10: Palliative and Hospice Care Flashcards Preview

Simmons NURP 503 Exam 3 > 10: Palliative and Hospice Care > Flashcards

Flashcards in 10: Palliative and Hospice Care Deck (119)
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1
Q

Automatic or suggested referral to peds palliative care?

Severe progressive scoliosis

A

Suggested

2
Q
Automatic or suggested referral to peds palliative care?
Pulmonary atresia (especially if associated with hypoplastic pulmonary arteries)
A

Automatic

3
Q

Hospice falls under what section of government healthcare?

A

Medicare Part A

4
Q

Automatic or suggested referral to peds palliative care?

Severe encephalitis

A

Suggested

5
Q

Automatic or suggested referral to peds palliative care?

Severe mitochrondrial disorder

A

Suggested

6
Q

Automatic or suggested referral to peds palliative care?

Tay Sachs disease

A

Automatic

7
Q

Automatic or suggested referral to peds palliative care?

Down syndrome with significant cardiac abnormality

A

Automatic

8
Q

Automatic or suggested referral to peds palliative care?

Asphyxiating thoracic dystrophy

A

Automatic

9
Q

Automatic or suggested referral to peds palliative care?

Bone marrow/stem-cell transplant

A

Automatic

10
Q

Automatic or suggested referral to peds palliative care?

Progressive neurodegenerative conditions

A

Automatic

11
Q

Automatic or suggested referral to peds palliative care?

Renal failure, not transplant candidate

A

Suggested

12
Q

Automatic or suggested referral to peds palliative care?

Severe immunodeficiency syndromes, particularly those for which BMT is a consideration

A

Suggested

13
Q

Automatic or suggested referral to peds palliative care?

Menke’s disease

A

Automatic

14
Q

Automatic or suggested referral to peds palliative care?

Hunter’s/Hurlerí’s disease

A

Automatic

15
Q

Automatic or suggested referral to peds palliative care?

Immersion injury

A

Suggested

16
Q

Automatic or suggested referral to peds palliative care?

VLBW infants

A

Suggested

17
Q

Automatic or suggested referral to peds palliative care?

Short-gut syndrome with TPN dependence

A

Suggested

18
Q

Automatic or suggested referral to peds palliative care?

Patients with CF with vent dependence or those ineligible for lung transplant

A

Automatic

19
Q

Automatic or suggested referral to peds palliative care?

Family with limited social supports

A

Suggested

20
Q

Automatic or suggested referral to peds palliative care?

Congenital CMV/toxoplasmosis with neurological sequelae

A

Suggested

21
Q

Automatic or suggested referral to peds palliative care?

Persistent vegetative state

A

Automatic

22
Q

Automatic or suggested referral to peds palliative care?

Severe pulmonary hypertension

A

Automatic

23
Q

Automatic or suggested referral to peds palliative care?

Sandoff’s disease

A

Automatic

24
Q

Automatic or suggested referral to peds palliative care?

Sanfilippo syndrome

A

Automatic

25
Q

Automatic or suggested referral to peds palliative care?

Patients with CF with pain, dyspnea, or other symptoms who would benefit from symptom management

A

Suggested

26
Q

Automatic or suggested referral to peds palliative care?

Need for hospice resource utilization

A

Suggested

27
Q

Automatic or suggested referral to peds palliative care?

ECMO candidate

A

Suggested

28
Q

Automatic or suggested referral to peds palliative care?

New diagnosis of life-limiting/threatening condition

A

Suggested

29
Q

Automatic or suggested referral to peds palliative care?

Difficult pain or symptom management

A

Suggested

30
Q

What level of HF qualifies for hospice?

A

NYHA Class 4

31
Q

Automatic or suggested referral to peds palliative care?

Irreversible brain injury that will impact functional status

A

Suggested

32
Q

T/F A palliative care approach decreases length of hospital stay, including the ICU/CCU, and eases the transition between care settings for patients. This results in increased patient and family satisfaction and compliance with hospital standards (JCAHO). Integrative and consultant services have been used with success.

A

True

33
Q

Automatic or suggested referral to peds palliative care?

Krabbe’s disease

A

Automatic

34
Q

Automatic or suggested referral to peds palliative care?

New diagnosis with complex pain or symptom management issues

A

Suggested

35
Q

Automatic or suggested referral to peds palliative care?

Severe birth asphyxia

A

Automatic

36
Q

Automatic or suggested referral to peds palliative care?

Long-segment Hirshsprung’s

A

Suggested

37
Q

Stems from the word “hospitality.” Beginning in medieval times, monks offered shelter to weary or ill travelers.

A

Hospice

38
Q

Automatic or suggested referral to peds palliative care?

Neonatal polycystic kidney disease

A

Automatic

39
Q

Automatic or suggested referral to peds palliative care?

Severe metabolic disorders for which BMT is a therapeutic consideration

A

Suggested

40
Q

Automatic or suggested referral to peds palliative care?

Severe head injury following NAT

A

Automatic

41
Q

Automatic or suggested referral to peds palliative care?

