Study sets, textbooks, questions
Upgrade to remove ads
PALL CARE MIDTERM
Terms in this set (65)
what approach with hospice care?
to make it known that you are aware of another's distress and that you have compassion for them
takes things a step further by not only expressing compassion but also showing a deeper level of understanding by entering into the other person's experience
show that you are listening
teach back method
Use a caring tone of voice and attitude.
Display comfortable body language and make eye contact.
Use plain language.
Ask the patient to explain back, using their own words.
Use non-shaming, open-ended questions.
Avoid questions that can be answered with a simple yes or no.
Emphasize that the responsibility to explain clearly is on you, the provider.
If the patient is not able to teach-back correctly, explain again and re-check.
Use reader-friendly print materials to support learning.
Document use of, and the patient response to, teach-back
You should respond to the couple by stating that only unanticipated treatments and procedures that are not included in the advance directive can be made by the legally appointed durable power of attorney for healthcare decision
You are caring for a client at the end of life. The client tells you that they are grateful for having considered and decided upon some end of life decisions and the appointments of those who they wish to make decisions for them when they are no longer able to do so. During this discussion with the client and the client's wife, the client states that "my wife and I are legally married so I am so glad that she can automatically make all healthcare decisions on my behalf without a legal durable power of attorney when I am no longer able to do so myself" and the wife responds to this statement with, "that is not completely true. I can only make decisions for you and on your behalf when these decisions are not already documented on your advance directive."
How should you, as the nurse, respond to and address this conversation between the husband and wife and the end of life?
Orientation and opportunity
comfort model stands for?
aligns with differences or seeks to understand tensions while not alienating
do ___ at:
patient self determination act
November 1990 marked an important step in assuring that individuals' choices regarding health care matters would be honored.
Patients are given written notice upon admission to the health care facility of their decision-making rights, and policies regarding advance health care directives in their state and in the institution to which they have been admitted. Patient rights include:
The right to facilitate their own health care decisions
The right to accept or refuse medical treatment
The right to make an advance health care directive
Don't need to have one, it is not illegal to not.
Facilities must inquire as to whether the patient already has an advance health care directive, and make note of this in their medical records.
Facilities must provide education to their staff and affiliates about advance health care directives.
Health care providers are not allowed to discriminately admit or treat patients based on whether or not they have an advance health care directive.
patient/family as unit of care
physical emotional spiritual support
care team structure
site of care
continuum of care
2 palliative active
3 palliative symptomatic
4 pall support/HOSPICE
final hours before death, shut down of physiological processes
keep compromised lung down
first pharm tx for dyspnea
lower dose usually effective
consider benzos if anxiety also
t/f: generally O2 is relief for dyspnea
breathing becomes shallow with periods of apnea around death, can last several minutes
failing neurological controls
irregular rapid shallow breaths with apnea, expiratory grunting
t/f: cheyne stoke at death is painful and indicative of respiratory distress
dementia pain scale
changes in breathing
unable to console
2 pharm tx for mild pain
pharm tx or moderate-severe pain
what to remember with pain meds?
route preferred for pain meds bc lasts longer and more sustained relief?
good pain med for people with chronic renal failure
t/f: deep suctioning is rarely indicated for respiratory secretions
pharm tx for respiratory secretions
do not exceed 4 doses a day
*doesn't cross BBB
*sedation, delirium, dry mouth SE
typical meds used for delirium at EOL, meds arent typically used though
t/f: decreased intake is part of the dying process and does not increase suffering
*hydration can increase risk of third space fluid retention and respiratory congestion
t/f: artificial hydration improves the natural anorexia/cachexia at EOL
VALUE family conference framework
ABCDs of dignity deserving care
reaction of the survivor to the death
grief not acknowledged by society
kubler ross tasks of grief
can be random, not necessarily in that order
how many adults have 1+ chronic health condtions
how many adults were obese in 2012
most common cause of disability?
Medical or health problems with associated symptoms or disabilities that require long-term management
Experience of living with a chronic disease or condition
Individual's perception of the experience
Individual's response to chronic disease
Others' responses to chronic disease
looks at society as the problem and we cause the disability
what does this person want, how can we help them in all realms to improve QOL *note difference between this and BPS model
In which phase of the trajectory model of chronic illness are the symptoms under control and managed?
going about life
Which phase of the trajectory model of chronic illness is characterized by reactivation of the illness?
exacerbation, disease comes back
when disease begins
disease goes downhill but only short period of time
signifigant downhill, life threatening
recovery from acute episode
t/f: most people with chronic illnesses do not consider themselves sick or ill
t/f: poverty and chronic disease result in a circuitous cycle with decreased access to healthcare that leads to increase in health issues
Make referrals (e.g. genetic testing)
Provide education about prevention, health promotion, self-care, diagnostic tests/procedures, etc.
Provide emotional support
Reinforce positive behaviors
Provide direct care when needed
Collaborate with healthcare team
Supportive care is just as important as technical/direct care
Involves how a person exhibits and experiences maleness or femaleness physically, emotionally, & mentally
*more than just sex.
can be a cause of dysparenuia/affect sexual functioning
ex-PLISSIT model tool for addressing sexuality in pall care
two body systems important to monitor with delirium
climbing out of bed, pulling out IV, picking at hair, incoherent speech
quiet, very sleepy, hard to arouse, mumbling speech
delirium assessment tool
t/f: delirium is a normal part of the dying process
causes of delirium
Bladder catheter or outlet obstruction
t/f: at EOL, avoid invasive testing. Search for common causes only
what is key in tx of delirium
dementia patients have ___ access to hospice care
intensity duration extent
3 things that differ psychiatric complications from psychological responses
Sets with similar terms
NUR 353 Exam 4 Week 14
671 Palliative Care
nur151 mod 14
Gerontology Exam 2
Other sets by this creator
levels for NCLEX
PALL CARE FINAL
PEDS - MUSCULOSKELETAL NEURO
PEDS - ENDOCRINE
Other Quizlet sets
Chapter 5 Biology
Lecture #5 and 6
Chapter 27: New Power Balance 1850-1900