Ch. 9 - End Of Life Care

Question 1

When is death viewed as a relief ?

Answer 1

When the dying process is long or painful

Question 2

What are the Kubler-Ross’ stages of grief ?

Answer 2

• Denial
• Anger
• Depression
• Bargaining
• Acceptance

Question 3

What are some key identifiers of the Denial stage of grief ?

Answer 3

• Avoidance
• Confusion
• Elation
• Shock
• Fear

Question 4

what are some key identifiers in the Anger stage of grief ?

Answer 4

• Frustration
• Irritation
• Anxiety

Question 5

What are some key identifiers in the Depression stage of grief ?

Answer 5

• Overwhelmed
• Helplessness
• Hostility
• Flight

Question 6

What are some key identifiers in the Bargaining stage of grief ?

Answer 6

• Struggling to find meaning
• Reaching out to others
• Telling one’s story
• Support groups

Question 7

What are some key indentifiers in the Acceptance stage of grief ?

Answer 7

• Exploring options
• New plan in place
• Moving on

Question 8

When does Dying begin ?

Answer 8

At the moment called “crisis knowledge of death”

Question 9

When does dying end ?

Answer 9

At the moment of physiologic death

Question 10

the Living-dying interval is the time between what two points ?

Answer 10

Crisis knowledge of death THROUGH physiologic death

Question 11

The __________ phase is when the speed of physical dying is accelerated, and the person no longer has the energy to maintain the activities of everyday life

Answer 11

Terminal phase

Question 12

What is the six C’s approach during the dying period ?

Answer 12

• Care
• Control (help keep self control/independence, etc.)
• Composure
• Communication
• Continuity (perserve as normal life as possible)
• Closure

Question 13

Palliative care can be provided along with what ?

Answer 13

Curative treatment

Question 14

_________ care is appropriate at any age and at any stage in a serious illness ?

Answer 14

Palliative care

Question 15

Palliative care is made up of what two things ?

Answer 15

Care & Comfort

Question 16

What is the Focus of palliative care ?

Answer 16

Focus is on care and comfort (treatment of symptoms) versus cure.

Question 17

What is the goal of palliative care ?

Answer 17

To improve quality of life for both the patient and the family

Question 18

_________ care may progress to hospice care ?

Answer 18

Palliative

Question 19

Types of Hospice care ?

Answer 19

• Inpatient
• Hospice facility
• Long-term care
• Home (most common)

Question 20

What is the average length of stay in Hospice ?

Answer 20

22 days

Question 21

Is there a time frame for palliative care ?

Answer 21

There are NO time restrictions

Question 22

What is the typical time frame for Hospice ?

Answer 22

Considered to be terminal or within six months of death

Question 23

Euthanasia definition

Answer 23

Is the client’s right to refuse life-sustaining medical measures

????????

Question 24

What is Xerostomia ?

Answer 24

Sensation of oral dryness

Question 25

Xerostomia _____________ with age ?

Answer 25

increases

Question 26

What assessment is crucial when dealing with anorexia/decreased swallowing ?

Answer 26

ASSESS ABILITY TO SWALLOW pills and/or food bolus

Question 27

Ascites definition ?

Answer 27

Accumulation of vascular fluid in the peritoneal space resulting from altered capillary dynamics

Question 28

Comfort measures for Ascites treatment ?

Answer 28

- Small frequent meals - Positioning - Skin care

Question 29

Initial drug treatment for Ascites ?

Answer 29

- Diuretics - Eventually not responsive - Paracentesis : may be intermittent or placement of catheter

Question 30

What is the only reliable indicator of Dyspnea ?

Answer 30

The subjective report by the patient | Similar to pain

Question 31

Increased Dyspnea is common in which age group ?

Answer 31

The elderly

Question 32

Nebulized opioids have no benefit compared to _______/________ delivery ?

Answer 32

Oral/Parenteral

Question 33

What are end of life medications used to treat dyspnea ?

Answer 33

- benzodiazepines - opioids - corticosteroids

Question 34

When should an opioid infusion be considered ? (ex: morphine drip)

Answer 34

If actively dying with respiratory distress

Question 35

Respiratory secretions occur most commonly when ?

Answer 35

In the last hours of life

Question 36

What is Myoclonus ?

Answer 36

Sudden, uncontrollable, non-rhythmic jerking, usually of the extremities

Question 37

Cause of Myoclonus in palliative care ?

Answer 37

Often related to opioid use

Question 38

As a nurse, what should you do when you suspect imminent Death ?

Answer 38

start calling the family | - Imminent = About to happen

Question 39

As a nurse, what is one rule you should abide by when engaging in a family meeting ?

Answer 39

Listen twice as much as you speak