Chapter 9 Flashcards
Describe the 2 overall goals of palliative care
*Prevent and relieve suffering
*Improve quality of life for patients with serious life-limiting illnesses
Describe 3 outcomes from utilizing palliative care in those with chronic illnesses.
*Improve quality of life for those with chronic illness
*Decrease the associated economic costs for their health care
*Ease caregiver burden for those with chronic and terminal illnesses
Identify the main goal and 3 areas of emphasis of hospice care.
*Main goal: to assist the patient to live as fully and comfortably as possible while dying with dignity.
1.Symptom management
2. Advance care planning
3. Spiritual care
Contrast palliative care vs hospice care.
*Palliative care: The “Big Umbrella”
1. Often includes hospice care before or at the EOL (end of life).
2. Goal is to prevent/relieve suffering and to improve quality of life.
3. Can be on dialysis, have home health, or utilize any other “curative” treatment.
*Hospice provides compassion, concern, and support for persons in the last phases of a terminal disease.
1. Goal is a full and comfortable life.
2. Cannot be on dialysis, home health, or have any other “curative” treatment.
Criteria for hospice (2)
- Patient must want the service
- Patient must be medically eligible:
1 dr must certify terminal illness
+
Less than 6 months to live
Describe the role of the interdisciplinary team of hospice care. (2)
*Hospice RN coordinate team to provide care/support to pt and fam.
*focused on pain control and symptom management
Define brain death and criteria for clinical diagnosis of brain death. (6)
*irreversible loss of all brain functions (including brain stem)
Looks like…
*coma or unresponsive
*absence of brainstem reflexes
*apnea
*requires specific dx by physician to confirm
*important when considering organ donation
List 4 goals of end-of-life care in all care settings.
1 Provide comfort and supportive care during the dying process
- Improve the quality of the patient’s remaining life
- Help ensure a dignified death
- Provide emotional support to the family
Define advance directive and how this document impacts one’s medical care at end of life
*Advanced directives are the written documents that provide information about the patient’s wishes and his/her designated spokesperson.
*Patient’s often change their minds about desired treatments as their disease state progresses. It is important to reassess a patient’s advance directives.
Compare Allow Natural Death and comfort measures only
*allow natural death: “no code” or DNR
*comfort measures only: all measures associated w/pain control and symptom management
Describe a POLST form and how it is utilized at the end of life. (2)
- Physician Order for Life-Sustaining Treatment
*state specific doc to outline tx options at the end of life when pt is not capable of communicating their wishes
Describe the impact of anxiety, depression on death (causes and management)
*Causes: uncontrolled pain and dyspnea, psychosocial factors r/t the disease process or impending death, altered physiologic states, and drugs used in high dosages.
*Management: medications and nonpharmacologic interventions. Relaxation strategies, such as relaxation breathing, muscle relaxation, music, and imagery, may be useful.
impact of anger on death (2)
*may be directed at dying pt or nurse (not personal)
*encourage expression of feelings
Impact of hopelessness on death (2)
*encourage realistic hope w/i the limits of the situation
*decision making about care gives sense of control and autonomy
Impact of fear on death (4 fears + management)
*specific fears: fear of pain, fear of SOB, fear of loneliness, fear of meaninglessness
*How to help: Assist patients and their families to identify the positive qualities of the patient’s life.
