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End Of Life Care Flashcards

(63 cards)

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1
Q

What is the definition of end of life care

A

Term used for issues and services related to death and dying

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2
Q

What doe palliative care do for pt’s

A

Reducing severity of disease symps
Improve QOL
Decrease economic costs of health care
Alleviate burden of caregivers
Pain control

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3
Q

What is hospice care

A

A concept that helps a pt die pain free and with dignity

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4
Q

A physician decides to place a pt on hospice care when they feel that the pt has how many months to live

A

6 months

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5
Q

When a pt is on hospice are they allowed to try new cures or survives for their illness

A

No

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6
Q

If a pt chooses to seek a cure while they are on hospice, what happens

A

The pt will be discharged from hospice and able to go seek treatment

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7
Q

Can a pt join or leave hospice at any point

A

Yes they can

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8
Q

If a pt on hospice goes to the ER and chooses to be admitted to the hospital, what happens to their hospice

A

they are discharged from hospice but can come back after being discharged from the hospital

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9
Q

Hospice wants to provide the best

A

Best quality of life

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10
Q

What settings can hospice care be done

A

Home
Inpatient settings
acute and long-term care facilities
Rehabilitation centers

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11
Q

What are the four levels of hospice care

A

Routine home care
Inpatient respite care
Continuous care
General pt care

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12
Q

What defines routine home care

A

Med admin
Daily baths
Hospice pays for meds and DMEs
Full care at home

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13
Q

What is inpatient respite care

A

It is where the family can choose to put pt in a facility for 5 days to take a break and get rest

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14
Q

What is continuous care

A

Caregiver stays all day or goes multiple times a day

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15
Q

When giving pain meds to hospice pts are we worried about respiratory distress with those pain meds

A

No because hospice pts are in lots of pain and need these meds

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16
Q

Why do we want to do a spiritual assessment of pt and family

A

Want to know these beliefs for comfort

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17
Q

Why should we assess and manage family needs

A

We always worry about the family and want them to be comfortable along with the pt

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18
Q

We need to teach the family about what management in general

A

Pain management

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19
Q

What are the four awareness contexts

A

Closed awareness
Suspected awareness
Mutual pretense awareness
Open awareness

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20
Q

What is the definition of closed awareness

A

Everyone in family knows pt is dying but do not want the pt to know
So hospice cannot say they are from hospice

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21
Q

What is the definition of suspected awareness

A

Pt suspects something is going on but the family hasn’t told them anything about what is going one

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22
Q

What is the definition of mutual pretense awareness

A

Pt and family are aware of pt dying but no one is talking about what’s happening

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23
Q

What is the definition of open awareness

A

Everyone knows what’s going on (pt and family)

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24
Q

What two DNRs do hospice pts need

A

In hospital and out of hospital DNRs

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25
What two advanced directives should hospice pts have
A living will Power of Attorney
26
What is a living will
This is what pt wants done in case something happens to them
27
What is a power of attorney
In case pt is incapacitated this distinguishes a person to make medical decisions on their behalf
28
What is assisted suicide
Where you are given meds to kill yourself but you get to choose when and where. A medical professional does not give you these drugs
29
Is assisted suicide legal
Yes, but only in some states
30
What is euthanasia
A medical professional hooks you up to iv and runs the meds that will kill you
31
Is euthanasia legal
No it is not
32
For assisted suicide you must have proof of what
Proof of terminal illness
33
As hospice nurses we need to ask what a pt wants done, like?
Organ & tissue donations Advanced directive Resuscitation Mechanical ventilation Tube feeding placement
34
What are barriers to end of life care
Cures for disease Financial criteria, reimbursement issues Cultural, social issues Discomfort with death (family, pt, and med staff) Psychological, coping responses to death, dying denial
35
What do hospice pts have to be on in order to have care
Insurance or Medicaid/Medicare
36
When communicating with a hospice pt we should
Reflect on pwn experiences Use lay terms, not medical jargon Respect cultural background Be fully present in convo Silence is okay Allow pt, family to set agenda regarding depth of convo Allow pt and family time to reflect Avoid distractions Avoid impulse to give advice Avoid canned responses Ask q’s Address your and pt’s understanding
37
We should give culturally competent care by owing what
Understand cultures may have different processes about death Assess nonverbal cues
38
Is spiritual care synonymous with religion
No
39
Does spirituality include religion
Yes
40
As hospice nurses we must assess the spirituality because
It’s an important care of a dying pt
41
What physical care do hospice nurses do
Symptom management and comfort Priority is to meet physiologic and safety needs Deserve and require same care as people who are expected to recover
42
As end of life care nurses we should help treat these 5 symptoms
Pain Dyspnea Nausea Weakness Anxiety
43
What are signs of approaching death
Refusal of foods/fluids Urinary output decreases Weakness, sleep, confusion, restlessness Impaired vision/hearing-hallucinations Thick secretions Cheyenne-Stokes Reparations CV changes Integumentary changes - develop mottling, Kennedy terminal ulcer Third-spacing
44
As death approaches we need to monitor for
System failure
45
If pt is alert we need to review body systems to detect
S/S
46
If patient is alert we need to also asses for what four things
Discomfort Pain Nausea Dyspnea
47
We need to asses what abilities of pts and family
Coping
48
We need to pay attention to subtle ___ changes
Physical
49
We need to advocate for our pt’s what when they are passing
Needs
50
We need to make sure pt’s psychosocial needs are met like (7)
Anxiety Depression Anger Hopelessness Powerlessness Fear Communication
51
Pts may have a fears such as (5)
Pain SOB Loneliness Abandonment Meaninglessness
52
We need to have these four parts of communication
Empathy Active listening Silence Respect cultural differences
53
What physical care do we do for end of life care
Oxygen Nutrition Pain relief Mobility Elimination Skin care Postmortem care
54
What concepts go into postmortem care
Pronouncement of death Allow privacy & as much time as family needs with deceased When to call medical examiner Security takes body to morgue Security releases the body to the morgue
55
When do we need to call medical examiner
Death upon arrival or death occurs w/in 24 hrs of admission Death was result of homicide or unnatural means Absence of a witness Suicide or suspected suicide Dies w/o being seen by a licensed provider Child younger than 6 when death is not expected
56
What should we document when a pt passes in our care
What time vitals ceases Who pronounced death at what time What postmortem care was done Where are pts clothing and valuables and who did we give them too. If there is not family give belongings to security What time and who came to pick them up for the morgue Name of funeral home Is there going to be an autopsy Across the dismissal form write deceased
57
What is bereavement (grief)
3 days after death
58
Grief is a
Reaction to loss
59
What is anticipatory grief
Know death is coming. Grieving at diagnoses and then grieving again once family member has passed
60
What is adaptive grief
Acceptance of the person passing and moving on with life
61
What is prolonged grief disorder
Family stops living and grieves Do not live for themselves anymore
62
What are the 5 stages of grief according to the Kubler-Ross model
Denial Anger Bargaining Depression Acceptance
63
What comprises the grief wheel model
Shock Protest Disorganization Reorganization

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