test 4

Question 1

hospice home

Answer 1

a place you go in last few months when you dont want to pass away at home or at hospital

Question 2

most common place of death in us

Answer 2

hopsital

Question 3

factors that influence peoples ability to cope with death

Answer 3

personal and cultural views
age- older is less anxious
religious beliefs- less depression in those who have a strong faith

Question 4

s/s of death approaching

Answer 4

weakness, immobility
weight loss, decreased appetite
loss of bowel and bladder control
decreased awareness of surroundings
diaphoresis and lung congestion “death rattle”
altered breathing patterms, slowed pulse
cold and mottled extremites
relazed and open jaw

Question 5

2 step process of death

Answer 5

psychological- when told they are dying

physiological- when body declines in function

Question 6

Kubler Ross grief cycle

Answer 6

denial, anger, bargaining, depression, acceptance

not everyone has all of these steps- not universal

Question 7

options for end of life care

Answer 7

acute care
hospice care

Question 8

palliative services

Answer 8

paid by-self, insurance
any stage of disease!
same time as curative treatment!!
typically happens in hospital

Question 9

hospice services

Answer 9

paid by medicare, medicaid, insurance
for when prognosis is 6 months or less!!
excludes curative treatment
occurs at wherever patient calls home

Question 10

what is one of the biggest thing we want to do for dying patient

Answer 10

taking care of pain

Question 11

acute care of the dying patient options

Answer 11

continuation of full life support?

full cardiopulmonary resuscitation- CPR ?

removing all life support or life sustaining equipment?

stopping all drugs except for sedation and pain?

Question 12

the 5 wishes document

Answer 12

1. The person they want to make care decisions for them when patient cant
2. The kind of medical treatment they want vs dont want
3. How comfortable they want to be in final days
4. How they want people to treat them
5. what they want there loved ones to know

Question 13

advanced directives

Answer 13

Health care power of attorney
living will
do not resuscitate (DNR)

very important!

a living will is needed to have a DNR

Question 14

Commonalities of palliative vs hospice

Answer 14

comfort varer
reduce stress
symptom relief
physical and psychosocial relief

Question 15

informed consent

Answer 15

have a right to know you are dying and make decisions about your life

this is a grey area for peds

Question 16

assisted suicide and euthansia

Answer 16

some people believe in right to die- they can die when they want.
lots of legal, moral and ethical issues

Active euthanasia- illegal in US. done for you by dr

assisted suicide- with active euthanasia- legal in some states, dr gives you prescription med and you do it yourself

passive euthanasia- withholding life sustaining measures so death occurs naturally. legal in all states.

Question 17

role of healthcare worker in end of life

Answer 17

educate patient and family concerning the diagnosis
ensure informed consent
ensure wishes are respected
communicate with healthcare team when death is imminent or has occurred

Question 18

how to tell children theyre dying

Answer 18

toddlers- very simple language

preschooler- tell them in language they understand

school age- can be more incorporated in planning. they know what death is but afraid it will hurt

adolescent- ^

Question 19

normal losses: maturational

Answer 19

newborns loss of security of womb

toddlers loss of being exclusive focus when sibling arrives

teens loss of security when leaving college

Question 20

normal losses: situational

Answer 20

loss of income
loss of health

Question 21

abnormal losses

Answer 21

loss of national security- such as world trade center

loss of health and control- covid pandemic

Question 22

grief

Answer 22

process of when going through loss
can start before death

delayed grief- doesn’t come to terms right away, grieves later from a different triggering event

complicated grief- deliberating prolonged grief

anticipatory grief- grief as people emotionally prepare themselves for a loss of loved one

Question 23

death of a child

Answer 23

ensure other children (siblings) are token care of

Question 24

bereavement

Answer 24

the process during which people cope with a loved ones death. the entire coping process. similar to grief

Question 25

bereavement overload

Answer 25

occurs when loosing several people in a short time

Question 26

when are infants capable of responding to loss

Answer 26

10 months (if they see them often).
could effect trust vs mistrust