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):
1

Automatic or suggested referral to peds palliative care?
Severe progressive scoliosis

Suggested

2

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

Automatic

3

Hospice falls under what section of government healthcare?

Medicare Part A

4

Automatic or suggested referral to peds palliative care?
Severe encephalitis

Suggested

5

Automatic or suggested referral to peds palliative care?
Severe mitochrondrial disorder

Suggested

6

Automatic or suggested referral to peds palliative care?
Tay Sachs disease

Automatic

7

Automatic or suggested referral to peds palliative care?
Down syndrome with significant cardiac abnormality

Automatic

8

Automatic or suggested referral to peds palliative care?
Asphyxiating thoracic dystrophy

Automatic

9

Automatic or suggested referral to peds palliative care?
Bone marrow/stem-cell transplant

Automatic

10

Automatic or suggested referral to peds palliative care?
Progressive neurodegenerative conditions

Automatic

11

Automatic or suggested referral to peds palliative care?
Renal failure, not transplant candidate

Suggested

12

Automatic or suggested referral to peds palliative care?
Severe immunodeficiency syndromes, particularly those for which BMT is a consideration

Suggested

13

Automatic or suggested referral to peds palliative care?
Menke's disease

Automatic

14

Automatic or suggested referral to peds palliative care?
Hunter's/Hurlerí's disease

Automatic

15

Automatic or suggested referral to peds palliative care?
Immersion injury

Suggested

16

Automatic or suggested referral to peds palliative care?
VLBW infants

Suggested

17

Automatic or suggested referral to peds palliative care?
Short-gut syndrome with TPN dependence

Suggested

18

Automatic or suggested referral to peds palliative care?
Patients with CF with vent dependence or those ineligible for lung transplant

Automatic

19

Automatic or suggested referral to peds palliative care?
Family with limited social supports

Suggested

20

Automatic or suggested referral to peds palliative care?
Congenital CMV/toxoplasmosis with neurological sequelae

Suggested

21

Automatic or suggested referral to peds palliative care?
Persistent vegetative state

Automatic

22

Automatic or suggested referral to peds palliative care?
Severe pulmonary hypertension

Automatic

23

Automatic or suggested referral to peds palliative care?
Sandoff's disease

Automatic

24

Automatic or suggested referral to peds palliative care?
Sanfilippo syndrome

Automatic

25

Automatic or suggested referral to peds palliative care?
Patients with CF with pain, dyspnea, or other symptoms who would benefit from symptom management

Suggested

26

Automatic or suggested referral to peds palliative care?
Need for hospice resource utilization

Suggested

27

Automatic or suggested referral to peds palliative care?
ECMO candidate

Suggested

28

Automatic or suggested referral to peds palliative care?
New diagnosis of life-limiting/threatening condition

Suggested

29

Automatic or suggested referral to peds palliative care?
Difficult pain or symptom management

Suggested

30

What level of HF qualifies for hospice?

NYHA Class 4

31

Automatic or suggested referral to peds palliative care?
Irreversible brain injury that will impact functional status

Suggested

32

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.

True

33

Automatic or suggested referral to peds palliative care?
Krabbe's disease

Automatic

34

Automatic or suggested referral to peds palliative care?
New diagnosis with complex pain or symptom management issues

Suggested

35

Automatic or suggested referral to peds palliative care?
Severe birth asphyxia

Automatic

36

Automatic or suggested referral to peds palliative care?
Long-segment Hirshsprung's

Suggested

37

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

Hospice

38

Automatic or suggested referral to peds palliative care?
Neonatal polycystic kidney disease

Automatic

39

Automatic or suggested referral to peds palliative care?
Severe metabolic disorders for which BMT is a therapeutic consideration

Suggested

40

Automatic or suggested referral to peds palliative care?
Severe head injury following NAT

Automatic

41

Automatic or suggested referral to peds palliative care?
Fabry's disease

Automatic

42

Automatic or suggested referral to peds palliative care?
Patients with CF with multiple hospitalizations

Suggested

43

Automatic or suggested referral to peds palliative care?
Three or more hospitalizations within six months

Suggested

44

Automatic or suggested referral to peds palliative care?
Niemann-Pick disease

Automatic

45

5 cues that could prompt a referral to palliative care.

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

Automatic or suggested referral to peds palliative care?
Any newly diagnosed malignant disease with an EFS

Suggested

47

Automatic or suggested referral to peds palliative care?
MRCP with comorbidities

Suggested

48

Automatic or suggested referral to peds palliative care?
Eisenmanger's syndrome

Automatic

49

Automatic or suggested referral to peds palliative care?
Relapsed malignant disease following stem-cell/bone marrow transplant

Automatic

50

Automatic or suggested referral to peds palliative care?
Cardiomyopathy: hypertrophic or severe dilated

Automatic

51

Automatic or suggested referral to peds palliative care?
Total aganglionosis of colon

Automatic

52

Automatic or suggested referral to peds palliative care?
Rett's syndrome

Suggested

53

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

Palliative Care

54

Automatic or suggested referral to peds palliative care?
Other rare chromosomal anomalies with known poor neurologic prognosis

Suggested

55

Automatic or suggested referral to peds palliative care?
PICU stay longer than two weeks

Suggested

56

Automatic or suggested referral to peds palliative care?
Severe feeding intolerance (autonomic enteropathy/chronic intestinal pseudoobstruction)

Suggested

57

Automatic or suggested referral to peds palliative care?
Prolonged or failed attempt to wean mechanical ventilation

Automatic

58

Automatic or suggested referral to peds palliative care?
Spinal muscular atrophy

Automatic

59

Automatic or suggested referral to peds palliative care?
Severe progressive scoliosis

Suggested

60

When did hospice come to the US?

