PP - EOL Flashcards
Hospice Care
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
when is hospice care given
when treatment will no longer cure or control the illness
how has hospice changed
Originally offered only to clients diagnosed with terminal cancer but has grown to include any client with a life-limiting illness
admission to hospice care is dependent on
client meeting specific criteria
health care provider diagnosis - life expectancy < six months
Palliative Care
Holistic care
provided throughout lifespan - clients experiencing severe medical illness
particularly - clients approaching end of life
what is the goal of palliative care
improve quality of life for client / family / caregivers
current best practice of palliative care dictates what
Initially concentrated - lessening client suffering at end of life
current best practice dictates - implemented earlier in course of life-threatening health events
how is palliative care different than hospice care
palliative care is provided while client still engaging in curative treatment methods
Physiological changes at the end of life follow
familiar pattern of signs and symptoms
terminal phase of a client’s life is characteristically referred to as
“actively dying” or “imminent death
Physiological Alterations at End of Life
Breathing and Respirations
Pain
Temperature
Vision and Hearing
breathing and respiration alterations at end of life
•Dyspnea
Death rattle
Cheyne-Stokes respirations
Dyspnea:
shortness of breath
Death rattle
Retention of secretions in the respiratory tract
Cheyne-Stokes respirations:
an irregular respiratory rate fluctuating between several quick breaths and periods of apnea
pain alterations at end of life
•Experienced by nearly 60% of older adult hospice clients w/ cancer.
result of
nerve injury
organs being stretched / compressed
bone pain
termperature alterations at end of life
•Ability ofnervous system - regulate body temperature diminishes
causing clients experience both increased / decreased temps
Also caused by infection, cancer, cancer therapy
what is mottling
occurs hours / days before death
upper / lower extremities becoming cool to touch.
why does mottling occur
result of heart’s inability to pump blood effectively
leading to decreased blood perfusion throughout body
vision and hearing alterations - end of life
hallucinations
report hearing / seeing those who have already died
dignity
regarded as an everyday necessity
essential to well-being of all clients
Most complaints related to nursing care at end of life are associated with
a lack of caring
As clients near the end of life, illness contributes to a loss of ______________, which lessens what
control, sens of dignity
When a client is actively dying, health care providers, family, and caregivers are responsible for
providing a “good death” for the client
what is a “good death”
generally includes
pain management
planning for death
closure at the end of life
clear decision making
being able to contribute to others
postmortem care
Physical care performed after death
prepares body for
viewing
autopsy
release to funeral home
what does postmortem care include
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)
what type of documentation is needed as part of postmortem care
documenting date / time of death
name of anyone notified
location of belongings
where client’s body is moved (ie. funeral home name)
organ tissue donation
voluntary - donor must give authorization before death
or a surrogate can give permission when client has previously consented
is a nurse allowed to begin conversation about organ / tissue donation with client or family member
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
OPO
organ procurement organization
what is the nurses role in organ/tissue donation
nurse’s role is to assist families who are dealing with this challenging decision