Fabry’s disease

A

Automatic

42
Q

Automatic or suggested referral to peds palliative care?

Patients with CF with multiple hospitalizations

A

Suggested

43
Q

Automatic or suggested referral to peds palliative care?

Three or more hospitalizations within six months

A

Suggested

44
Q

Automatic or suggested referral to peds palliative care?

Niemann-Pick disease

A

Automatic

45
Q

5 cues that could prompt a referral to palliative care.

A
  1. Unacceptable level of pain or other symptom or distress.
  2. Uncontrolled psychosocial or spiritual issues.
  3. Frequent visits to the emergency department for the same diagnosis.
  4. More than one hospitalization for the same diagnosis in the last 30 days.
  5. Team/resident/family needs help with complex decision making and determination of goals of care.
46
Q

Automatic or suggested referral to peds palliative care?

Any newly diagnosed malignant disease with an EFS

A

Suggested

47
Q

Automatic or suggested referral to peds palliative care?

MRCP with comorbidities

A

Suggested

48
Q

Automatic or suggested referral to peds palliative care?

Eisenmanger’s syndrome

A

Automatic

49
Q

Automatic or suggested referral to peds palliative care?

Relapsed malignant disease following stem-cell/bone marrow transplant

A

Automatic

50
Q

Automatic or suggested referral to peds palliative care?

Cardiomyopathy: hypertrophic or severe dilated

A

Automatic

51
Q

Automatic or suggested referral to peds palliative care?

Total aganglionosis of colon

A

Automatic

52
Q

Automatic or suggested referral to peds palliative care?

Rett’s syndrome

A

Suggested

53
Q

Aims to relieve suffering and improve quality of life for patients with advanced illness or chronic disease, and their families.

A

Palliative Care

54
Q

Automatic or suggested referral to peds palliative care?

Other rare chromosomal anomalies with known poor neurologic prognosis

A

Suggested

55
Q

Automatic or suggested referral to peds palliative care?

PICU stay longer than two weeks

A

Suggested

56
Q

Automatic or suggested referral to peds palliative care?

Severe feeding intolerance (autonomic enteropathy/chronic intestinal pseudoobstruction)

A

Suggested

57
Q

Automatic or suggested referral to peds palliative care?

Prolonged or failed attempt to wean mechanical ventilation

A

Automatic

58
Q

Automatic or suggested referral to peds palliative care?

Spinal muscular atrophy

A

Automatic

59
Q

Automatic or suggested referral to peds palliative care?

Severe progressive scoliosis

A

Suggested

60
Q

When did hospice come to the US?

A
  1. The first hospice in the United States opens: The Connecticut Hospice.
61
Q

Automatic or suggested referral to peds palliative care?

Static encephalopathy

A

Suggested

62
Q

Automatic or suggested referral to peds palliative care?

Progressive metastatic cancer

A

Automatic

63
Q

Automatic or suggested referral to peds palliative care?

Severe traumatic brain injury

A

Automatic

64
Q

Hospice eligibility (3).

A
  1. Two physicians must certify.
  2. <6 months to live in normal course of disease.
  3. Patient must elect hospice.
65
Q

Automatic or suggested referral to peds palliative care?

Multiorgan system failure

A

Automatic

66
Q

Automatic or suggested referral to peds palliative care?

Combination of cardiac diagnosis with underlying neurologic/chromosomal diagnosis

A

Automatic

67
Q

Automatic or suggested referral to peds palliative care?

Bronchiolitis obliterans

A

Automatic

68
Q

Automatic or suggested referral to peds palliative care?

Batten disease

A

Automatic

69
Q

Automatic or suggested referral to peds palliative care?

Central hypoventilation syndromes

A

Suggested

70
Q

Automatic or suggested referral to peds palliative care?

Potter syndrome

A

Automatic

71
Q

Automatic or suggested referral to peds palliative care?

Pompe disease

A

Automatic

72
Q

Automatic or suggested referral to peds palliative care?

HIV/AIDS resistant to antiretrovirals

A

Automatic

73
Q

Automatic or suggested referral to peds palliative care?

Metastatic solid tumors

A

Suggested

74
Q

Automatic or suggested referral to peds palliative care?

HIV/AIDS resistant to antiretrovirals

A

Automatic

75
Q

Automatic or suggested referral to peds palliative care?

Epidermolysis bullosa

A

Automatic

76
Q

Automatic or suggested referral to peds palliative care?

Any relapsed malignant disease

A

Suggested

77
Q

Automatic or suggested referral to peds palliative care?

Patients with CF considering lung transplant/at the time of transplant

A

Automatic

78
Q

Automatic or suggested referral to peds palliative care?

Patients with CF with FEV1 < 30%

A

Automatic

79
Q

Automatic or suggested referral to peds palliative care?

Progressive hepatic or uremic encephalopathy

A

Automatic

80
Q

How long are hospice benefits under Medicare?

A

Benefit periods are two 90-day periods, followed by unlimited number of 60-day periods.

