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109 Cards in this Set
- Front
- Back
When was the first National Training session held?
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Jan 2001
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What is ELNEC?
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End-of-Life Nursing Education Consortium (ELNEC)
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Are HCP comfortable with death?
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No
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What are the 4 Dimentions to the Quality of Life?
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Physical
Psychological Social Spiritual |
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How many people will die yearly in the US from Disease/Aging?
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2.5M
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How much of medical expenses are incurred during the last 6 months of life?
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50%
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What percentage of people die in hospitals or nursing homes?
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75%
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What percentage of nurses (according to ELNEC) feel inadequately prepared for EOL issues?
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Over 50^
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What percentage of nursing textbooks are devoted to EOL?
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<2%
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When did hospice come to the US?
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1970's
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In 2000 what percentage of deaths were in hospice?
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25-29%
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In 2000 what was the median number of days in hospice care?
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25
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What percentage of Hospice clients died (2000) within 7 days of admission?
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33%
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What are some principles of hospice care?
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-Patient and family as uint of care
-Attention of phy, psych, spriit -Interdisclipinary -Educate client and family -Bereavement |
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What does hospice promote?
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Living until you die.
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Define Palliative Care.
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Active total care of patients whose disease is not responsive to cure.
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Who spends the most time with EOL clients than any other HCP?
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Nurses
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Who were the psychoanalytic?
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Freud and Jung
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Who were the human developmentists?
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Skinner
Erickson |
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Who were the existentialists?
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Sartre
Cumus Kierkegaard Frankl |
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Who were the Humanists?
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Rogers
Maslow |
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What makes the humanists differerent?
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Active Listening
Patients were Equal |
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Maslow
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Self-Act
Esteem Love & Belonging Safety Physiological |
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Is Kubler Ross Cycle or Stages?
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Stages that are traveled through in cycles.
Denial Anger Bargaining Depression Acceptance |
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Who are the two participants in Communication?
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Sender and Receiver
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How does Potter Define Communication?
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"...A complex process involving behaviors and relationships".
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Is communicatio deliberate?
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No, it happens even when we dont mean to.
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Do words mean the same to both the speaker and listener?
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No, I can say something, and you hear something different.
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Is the primary move of communication verbal?
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No
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Is communication one way?
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No
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What is a myth about the amount of information that can be exchagned.
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That you can't give too much information. Keep it Simple.
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What are the expectations of the Sender?
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Be Honest
Not Abandon Elicet Values and Goals Team Communication Take time to listen to feedback |
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What are the expectations of the message?
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-Provide for informed choices
-Offer Support -Allow Permission to verbalize fears -Provide tools to gain control |
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What are the expectations of the receiver of information?
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-Be Empowered by understanding
-Absorb only as much as can handle -Comprehend according to energy level and development |
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What percentage of communication is non-verbal?
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80%
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What are some examples of non-verbal communication?
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Body Posture
Eye contact Gestures Tone of voice |
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What are the three parts of the Holistic Client?
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Physical - Cellular Level
Emotional - Self and Enviroment Spiritual - Higher/Greater State |
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A client at EOL with little family support would have which piece of the pie larger?
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Spirit
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A client at EOL with good family support would have which piece of the pie larger?
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Emotional
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What are some commonalities of spiritual definations?
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Another Source of Strength
An interaction or relationship Trancends physical Can be deep within Greater than physical self |
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When are people most likely to examine their spiritual self?
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When life threatening or termal illness
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How is allopathic care defined in this course?
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Western Medicine.
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When did Western medicine take spirituality out of healing?
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1600's
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Do all cultures separate allopathic and spiritual care?
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No, and Western trying to Integrate again.
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What are laws?
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Body of rules to guide societys actions
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What are ethics?
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Moral rules used to guide basic principles of our actions.
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What happens when Laws and morals collide?
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Dillemmas.
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What guides our actions with regard to law and ethics?
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Nurse Practice Acts
Institutional Policies Educated Critical Thinking Skills |
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Name two types of Advance Directives.
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Living Will
DPOA |
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Name three components of an AD.
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-Exercise control over my own body
-Direction of what to do to me when I cant tell you and my life is threatened. -Harm will not come to you the provider if you do what I ask |
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What is the Patient Self Determination Act?
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A written document that must be provided by all institutions getting Medicare/Aid telling clients they have a right to participate in medical decision making.
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What is a Utilitarian Framework?
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What is good for the greatest number is right.
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What is a Egoism Framework?
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What is best for the individual is right.
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What is a Relativism Framework?
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What is best for the situation is right.
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What is a Naturalism Framework?
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If it is positive, it is good
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What is beneficence?
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1. An ethical principle that emphasizes doing what is best for the patient. 2. Choosing to do good; acting kindly or charitably.
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What is nonmaleficence?
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The principal of not doing something that causes harm.
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What is Justice?
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Be fair and treat people equally.
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What is Fidelity?
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Respect our duty to clients.
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What is Autonomy?
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The respect for the client's freedom and rights.
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How much spent yearly on CAM?
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$21.2B
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What percentage tell PCP that they are using CAM?
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Only 40% because of Fear of negative reaction.
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What is any Non-Western Tx Called?
