PP - EOL

Question 1

Hospice Care

Answer 1

administration of medical care
support client - terminal illness
live last days - as best as they can / long as they can
Interprofessiona
holistic care - treats whole person
including caregivers / family members

Question 2

when is hospice care given

Answer 2

when treatment will no longer cure or control the illness

Question 3

how has hospice changed

Answer 3

Originally offered only to clients diagnosed with terminal cancer but has grown to include any client with a life-limiting illness

Question 4

admission to hospice care is dependent on

Answer 4

client meeting specific criteria
health care provider diagnosis - life expectancy < six months

Question 5

Palliative Care

Answer 5

Holistic care
provided throughout lifespan - clients experiencing severe medical illness
particularly - clients approaching end of life

Question 6

what is the goal of palliative care

Answer 6

improve quality of life for client / family / caregivers

Question 7

current best practice of palliative care dictates what

Answer 7

Initially concentrated - lessening client suffering at end of life
current best practice dictates - implemented earlier in course of life-threatening health events

Question 8

how is palliative care different than hospice care

Answer 8

palliative care is provided while client still engaging in curative treatment methods

Question 9

Physiological changes at the end of life follow

Answer 9

familiar pattern of signs and symptoms

Question 10

terminal phase of a client’s life is characteristically referred to as

Answer 10

“actively dying” or “imminent death

Question 11

Physiological Alterations at End of Life

Answer 11

Breathing and Respirations
Pain
Temperature
Vision and Hearing

Question 12

breathing and respiration alterations at end of life

Answer 12

•Dyspnea
Death rattle
Cheyne-Stokes respirations

Question 13

Dyspnea:

Answer 13

shortness of breath

Question 14

Death rattle

Answer 14

Retention of secretions in the respiratory tract

Question 15

Cheyne-Stokes respirations:

Answer 15

an irregular respiratory rate fluctuating between several quick breaths and periods of apnea

Question 16

pain alterations at end of life

Answer 16

•Experienced by nearly 60% of older adult hospice clients w/ cancer.
result of
nerve injury
organs being stretched / compressed
bone pain

Question 17

termperature alterations at end of life

Answer 17

•Ability ofnervous system - regulate body temperature diminishes
causing clients experience both increased / decreased temps
Also caused by infection, cancer, cancer therapy

Question 18

what is mottling

Answer 18

occurs hours / days before death
upper / lower extremities becoming cool to touch.

Question 19

why does mottling occur

Answer 19

result of heart’s inability to pump blood effectively
leading to decreased blood perfusion throughout body

Question 20

vision and hearing alterations - end of life

Answer 20

hallucinations
report hearing / seeing those who have already died

Question 21

dignity

Answer 21

regarded as an everyday necessity
essential to well-being of all clients

Question 22

Most complaints related to nursing care at end of life are associated with

Answer 22

a lack of caring

Question 23

As clients near the end of life, illness contributes to a loss of ______________, which lessens what

Answer 23

control, sens of dignity

Question 24

When a client is actively dying, health care providers, family, and caregivers are responsible for

Answer 24

providing a “good death” for the client

Question 25

what is a “good death”

Answer 25

generally includes
pain management
planning for death
closure at the end of life
clear decision making
being able to contribute to others

Question 26

postmortem care

Answer 26

Physical care performed after death
prepares body for
viewing
autopsy
release to funeral home

Question 27

what does postmortem care include

Answer 27

washing the body
accounting for client’s possessions
removing invasive devices (ie. intravenous catheters / indwelling catheters)
placing identification tags - at least two areas (toe, arm, outside of body bag)

Question 28

what type of documentation is needed as part of postmortem care

Answer 28

documenting date / time of death
name of anyone notified
location of belongings
where client’s body is moved (ie. funeral home name)

Question 29

organ tissue donation

Answer 29

voluntary - donor must give authorization before death
or a surrogate can give permission when client has previously consented

Question 30

is a nurse allowed to begin conversation about organ / tissue donation with client or family member

Answer 30

NO
Only health care professionals who have completed a course provided / endorsed by an organ procurement organization can initiate the request to client or surrogate

Question 31

OPO

Answer 31

organ procurement organization

Question 32

what is the nurses role in organ/tissue donation

Answer 32

nurse’s role is to assist families who are dealing with this challenging decision