Week 14 - Family Dynamics and End of Life Care

Question 1

What is the general definition of a family according to HRSA (2023)?

Answer 1

A group of two or more persons related by birth, marriage, or adoption who live together.

Question 2

What key point should guide nurses in identifying who constitutes a family?

Answer 2

Family is who the patient says they are.

Question 3

What are the structural elements of a family?

Answer 3

Number of members, age and gender of each member, relationships, interactions within the family and society.

Question 4

List the six primary functions of a family.

Answer 4

Physical, reproductive, socialization, economic, affective nurturance, and health promotion/self-care.

Question 5

What is family nursing?

Answer 5

A nursing role involving assessment, care, education, collaboration, advocacy, and promotion of family health across all settings.

Question 6

Name three positive characteristics of a healthy family.

Answer 6

Commitment, appreciation and affection, positive communication.

Question 7

What is affective nurturance in family function?

Answer 7

The emotional support, care, and love family members show each other.

Question 8

What are family dynamics?

Answer 8

The patterns of interactions and relationships among family members.

Question 9

Name one factor that contributes to positive family dynamics.

Answer 9

Effective communication.

Question 10

Give two examples of circumstances that can cause family stress.

Answer 10

Job loss and unexpected health events.

Question 11

What is family dysfunction?

Answer 11

Disorganization in psychosocial, spiritual, or physiological family functions.

Question 12

How can unhealthy family dynamics affect health?

Answer 12

They can lead to stress-related health issues like poor sleep and hypertension.

Question 13

What does a genogram assess in family risk assessment?

Answer 13

Family history of health conditions, behavioral patterns, and relational issues.

Question 14

What does the “A” in APGAR stand for?

Answer 14

Adaptation – using family resources to solve problems.

Question 15

What are the five components of the APGAR assessment?

Answer 15

Adaptation, Partnership, Growth, Affection, Resolve.

Question 16

What does the SCREEM tool assess?

Answer 16

Social, Cultural, Religious, Economic, Educational, and Medical factors.

Question 17

What is the ECO-MAP used for?

Answer 17

Mapping individual-family interactions and support systems.

Question 18

What does strengths-based nursing focus on in family assessments?

Answer 18

Family strengths, support systems, and positive opportunities.

Question 19

What theory views the family as a unit where changes to one member affect all?

Answer 19

Family Systems Theory.

Question 20

How does Family Life Cycles Theory describe families?

Answer 20

Families move through predictable stages, each with different needs and challenges.

Question 21

What is the central idea of Biological Ecological Systems Theory?

Answer 21

Individuals are shaped by both genetic tendencies and multiple environmental systems.

Question 22

What are common positive responses to family stress?

Answer 22

Communication, flexibility, and collaborative problem-solving.

Question 23

Name a health outcome influenced by family dynamics.

Answer 23

Cardiovascular health.

Question 24

What family function includes teaching children to behave in society?

Answer 24

Socialization.

Question 25

Give one example of how family dynamics affect immune function.

Answer 25

Chronic stress can suppress immune responses.

Question 26

What aspect of family function relates to money management?

Answer 26

Economic function.

Question 27

What does “resolve” in the APGAR tool refer to?

Answer 27

Ensuring family members are cared for emotionally and physically.

Question 28

How does a nurse act as a "change agent" in family nursing?

Answer 28

Ensuring family members are cared for emotionally and physically.

Question 29

What is one benefit of using the ECO-MAP in assessment?

Answer 29

It reveals gaps in support and potential stressors.

Question 30

How can nurses use family theories in practice?

Answer 30

To understand and support the structure, development, and functioning of families.

Question 31

What is the primary goal of hospice care?

Answer 31

To provide comfort, quality of life, and dignity for clients with terminal illnesses.

Question 32

What is the expected life expectancy for someone receiving hospice care?

Answer 32

Six months or less.

Question 33

What is palliative care?

Answer 33

Holistic care for patients with serious illnesses, focusing on quality of life, not necessarily end-of-life.

Question 34

How is palliative care different from hospice care?

Answer 34

Palliative care may include curative treatments; hospice care does not.

Question 35

What is comfort care in a hospital setting?

Answer 35

Care focused on holistic support for actively dying patients.

Question 36

What are common respiratory changes at the end of life?

Answer 36

Dyspnea, "death rattle," irregular respirations, Cheyne-Stokes, and apneic periods.

Question 37

What nursing interventions help manage end-of-life breathing difficulties?

Answer 37

Positioning, atropine drops, scopolamine patches, and avoiding deep suctioning.

Question 38

What percentage of patients experience pain at end of life?

Answer 38

64%.

Question 39

What pain management strategies should nurses use?

Answer 39

Scheduled and PRN opioids/non-opioids, relaxation, imagery, massage, and more.

Question 40

What skin change may indicate imminent death?

Answer 40

Mottling—purple or grey marbling starting at the feet.

Question 41

What temperature-related symptoms occur at the end of life?

Answer 41

Hot/cold episodes due to impaired temperature regulation.

Question 42

What is appropriate nursing care for temperature changes?

Answer 42

Use of blankets, fans, hot/cold packs, or antipyretics.

Question 43

What may clients at the end of life experience related to vision and hearing?

Answer 43

Hallucinations, including seeing deceased individuals.

Question 44

How should nurses respond to end-of-life hallucinations?

Answer 44

Avoid denying them; provide reassurance and support.

Question 45

List three goals at the end of life for clients and families.

Answer 45

Maintain dignity, prevent social isolation, provide spiritual and cultural care.

Question 46

What is the nurse’s role in managing comfort at the end of life?

Answer 46

Maintain comfort, control pain, manage breathing, skin care, and dignity.

Question 47

Why is education important for families in hospice care?

Answer 47

Families are often primary caregivers and need guidance on changes and support.

Question 48

What is the nurse’s role in postmortem care?

Answer 48

Document death, remove devices, wash the body, tag, and prepare for transport.

Question 49

What must nurses document after death?

Answer 49

Time of death, who was notified, body location, and belongings.

Question 50

Should nurses discuss organ donation with families?

Answer 50

No, only trained personnel should handle donation discussions.

Question 51

What organization might nurses refer to for organ donation?

Answer 51

Life Source.

Question 52

What can influence a person’s view on organ/tissue donation?

Answer 52

Religious, cultural, and personal beliefs.

Question 53

Name a sign of grief that nurses may experience.

Answer 53

Sleep disturbances, chest tightness, headaches, or emotional symptoms.

Question 54

What might help nurses process grief?

Answer 54

Attending funerals, peer support, or professional counseling.

Question 55

What interdisciplinary team members are involved in hospice care?

Answer 55

Providers, nurses, social workers, and spiritual leaders.

Question 56

What types of support are essential for families in hospice?

Answer 56

Emotional, educational, and spiritual support.

Question 57

What is a "good death" in end-of-life care?

Answer 57

One that honors patient dignity, comfort, control, and cultural/religious values.

Question 58

Why must nurses assess cultural and religious needs at end of life?

Answer 58

To provide care aligned with patient values and beliefs.