Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
63 Cards in this Set
- Front
- Back
|
moment called “crisis knowledge of death
|
dying begins
|
|
|
“moment of physiological death”.
|
dying ends
|
|
|
Crisis intervention most effective Anticipatory grieving chronic phase Life can still be lived Terminal “physical dying” accelerated no energy |
Dying time
|
|
|
Withdrawn Engage in coded communication Give away cherished items Urgent contact “death watch”
|
Responses to death
|
|
|
whites positive toward death Non-European family-centered; expect family to make best possible decisions about patient’s death |
Cultural awareness
|
|
|
Interdisciplinary approach addresses holistic needs patients /families facilitate quality of life peaceful death |
hospice
|
|
|
Philosophy of care organized/structured system delivering care for life-threatening illness |
Palliative
|
|
|
All hospices encourage family involvement and promote?
|
death with dignity
|
|
|
assisting the patient with important end-of-life task of finding meaning in the patient’s life.
|
role of hospice nurse
|
|
|
Comfort improves the quality of life of patients /families prevention /relief of suffering early identification treatment of pain other problems physical, psychosocial and spiritual |
Palliative care
|
|
|
gives direct care
|
staff nurse
|
|
|
implements interdisciplinary team
|
nursing coordinator
|
|
|
responsible for clinical care
|
Nursing executive officer
|
|
|
Denial Anger Bargaining Depression Acceptance |
Kubler-Ross stages of grief and dying
|
|
|
Visions hallucinations inability to communicate after loss |
not normal grieving process
|
|
|
occurs before the death patient/survivor experience detached environment psychological death no day- to – day activities enacts a premature death |
anticipatory grief
|
|
|
preoccupied with deceased, daydreaming/ unreality triggers overwhelming pain incapacitated simple tasks impossible
|
Acute grief |
|
|
periods of pain exacerbated on specific dates |
Chronic grief
|
|
|
Those at risk for adverse effects of grief include?
|
Older spouses life partners |
|
|
rigid and pessimistic demanding emotional extremes Live alone non social mental illness guilt |
Ineffective coping
|
|
|
assists the older adult to cope collects info avoid impulse action no hasty decision making restore control for the bereaved avoid regrettable decisions |
counter coping intervention
|
|
|
Clarification control Collaboration Direct relief Cooling off |
counter coping strategies
|
|
|
What guides the interdisciplinary team in providing individualized care with respect for the patient’s wishes?
|
Nurse's assessment
|
|
|
Who is at increased risk for depression, fatigue, and changes in social interaction with prolonged caregiving?
|
Geriatric nurse informal care givers
|
|
|
Care Control Composure Communication Continuity Closure |
Six C's approach
|
|
|
in order to provide individual culturally competent care, the nurse's best action is to assess the expectations of both...
|
patient and family
|
|
|
What is the basis of pain treatment and should be done in a systematic and ongoing manner?
|
Accurate pain assessment
|
|
|
What is essential for quality end-of-life care in the older patient?
|
Pain relief
|
|
|
What is most feared symptom of dying patients?
|
Pain
|
|
|
When administering pain medication to a dying patient, what should be considered?
|
alternative routes
|
|
|
emotional social spiritual suffering |
also associated with pain
|
|
|
massage music therapy therapeutic touch aromatherapy |
Complementary & Alternative Therapies
|
|
|
The body prepares for death through the deterioration of?
|
organ system functioning
|
|
|
Cool extremities Increased sleeping Fluid and food intake decreased Incontinence Congestion, gurgling Changes in breathing pattern Disorientation Restlessness
|
Physiological Signs of Approaching Death |
|
|
Withdrawal Vision-like experiences Letting go Saying goodbye
|
Emotional Signs of Approaching Death |
|
|
Presence Life review Reminiscence Spirituality Religion |
Interventions for Providing Psychosocial Support
|
|
|
randomly reflecting on memories of events
|
reminiscence
|
|
|
ultimate meaning and purpose
|
spirituality
|
|
|
formal belief systems
|
religions
|
|
|
structured process of reflecting
|
life review
|
|
|
Someone else is appointed (health care proxy) to make patient’s health care decisions
|
dual power of attorney
|
|
|
The nurse does not have the authority to place the DNR order in the care plan, but a nurse can?
|
Document the patients request
|
|
|
Aspiration precautions Mouth care moisture for lips Altered routes for medication least invasive route most effective treatment |
Weakness management
|
|
|
Opioids Anticholinergics Bronchodilators Sedatives Corticosteroids Oxygen therapy Diuretics Antibiotics |
Med Dyspnea Management
|
|
|
What is the standard treatment for dyspnea near death?
|
opioids (morphine)
|
|
|
alters air hunger perception reduce anxiety dilates pulmonary vessels |
opioids (morphine)
|
|
|
if dyspnea occurs only before activity, when should morphine be given?
|
before activity
|
|
|
Morphine starting dose
|
5-6 mg q 4hr
|
|
|
given for disorders outside the lung
|
corticosteroids
|
|
|
Cool air Wet cloths to face Positioning Frequent rest periods imagery and deep breathing |
Dyspnea Management (Nonpharmacologic)
|
|
|
characterized by periods of apnea alternating with deep and rapid breaths and are expected the last days of life
|
Cheyne-Stokes Respirations
|
|
|
Heart and respiratory rate may do what before the slowing of bodily fx in the dying patient?
|
increases
|
|
|
When the patient progress further toward death, the heart and respiratory rate typically does what?
|
decreases
|
|
|
Prochlorperazine (Compazine) Dexamethasone (Decadron, Deronil) Metoclopramide (Reglan, Maxeran) |
Antiemetic agents (nausea/vomiting) |
|
|
Remove any source of odors Comfortable room temperature |
nausea/vomiting management
|
|
|
Assess: pain urinary retention constipation |
restlessness/agitation
|
|
|
Pharmacologic agents haloperidol [Haldol, Peridol]) |
used to treat restlessness and agitation
|
|
|
What drugs are used for seizure management?
|
benzodiazepines barbiturates (phenobarbital) |
|
|
Legal considerations (e.g., death certificate) Contact Doctor Notify Family Determine autopsy Transfer of body |
postmortem care
|
|
|
Withdrawing or withholding life-sustaining therapy (WWLST) active passive |
Euthanasia
|
|
|
Requires health care providers take action to purposely end life
|
active euthanasia
|
|
|
allowing natural death
|
passive euthanasia
|
|
|
adult patient has the ultimate authority to accept or forgo treatment.
|
Patient Self-Determination Act
|