1974. The first hospice in the United States opens: The Connecticut Hospice.

61

Automatic or suggested referral to peds palliative care?
Static encephalopathy

Suggested

62

Automatic or suggested referral to peds palliative care?
Progressive metastatic cancer

Automatic

63

Automatic or suggested referral to peds palliative care?
Severe traumatic brain injury

Automatic

64

Hospice eligibility (3).

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

65

Automatic or suggested referral to peds palliative care?
Multiorgan system failure

Automatic

66

Automatic or suggested referral to peds palliative care?
Combination of cardiac diagnosis with underlying neurologic/chromosomal diagnosis

Automatic

67

Automatic or suggested referral to peds palliative care?
Bronchiolitis obliterans

Automatic

68

Automatic or suggested referral to peds palliative care?
Batten disease

Automatic

69

Automatic or suggested referral to peds palliative care?
Central hypoventilation syndromes

Suggested

70

Automatic or suggested referral to peds palliative care?
Potter syndrome

Automatic

71

Automatic or suggested referral to peds palliative care?
Pompe disease

Automatic

72

Automatic or suggested referral to peds palliative care?
HIV/AIDS resistant to antiretrovirals

Automatic

73

Automatic or suggested referral to peds palliative care?
Metastatic solid tumors

Suggested

74

Automatic or suggested referral to peds palliative care?
HIV/AIDS resistant to antiretrovirals

Automatic

75

Automatic or suggested referral to peds palliative care?
Epidermolysis bullosa

Automatic

76

Automatic or suggested referral to peds palliative care?
Any relapsed malignant disease

Suggested

77

Automatic or suggested referral to peds palliative care?
Patients with CF considering lung transplant/at the time of transplant

Automatic

78

Automatic or suggested referral to peds palliative care?
Patients with CF with FEV1 < 30%

Automatic

79

Automatic or suggested referral to peds palliative care?
Progressive hepatic or uremic encephalopathy

Automatic

80

How long are hospice benefits under Medicare?

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

81

Automatic or suggested referral to peds palliative care?
Complex congenital heart disease

Suggested

82

Automatic or suggested referral to peds palliative care?
Extreme prematurity with concomitant severe BPD, Grade IV IVH, PVL, etc.

Automatic

83

Who helped establish the first US hospice in Connecticut?

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

84

Automatic or suggested referral to peds palliative care?
Metachromatic leukodystrophy

Automatic

85

Automatic or suggested referral to peds palliative care?
Trisomy 13, 15, 18

Automatic

86

Automatic or suggested referral to peds palliative care?
Hydranencephaly

Automatic

87

Automatic or suggested referral to peds palliative care?
Diffuse intrinsic pontine glioma

Automatic

88

8 components of palliative care.

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

Automatic or suggested referral to peds palliative care?
Single ventricle cardiac physiology

Automatic

90

Automatic or suggested referral to peds palliative care?
Ebstein's anomaly

Automatic

91

Automatic or suggested referral to peds palliative care?
Ongoing discussion of cardiac transplant

Automatic

92

Automatic or suggested referral to peds palliative care?
Severe forms of osteogenesis imperfecta (type 3 or 4)

Automatic

93

Automatic or suggested referral to peds palliative care?
Hypoxic ischemic encephalopathy (moderate to severe)

Automatic

94

Automatic or suggested referral to peds palliative care?
Biliary atresia

Automatic

95

To ease pain without curing.

Palliative

96

Automatic or suggested referral to peds palliative care?
Severe anoxic brain injury (not neonatal)

Suggested

97

Automatic or suggested referral to peds palliative care?
Stage IV neuroblastoma

Automatic

98

Automatic or suggested referral to peds palliative care?
Anencephaly

Automatic

99

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

2006

100

Automatic or suggested referral to peds palliative care?
Lissencephaly

Automatic

101

Automatic or suggested referral to peds palliative care?
Muscular dystrophy

Automatic

102

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

1967. Dr. Cicely Saunders applied the term to specialized care for dying patients at St. Christopher's Hospice in London.

103

Automatic or suggested referral to peds palliative care?
AND (Allow Natural Death)/DNR order or other ethical conflicts

Suggested

104

Automatic or suggested referral to peds palliative care?
Severe schizencephaly

Automatic

105

Automatic or suggested referral to peds palliative care?
Thanatophoric dwarfism

Automatic

106

Automatic or suggested referral to peds palliative care?
Multivisceral organ transplant under consideration

Automatic

107

Automatic or suggested referral to peds palliative care?
Patient, family, or physician uncertainty regarding prognosis

Suggested

108

Automatic or suggested referral to peds palliative care?
Severe myocarditis

Suggested

109

Automatic or suggested referral to peds palliative care?
Compassionate extubation

Automatic

110

Automatic or suggested referral to peds palliative care?
Patients who are chronically ventilator-dependent

Suggested

111

What is the goal of palliative care?

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

112

T/F Palliative care helps postpone death.

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

113

Automatic or suggested referral to peds palliative care?
Complex care coordination and/or home-going needs

Suggested

114

Automatic or suggested referral to peds palliative care?
Leukodystrophy/ALD

Automatic

115

T/F Hospice and palliative care are synonymous concepts.

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

When did palliative care begin?

1988. The American Academy of Hospice Physicians was formed.

117

Automatic or suggested referral to peds palliative care?
Feeding tube under consideration for any neurological condition

Suggested

118

Automatic or suggested referral to peds palliative care?
Prolonged hospitalization for more than three weeks

Suggested

119

Automatic or suggested referral to peds palliative care?
Conflicts regarding use of medical nutrition/hydration in cognitively impaired, seriously ill, or dying patients.

Automatic