Role 3 End of Life UTF8 Flashcards

(55 cards)

1
Q

Loss

A

actual or potential situation where something of value changed or is gone.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Death is fundametal loss for

A

the dying person and survivors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Types of Loss

A

Actual, perceived, anticipatory

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

actual loss

A

can be recognized by others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

perceived loss

A

cannot be verified by others

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

anticipatory loss

A

feeling of loss before actual lose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Grief is

A

a total response to the emotional experience of loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Bereavement is

A

SUBJECTIVE response by survivors; family gather to share stories

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Mourning is

A

Behavioral process where grief is resolved/altered; RN what (objective) behavior can you assess?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Grieving is

A

essential for good mental health. It permits ppl to cope with loss gradually to accept as part of reality.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Types of Grief Responses are

A

abbreviated, anticipatory, disenfranchised, complicated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

abbreviated grief response

A

brief but genuine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

anticipatory grief response

A

grief felt in advance, like cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

disenfranchised grief response

A

grief canメt be spoken about, like suicide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

complicated grief response; like one person grieving alone.

A

unresolved or chronic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Kubler-Ross five stages of grief are

A

denial, anger, bargaining, depression, acceptance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

denial

A

refuse to believe; it’s not happening; RN use therapeautic presence and talking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

anger

A

resisting and directing anger towards others; RN this a safety issue. Say I know you’re angry and I understand why. Feeling angry is normal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

bargaining

A

feels guilty; take me instead; amputee grieve freedom lost; RN provide info to help with decision and do therapeautic talk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

depression

A

grieves over person and all their dreams; may or may not talk; don’t give antidepressants unless > 1 yr complicated grieving; therapeautic listen and talk

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

acceptance

A

come to term with loss after a year; begin making plans.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Factors affecting grief and death

A

culture, gender role, meaning of relationships, spiritual belief, support system, cause of death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

how infant sees death

A

don’t understand it

24
Q

how 5-9 yo sees death

A

death is final

25
how 9-12 sees death
death is inevitable
26
how 12-18 sees death
fears lingering death but defies it
27
how 18-45 sees death
look at death based on culture/religion
28
how 45-65 I am mortal
I am mortal
29
how 65+ yo sees death
death has multiple meaning
30
Euthanasia
lethal injection; not legal in US; don't confuse with Right to Die Law
31
Voluntary euthanasia
pt consent to end life; MD gives lethal dose; goes to another country, live there for 6 mon, file for voluntary euthanasia, MD gives lethal dose
32
Right to die law
pt admins lethal dose to self; allowed in Oregon, Washington, Montana, and Vermont; long process with a lot of documentation
33
Advance Care Planning
formal process to ensure pt preference carried out during time of incapacity
34
Advanced directives
legal document of end of life care preferences; PT CAN CHANGE MIND AT ANY TIME, as long as pt has decisional capacity.
35
6 Types of Advanced directives
living will; handwritten natural death act to MD; health care proxy/surrogate or durable power of attorney; do not resuscitate order (DNR); 5 wishes; Physician Orders for Life-sustaining treatment (POLST)
36
5 wishes is a
legal document written in everyday language stating preferences of care
37
describe each of 5 wishes
wish 1 who; wish 2 what treatment; wish 3 how comfortable; wish 4 respect me; wish 5 don't tell my family
38
POLST (physician orders for life sustaining treatment
form stating what kind of medical treatment pt want; ON PINK PAPER; pt and MD sign it
39
what is a good death
free from avoidable distress and suffering for pt and family; consistent with pt wishes, culture, ethics, clinic standards
40
dying with dignity is
all pt have the RIGHT to die a good death; consistent with pt values and culture
41
how do RN help pt die with dignity
give pt's family an enduring memory that pt death was calm and dignified; pain/dyspnea control; HYGIENE clean up pt, reposition/feed/hydrate; adjust for sensory changes; spiritual consult; sit them up; close eyes and jaw;
42
how do RN help family grieve
thereapeautic communication; empathy; keep family informed; calm demeanor (don't run around)
43
goal of quality end of life care
avoid prolonged dying; strengthen relationships; relieve burden; pain/symptom management; give family sense of control
44
difference between hospice and palliative care
hospice support and death in < 6 mon (avg. 11 days); palliative care and death from progressive illness
45
hospice care criterion
life expectancy < 6 mon; MD certification of terminal illness; caregiver present continuously; covered by medicare/medicaid
46
Signs of approaching death
alertness vary/hearing last to go; pulse is irregular; body temp fluctuate up/down non symmetrical; skin color change; fluid/GI needs decrease (Koreans continue to feed pt); breathing increase/decrease or pause for a while then return; gurgling sound called death rattle
47
signes of death
NO breathing, pulse, or response to commands; eyelids slight open and fixed at a certain spot; jaw relaxed and mouth slight open
48
Organ procurement
RN that is supporting family grieve is not same RN doing organ procurement; need a 2ndary RN (collaborate multidisciplinary team); notify ROPA/OPA; organ procurement consistent with pt cultural/spiritual needs.
49
Organ donation
d/t Omnibus Budget Reconcilation Act 1986; hosp getting medicare/medicate funding must have policy to identify potential organ donors and inform family about option to donate
50
Post mortem care
MD pronouce death; RN responsible for pt and environment; REMOVE TUBES (unless pt belong to the LAW), replace dentures; let family grieve in privacy; tell family when body will be picked up to buy them time
51
pt body is donated for research, do not
DO NOT DO NOT send body to the morgue; keep body in the room for UCLA pick up.
52
islamic death ritual
face to mecca; turn to right side; same sex as pt RN can cover body with sheet; sensitive discussion regarding organ donation by transplant team
53
christianity death ritual
anointed by minister or priest; prayers; communion; respect the body
54
hinduism death ritual
accepts death; holy rites by hindu priest; family washes body and wrap in red cloth
55
buddhism
SILENCE; needs depend on lineage of buddhism; goal is calmness or clarity or pt will not reincarnate; SILENCE