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Flashcards in End Of Life Deck (49):
1

What does palliative care involve

Addresses physical intellectual emotional social and special needs and facilitating patient autonomy access information and choice

2

Why Use palliative care

Relief from pain and other distressing symptoms
Affirms life and regards dying as a normal process
Intends neither to hasten nor postpone death
Offers a support system to patients and family

3

What does it integrate

Psychosocial and spirituals aspects of care

4

When does it begin

When a life threatening condition is diagnosed

5

What are the top priorities for a loved one with terminal illness

Someone to be sure that the patient's wishes are honored choice among the type of services the patient can receive
pain control Taylored to the patient's wishes
emotional support for the patient and family

6

The goal of palliative care

To relieve pain symptoms and stress of serious illness

7

Palliative care offered to

Those undergoing curative treatment even at the early stages of a serious and complex illness

8

The gold standard for end-of-life care

Hospice

9

What is the central belief of hospice

Each person is entitled to a pain-free death with dignity and that families are entitled to the support necessary to allow that to happen

10

Kind of approach is hospice based on

Interdisciplinary

11

What does the team for hospice develop

Individualized care plan to meet each patient's needs for pain management and symptom control

12

Are Medicare covered hospice services

Physician services
nursing care
medical equipment
medical supplies
drugs for symptom control
short term care in the hospital
short term respite care
home health aide
homemaker services
PT and OT
speech therapy
social worker
Dietary counseling
Bereavement for patients families

13

What does the right to die concept include

Suicide or voluntary active euthanasia

14

Where is right to die legal

Montana Oregon and Washington

15

What can be some disparities in end of life

Geographic racial and ethnic and language

16

Is palliative sedation therapy

The lowering of patient consciousness using medications for the express purpose of limiting patients awareness of suffering that is intractable an intolerable

17

What are advanced medical directive's

Documents containing patient's oral and written expression's other preferences about future medical care if they should become unable to speak for themselves

18

Palliative sedation therapy equated with

Euthanasia

19

What does federal law require

Hospitals to inform patient that they have the right to complete advanced directive

20

What are advanced medical directive's usually in the form of

A living will or medical power of attorney

21

What was a do not attempt resuscitation order formerly

Do not resuscitate

22

Where should A do not attempt resuscitation order to be placed

Head or foot of bed refrigerator

23

How to many older patients choose to end their lives

Refusing food and liquids

24

When does death occur in refusing food and liquid

Within 15 days
Little pain and suffering
No hunger or thirst experienced

25

Artificial nutrition and hydration will prolong life by days or weeks but will cause what

Physical and emotional damage

26

What is essential in end of life care

Honest compassionate communication

27

Guidelines in communicating about illness and death

Listen
make empathetic statements
elicit the patients values and goals of care
Offer information about prognosis
discuss death explicitly
maintain cultural sensitivity

28

What should conversations about death and dying always consider

Pts cultural and ethnic background and spirituality

29

What is called the fifth vital sign

Pain

30

Other effects pain has

Physical and emotional

31

Severe chronic pain cause

Depression anxiety fear decreased appetite impaired sleep thoughts of suicide (often disappear when pain is releived)

32

What does jcaho require

Hospitals and other healthcare facilities regularly assess monitor and manage pain in all patients

33

Pain meds should be given what

Freely to relieve pain with the concern of addiction

34

What should define the goal of pain management

Patient preferences

35

Who may have a higher pain threshold

Older pts

36

Why might older pts have a higher pain tolerance

Age related charges in neurophysiology

37

What may perception of pain be affected by

Cultural considerations

38

Side effects of opioid therapy

Drowsiness
Nassau vomitting
Dyspenea
Constipation
Dry mouth

39

What the most common fears

Fear of death
fear pain
of dying alone
fear of being a burden

40

Depression can be caused by

Weak support system
Persistent negative thinking
Increased dysfunction related to the illness
Untreated or under treated pain

41

What can loss consist of

Physical strength
Abilities
Mental abilities
Relationships
Self esteem
Body image
Independence
Control over life plans and lifestyle

42

What is grief

The normal human response to loss
Is universal individual and unpredictable

43

Stages of grief

Shocking and numbing
yearning and searching
disorganization and despair
some degree of reorganization

44

What is bereavement

Being deprived of someone through death and the feeling of desolation that follows

45

What to consider for family of the dying pt

Time and logistics (24/7 care)
Physical tasks - risk for injury
Financial
Caregiver emotional burden and mental health
Physical health risks for caregiver (respite care)

46

Signs that death has occured

No respiration or pulse
Eyes open but don't move or blink
Jaw relaxed and mouth slightly open
Bowel and bladder expelled
Don't respond to touch or speech

47

What is pronouncement

Formal process of death being certified by a physician

48

When should organ donation be discussed

When preparing advance directives

49

What is palliative care

Refers to patient and family centered care of that optimizes quality of life by anticipating preventing and treating suffering