nociceptive/ inflammatory pain

94
Q

Mechanical

low back pain

A

Nociceptive/ inflammatory pain

95
Q

sports or exercise injuries

A

Nociceptive/inflammatory pain

96
Q

pain caused by a primary lesion or dysfunction in the peripheral and/or central nervous systems

A

Neuropathic pain

97
Q

HIV sensory neuropathy

A

Peripheral neuropathy

98
Q

postherpetic neuralgia (PHN)

A

Peripheral neuropathy

99
Q

diabetic neuropathy

A

Peripheral neuropathy

100
Q

central poststroke pain

A

Central neuropathy

101
Q

spinal cord injury pain

A

Central neuropathy

102
Q

trigeminal neuralgia

A

Central neuropathy

103
Q

multiple sclerosis pain

A

Central neuropathy

104
Q

chronic pain can be of mixed etiology with both nociceptive and neuropathic characteristics.

A

Mixed type

105
Q

ASA, acetaminophen

A

Non-opiod analgesics

106
Q

NSAIDs, Cox-2 inhibitors

A

Non-opioid analgesics

107
Q

SNRIs, TCAs

A

Non-opiod analgesics

108
Q

alpha-2 delta ligands

A

Non-opioid analgesics

109
Q

anti-epileptics

A

Non-opiod analgesics

110
Q

NMDA receptor antagonists

A

Non-opiod analgesics

111
Q

alpha-2 delta ligands

A

Non-opiod analgesics

112
Q

anti-epileptics

A

Non-opiod analgesics

113
Q

NMDA receptor antagonists

A

Non-opioid analgesics

114
Q

Topical analgesics_

A

Non-opioid analgesics

115
Q

Naturally-occurring, semi-synthetic, synthetic, novel

A

Opioid analgesics

116
Q

Immediate release, sustained release, transdermal, IV, IM

A

Opiod analgesics

117
Q

Laxatives

A

Adjuvant therapy

118
Q

Antihistamines

A

Adjuvant therapy

119
Q

Antiemetics

A

Adjuvant therapy

120
Q

Antidepressants

A

Adjuvant therapy

121
Q

psychostimulants

A

Adjuvant therapy

122
Q

NSAIDS for mild pain

A

Step 1

123
Q

NSAIDS effective for bone and soft tissue pain

A

Step 1

124
Q

If the pain persists or is of moderate intensity, weak opioids are used, eg. codeine

A

Step 2

125
Q

For severe pain , strong opioids are the drug of choice

A

Step 3

126
Q

paracetamol,

aspirin, NSAIDs - +/- adjuvant

A

Non opioid

127
Q

codeine,

tramadol | +/- nonopioid | +/- adjuvant

A

Weak opioid

128
Q

morphine,
oxycodone,
fentanyl | +/- nonopioid | +/- adjuvant

A

Strong opiod

129
Q

______ administration of opioids is most convinient and cost-effective route

A

Oral

130
Q

______ administration of opioids provides slower absorption but with little first-pass effect

A

Rectal

131
Q

____ and _____ route is prefered over IM injections

A

IV;SC

132
Q

Usual effective dosage interval for opioid analgesics

A

3-4 hours

133
Q

Used in terminal illness

A

Morphine

134
Q

Adverse effects: nausea, sedation, confusion, constipation

A

Morphine

135
Q

Morphine: Two dosing rules: Much more than twice the stable tolerated dose

A

depress respiratory function

136
Q

Morphine: Two dosing rules: Reestablishing pain control when stable dose becomes inadequate ordinarily

A

requires more than or equal to 1.5 times the previous dose

137
Q

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

A

Fentanyl

138
Q

At least 24 hours is needed to attain maximum analgesia and can cause confusion and delirium

A

Fentanyl

139
Q

For severe pain in localized body regions

A

Anesthetics

140
Q

Indwelling epidural or intrathecal catheters may be placed to provide continuous infusion of analgesics

A

Anesthetics

141
Q

Nerve blocking techniques may also be used

A

Anesthetics

142
Q

Causes: mouth infection, nausea, constipation, depression, drugs, radiotherapy and disease itself

A

Anorexia

143
Q

Metoclopromide orally or subcutaneously

A

Nausea

144
Q

Phenothiazine such as promethazine 25mg orally 4x a day or prochlorperazine 10mg orallybefore meals

A

Nausea and vomitting

145
Q

SUPPORT SYSTEM THAT SERVES AS A NURSE, HOMEMAKER, SPOUSE, AND HEAD OF THE HOUSEHOLD AND MORE

A

Caregiver

146
Q

state of physical, emotional, and mental exhaustion that may be accompanied by a change in attitude – from positive and caring to negative and unconcerned.

A

Caregiver burnout/fatigue

147
Q

Yes = 1 , No = 0

A

Caregiver strainindex

148
Q

Role confusion, unrealistic expectations, lack of control and unreasonable demands

A

Causes caregiver burnout

149
Q

Integral part of patient care

A

Health education

150
Q

Central building block of the physician

A

Communication

151
Q

The more I listen, the more my patients understand

A

Communication

152
Q

The ability to be fully present in the moment of the interview with the person who has come for help and care

A

Listening skills

153
Q

3R’s fo an interview

A

Rapport, respect, relationship

154
Q

“I am listening to you and I understand where you are coming from.”

A

Attending

155
Q

L - lean forward, O _ open stance, V _ voice of compassion, E _ eye contact, R _ relaxed position, S _ sit at an angle

A

Attending

156
Q

Mental skill

A

Bracketing

157
Q

Setting aside our biases, prejudices and pre- conceived notions about the situation or condition that the patient is talking about

A

Bracketing

158
Q

Open invitation for the patient to talk about anything that he / she wishes

A

Indirect leading

159
Q

Open invitation for the patient to talk about anything that he / she wishes

A

Direct leading

160
Q

Yes? Go on… And then?

A

Leading

161
Q

Paraphrasing, Perception checking

A

Reflecting content

162
Q

Articulate the feelings for the patient

A

Reflecting feeling

163
Q

Counselor takes note of the patient’s gestures or nonverbal cues

A

Reflecting experiences

164
Q

“You seem to be quite anxious about your chest pain.”

A

Reflecting

165
Q

Enumerate the problems brought up by the patient and identify which one is the most troublesome

A

Focusing

166
Q

The patient is asked to choose which issue is most important

A

Focusing

167
Q

“So you feel afraid, angry and guilty. But of these three, which is the feeling that is giving you the most pain?”

A

Focusing

168
Q

Asked to elicit more information

A

Probing

169
Q

Usually consist of open-ended questions

A

Probing

170
Q

Probe for content or feeling

A

Probing

171
Q

Time demands

A

Barriers to effective communication

172
Q

Interruption

A

Barriers to effective communication

173
Q

Technology

A

Barriers to effective communication

174
Q

Advance preparation, Build a therapeutic environment and relationship, Communicate well, Deal with reactions, Encourage and validate

A

Sharing bad news

175
Q

Caregiver, Breadwinner, Decision-maker

A

Important members to communicate with

FCM MODULE 3 (1 decks)

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