Comfort, end of life care

Question 1

Primary purpose of End of life care

Answer 1

prolong life or to improve quality of life (QOL).

Question 2

what is more important prolonging life or preserving QOL

Answer 2

Preserving QOL

Question 3

Nurses role in end of life

Answer 3

Family and patient support/teaching
Medication administration
Assessing for death (heart auscultation)
Notifying the next of kin (NOK)
Coordination with the funeral home
Preparing the body (you will never do this alone!)
Assessing for organ donation

Question 4

Etiology

Answer 4

he cause, set of causes, or manner of causation of a disease or condition.

Question 5

Social death

Answer 5

occurs when others begin to withdraw from someone who is terminally ill or has been diagnosed with a terminal illness.

Question 6

Psychic death

Answer 6

occurs when the dying person begins to accept death and to withdraw from others and regress into the self.

Question 7

Brain death

Answer 7

is the irreversible cessation of all cerebral and brainstem functions, including the ability of the brain stem to regulate vegetative and respiratory activities

Question 8

Autonomy

Answer 8

Patients have the right to self-determination, including the right to stop or withhold lifesaving care.
Patients also have the right to a dignified death.

Question 9

Beneficence

Answer 9

The obligation to “do good” for the patient, including minimizing suffering

Question 10

Nonmaleficence:

Answer 10

The obligation to do no harm
This may come into conflict with the other principles (autonomy and beneficence) during end-of-life care, which generally take precedence over nonmaleficence.
Many situations offer no truly “good” options.

Question 11

What id the dying patient wishes to stop nutrition

Answer 11

We listen to them

Question 12

Inadequate hydration may do what to a dying patient

Answer 12

should be tailored to the individual case

Question 13

a living will allows the patient to

Answer 13

document wishes at the end of life. Goes into effect when 2 physicians certify the patient is unable to make decision. Patient is terminally ill or in a permanent state of unconsciousness

Question 14

Medical per of attorney is

Answer 14

known as a healthcare proxy. Allows the patient to appoint someone to make medical decisions for the patient. Goes in effect when a physician concludes that the patient is unable to make sure their own decisions

Question 15

“I feel bad. We are starving him!”

Answer 15

The digestive and respiratory systems begin to shut down during the gradual process of dying.A dying person no longer wants to eat as digestion slows and the digestive track loses moisture and chewing, swallowing, and elimination become painful processes.

Question 16

“Why is she so cold?”

Answer 16

Circulation slows and mottling or the pooling of blood may be noticeable on the underside of the body appearing much like bruising.

Question 17

“It sounds like he is drowning!”

Answer 17

Breathing becomes more sporadic and shallow and may make a rattling sound (“death rattle”) as air travels through mucus filled passageways

Question 18

“Should I be talking to her?”

Answer 18

The person often sleeps more and more and may talk less although continues to hear.

Question 19

“They passed away but they groaned!”

Answer 19

When air and gases left in a corpse start to escape through the throat and nose, they could make the vocal cords vibrate, resulting in a noise that sounds like a groan

Question 20

Birth - 2 understanding of death

Answer 20

no understanding sensitive to loss and serperation

Question 21

age 3-5 understanding on death

Answer 21

death is reversible thought include magical thinking

Question 22

age 6-9understanding of death

Answer 22

understand the concrete finality. difficult receiving their own death may be peroccupues with medical or physical aspects of dying

Question 23

age 10-12 understanding of death

Answer 23

understand that death is final and eventually affects everyone thinks about how death will effect you personally

Question 24

Adolescents

Answer 24

views death on an adult level. understands that their own death is inevitable but is a difficult concept to perceive able to think about the spiritual and religious aspects

Question 25

Kubler ross stage of grief

Answer 25

denial anger bargaining depression acceptance

Question 26

denial

Answer 26

defence mechanism and is temporary reaction. Denial, or disbelief or shock, protects us by allowing such news to enter slowly and to give us time to come to grips with what is taking place. The person who receives positive test results for life-threatening conditions may question the results, seek second opinions, or may simply feel a sense of disbelief psychologically even though they know that the results are true.