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Complementary
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What is a Tx called when it is used IN PLACE of traditioal Western TX?
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Alternative
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What is a Tx called when it is used IN TANDEM of traditioal Western TX?
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Integrated
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What would MASSAGE THERAPY be considered?
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Complementary
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What would MACROBIOTIC DIET in PLACE OF CHEMO be called?
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Alterntative
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Acupunture/Herbs to help turn a breech baby?
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Integrated
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Why do people choose CAM?
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CAM Page 2
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Who are people choosing? for PCP?
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Naturopaths
Chiropractors Culture Specific Medical Providers |
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Who are people choosing for Complimentary Providers?
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Massge Therapists
PT Assorted Practionors |
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What is Allopathic Medicine?
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Cure By Opposites. Used to describe conventional Western Medicine.
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What does the term Homeopahty mean?
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Cure by Same
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Three methods to plan CAM (Non Allopathic) Care.
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CAM Perspective
NIH Definations Client Safety Categories |
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Four Poles of the Medicine Wheel used for both Western and Non Western Medicine.
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EAST Biochemical
Block or Enhance Biochemical Reactions in the body. South Lifestyle & Mind/Body Change Lifestyle habits to correct problems West Biomechanical Physically manipulate or add to the body. North Bioenergetic Manipulate the bioenergy field |
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What are the three SAFETY CATEGORIES for CAM?
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Level 1 Low Risk. Sound Scientific Support. Guided Imagery.
Level 2 Low Risk. Limited Scientific Support. Therapeutic Touch Level 3 Potential High Risk. Minimal scientific support. Macrobiotic Diet/Many Herbal Remedies. |
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Can NATUROPATHIC PHYSICIANS delegate orders to nurses?
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Yes, according to State Law.
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What NATUROPATHIC medicine?
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Natural Cure
Dx and Tx or disease based on whole person Non-Toxic, Natural remedies used to Tx illness Provider is partner with client. |
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Tenets of NATUROPATHIC PRACTICE.
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FIRST - DO NO HARM
Prevent disease through lifestyle and attention to risk factors. Recognize/Encourage Bodys natural healing ability Tx whole person Identify & Treat Cause, not just Sx. |
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Definition of Suffering by Casssell 1992
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State of Distress induced by the threat of loss of intactness or the disintegration of a person from whaever cause.
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Define SUFFERING
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Emotional component to physiological painful experiences.
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Which patients are at risk fo UNDER TREATMENT?
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-Children and Elderly
-Cognitively Impainred -Patients who Deny Pain -Non English Speaking -Different Cultures -Hx of Substance Abuse |
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Pain Medication Routes
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Pain Slide 9
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Non Pharmacological Techniques
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Pain Slide 12
-Interdisciplinary colleagues -Cognitive Relax, Imagery, Distraction, Prayer -Physical Measures Heat/Cold/Massage -CAM |
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Other Pain Relieving Tx.
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-Radiation
-Ca+ Lowering Drugs -Palliative Chemo |
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DEPRESSION
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Pain Slide 14-15
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ANXIETY
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Pain Slide 16-17
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ANOREXIA & CACHEXIA
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Pain Slide 18-19
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DYSPNEA
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Pain Slide 20-21
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COUGH
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Pain Slide 22-23
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PAIN & Sx Management Overview
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-Multiple Sx are Common
-Interdisclipinary Coordination is Key -Use Drugs and Non Drugs -Patient/Family Teaching is Paramount |
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When TEACHING Time of Death issues, what Grade Level should be taught to?
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5th or 6th Grade
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What health care provider is exposed to death more than any other?
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NURSE
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There is no TYPICAL DEATH.
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-
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COMMON FEARS
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-Time of Death
-Painful Death -Giving Last Dose |
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Education Stratagies about TIME OF DEATH.
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-Verbal and Written
-Simple and Repetative -Small Incriments - Avoid Too Much Information |
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Give Concrte Facts.
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What will be:
-SEEN -HEARD -FELT -SMELL |
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Dying is a SLOWING DOWN PROCESS.
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-
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ACTIVE DYING
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Dying Slide 11-13
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When does RIGOR MORTIS happen?
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2-4 Hours /p death.
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When does EMBALMING happen?
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Withing 12 Hours
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What are some follow up issues AFTER DEATH?
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-Help with Notification Calls
-Destroy Medication -Assist with Arrangments -Initiate bereavement support |
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What kind of SUPPORT FOR THE NURSE might be necessary after a death?
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-Ask for Help
-Verbalize -Post Clinical Debriefing |
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Does the ANA support OR Right to Die Law?
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No.
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DEFINATIONS OF HOPE
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-Active Behavior
-Has Future/Forward Orientation -Gives meaning and purpose to oneself/actions |
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FALSE HOPE vs UNREALISTIC HOPE
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Hope slide 9
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How can a dying person be wreckless?
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Physical or Financial. Driving a car too fast or loosing thousands at the Emerald Queen.
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REALITY SEEPAGE
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People know the truth, yet attempt to sheild and protect others, bits of the thrugh seeps through the facade or shield.
Done to Attempt to MAINTIAN CONTROL |
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Difference between HOPE and WISH
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Hope set in Reality
Wish is more Fantasy |