81
Q

Automatic or suggested referral to peds palliative care?

Complex congenital heart disease

A

Suggested

82
Q

Automatic or suggested referral to peds palliative care?

Extreme prematurity with concomitant severe BPD, Grade IV IVH, PVL, etc.

A

Automatic

83
Q

Who helped establish the first US hospice in Connecticut?

A

Dame Cicely Saunders. She was a nurse, then social worker, then physician.

84
Q

Automatic or suggested referral to peds palliative care?

Metachromatic leukodystrophy

A

Automatic

85
Q

Automatic or suggested referral to peds palliative care?

Trisomy 13, 15, 18

A

Automatic

86
Q

Automatic or suggested referral to peds palliative care?

Hydranencephaly

A

Automatic

87
Q

Automatic or suggested referral to peds palliative care?

Diffuse intrinsic pontine glioma

A

Automatic

88
Q

8 components of palliative care.

A
  1. Pain management
  2. Symptom management
  3. Goals of care
  4. Quality of life
  5. Family is the unit of care
  6. Spiritual/cultural considerations
  7. Bereavement
  8. Communication is key
89
Q

Automatic or suggested referral to peds palliative care?

Single ventricle cardiac physiology

A

Automatic

90
Q

Automatic or suggested referral to peds palliative care?

Ebstein’s anomaly

A

Automatic

91
Q

Automatic or suggested referral to peds palliative care?

Ongoing discussion of cardiac transplant

A

Automatic

92
Q

Automatic or suggested referral to peds palliative care?

Severe forms of osteogenesis imperfecta (type 3 or 4)

A

Automatic

93
Q

Automatic or suggested referral to peds palliative care?

Hypoxic ischemic encephalopathy (moderate to severe)

A

Automatic

94
Q

Automatic or suggested referral to peds palliative care?

Biliary atresia

A

Automatic

95
Q

To ease pain without curing.

A

Palliative

96
Q

Automatic or suggested referral to peds palliative care?

Severe anoxic brain injury (not neonatal)

A

Suggested

97
Q

Automatic or suggested referral to peds palliative care?

Stage IV neuroblastoma

A

Automatic

98
Q

Automatic or suggested referral to peds palliative care?

Anencephaly

A

Automatic

99
Q

When did the medical board begin offering hospice and palliative care as a specialty?

A

2006

100
Q

Automatic or suggested referral to peds palliative care?

Lissencephaly

A

Automatic

101
Q

Automatic or suggested referral to peds palliative care?

Muscular dystrophy

A

Automatic

102
Q

When was the term hospice first utilized in the medical field?

A
  1. Dr. Cicely Saunders applied the term to specialized care for dying patients at St. Christopher’s Hospice in London.
103
Q

Automatic or suggested referral to peds palliative care?

AND (Allow Natural Death)/DNR order or other ethical conflicts

A

Suggested

104
Q

Automatic or suggested referral to peds palliative care?

Severe schizencephaly

A

Automatic

105
Q

Automatic or suggested referral to peds palliative care?

Thanatophoric dwarfism

A

Automatic

106
Q

Automatic or suggested referral to peds palliative care?

Multivisceral organ transplant under consideration

A

Automatic

107
Q

Automatic or suggested referral to peds palliative care?

Patient, family, or physician uncertainty regarding prognosis

A

Suggested

108
Q

Automatic or suggested referral to peds palliative care?

Severe myocarditis

A

Suggested

109
Q

Automatic or suggested referral to peds palliative care?

Compassionate extubation

A

Automatic

110
Q

Automatic or suggested referral to peds palliative care?

Patients who are chronically ventilator-dependent

A

Suggested

111
Q

What is the goal of palliative care?

A

The goal of palliative care is achievement of the best possible quality of life for patients and their families.

112
Q

T/F Palliative care helps postpone death.

A

False. It affirms life and regards death as a normal process. Palliative care neither hastens nor postpones death.

113
Q

Automatic or suggested referral to peds palliative care?

Complex care coordination and/or home-going needs

A

Suggested

114
Q

Automatic or suggested referral to peds palliative care?

Leukodystrophy/ALD

A

Automatic

115
Q

T/F Hospice and palliative care are synonymous concepts.

A

False. Palliative care extends the principles of hospice to a broader population that could benefit from this type of care earlier in their illness. Hospice is restricted to those with a certain amount of time left. Palliative care can be appropriate at any point along a disease trajectory. The goal is the relief of distressing symptoms and maximizing quality of life.

116
Q

When did palliative care begin?

A
  1. The American Academy of Hospice Physicians was formed.
117
Q

Automatic or suggested referral to peds palliative care?

Feeding tube under consideration for any neurological condition

A

Suggested

118
Q

Automatic or suggested referral to peds palliative care?

Prolonged hospitalization for more than three weeks

A

Suggested

119
Q

Automatic or suggested referral to peds palliative care?

Conflicts regarding use of medical nutrition/hydration in cognitively impaired, seriously ill, or dying patients.

A

Automatic