Question 27

Anger

Answer 27

direction toward people friends family healthcare workers situation It is much easier to be angry than to be sad or in pain or depressed. It helps us to temporarily believe that we have a sense of control over our future and to feel that we have at least expressed our rage about how unfair life can be.

Question 28

Bargaining

Answer 28

person is trying to regain control “if only”involves trying to think of what could be done to turn the situation around

Question 29

Depression

Answer 29

sadness, regret, and worry. This depression makes others feel very uncomfortable and family members may try to console their loved one

Question 30

acceptance

Answer 30

not everyone will reach this Acceptance involves learning how to carry on and to incorporate this aspect of the life span into daily existence. Reaching acceptance does not in any way imply that people who are dying are happy about it or content with it. It means that they are facing it and continuing to make arrangements and to say what they wish to say to others. Some terminally ill people find that they live life more fully than ever before after they come to this stage.

Question 31

perceived loss

Answer 31

defined by the individual experiencing the loss (friendship, independence, freedom)

Question 32

Maturational loss

Answer 32

necessary loss occurring across a life span

Question 33

Situational loss

Answer 33

sudden and unpredictable loss (vision, amputation)

Question 34

Bereavement

Answer 34

refers to outward expressions of grief

Question 35

anticipatory greif

Answer 35

occurs before impending loss. this is the process of letting go

Question 36

complicated grief

Answer 36

intense long lasting grief the person is unable to move forward

Question 37

Disfranchised greif

Answer 37

the heart is grieving the person us unable to talk about loss or pain

Question 38

Actual loss

Answer 38

the loss of ones senses loss go an actual person pet or role

Question 39

perceived loss

Answer 39

loss is real to the person but may not be seen by others

Question 40

maturational loss

Answer 40

occurs with natural stages of living (child goes to school)

Question 41

Situational loss

Answer 41

sudden unoredictable life events such as fire

Question 42

Palliative care focuses on

Answer 42

providing comfort and relief from physical and emotional pain to patients throughout their illness

Question 43

Therapeutic goal in palliative care

Answer 43

Alleviating refractory or intractable symptoms such as pain, dyspnea, or delirium in terminally ill patients (as opposed to terminating their life)

Question 44

Palliative sedation

Answer 44

Benzodiazepines – decrease anxiety
Antipsychotics – decrease confusion
Opioid analgesics – decrease pain

Question 45

Brain Death

Answer 45

A complete and permanent loss” of brain function.
Unresponsive coma with loss of capacity for consciousness.
Loss of brainstem reflexes.
Inability to breathe unassisted.
Loss of function unable to resume spontaneously and unable to be restored through intervention

Question 46

Postmortem Care

Answer 46

Postmortem care is a component of EOL care and is the care given to a deceased client. Nurses and unlicensed assistive personnel (UAPs) perform most postmortem care until the deceased client is transferred to funeral provider.

Question 47

what is the nurse responsible for when caring for a client after death

Answer 47

Coordination of organ and tissue donation
Coordination with the funeral home
The family and viewing

Question 48

Postmortem care supplies

Answer 48

bathing, cotton balls, clean sheets, short kit, absorbent pad, bag for the clients belonging

Question 49

what is an important aspect of end of life care

Answer 49

religious beliefs and traditions

Question 50

what is a way to help pain without meds

Answer 50

a massage using the palm of your hand is a circular motion

Question 51

When was MAID made legal

Answer 51

Feb 6 2015

Question 52

MAID eligibility

Answer 52

request voluntarily, 18 older, capacity to make decisions, must provide informed consent, diagnosed with serious and incurable illness, advanced decline, enduring physical suffering

Question 53

MAID natural death is reasonabley foreseable

Answer 53

-must make a written request with witness
-2 practitioners must confirm eligibility
-person must be informed they can withdraw
-Immediatly before it happens they must be offered to stop

Question 54

MAID natural death is not foreseable in the future

Answer 54

-must make a written request with witness
-2 practitioners must confirm eligibility
-person must be informed they can withdraw
-Immediatly before it happens they must be offered to stop
-Minimum 90 days
-must inform mental health professional
-both practitioners discussed

Question 55

do RNs need to be involved in MAID

Answer 55

Not if they wish not to

Question 56

can an RN administer substance for MAID

Answer 56

no