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109 Cards in this Set

  • Front
  • Back
When was the first National Training session held?
Jan 2001
What is ELNEC?
End-of-Life Nursing Education Consortium (ELNEC)
Are HCP comfortable with death?
No
What are the 4 Dimentions to the Quality of Life?
Physical
Psychological
Social
Spiritual
How many people will die yearly in the US from Disease/Aging?
2.5M
How much of medical expenses are incurred during the last 6 months of life?
50%
What percentage of people die in hospitals or nursing homes?
75%
What percentage of nurses (according to ELNEC) feel inadequately prepared for EOL issues?
Over 50^
What percentage of nursing textbooks are devoted to EOL?
<2%
When did hospice come to the US?
1970's
In 2000 what percentage of deaths were in hospice?
25-29%
In 2000 what was the median number of days in hospice care?
25
What percentage of Hospice clients died (2000) within 7 days of admission?
33%
What are some principles of hospice care?
-Patient and family as uint of care
-Attention of phy, psych, spriit
-Interdisclipinary
-Educate client and family
-Bereavement
What does hospice promote?
Living until you die.
Define Palliative Care.
Active total care of patients whose disease is not responsive to cure.
Who spends the most time with EOL clients than any other HCP?
Nurses
Who were the psychoanalytic?
Freud and Jung
Who were the human developmentists?
Skinner
Erickson
Who were the existentialists?
Sartre
Cumus
Kierkegaard
Frankl
Who were the Humanists?
Rogers
Maslow
What makes the humanists differerent?
Active Listening
Patients were Equal
Maslow
Self-Act
Esteem
Love & Belonging
Safety
Physiological
Is Kubler Ross Cycle or Stages?
Stages that are traveled through in cycles.
Denial
Anger
Bargaining
Depression
Acceptance
Who are the two participants in Communication?
Sender and Receiver
How does Potter Define Communication?
"...A complex process involving behaviors and relationships".
Is communicatio deliberate?
No, it happens even when we dont mean to.
Do words mean the same to both the speaker and listener?
No, I can say something, and you hear something different.
Is the primary move of communication verbal?
No
Is communication one way?
No
What is a myth about the amount of information that can be exchagned.
That you can't give too much information. Keep it Simple.
What are the expectations of the Sender?
Be Honest
Not Abandon
Elicet Values and Goals
Team Communication
Take time to listen to feedback
What are the expectations of the message?
-Provide for informed choices
-Offer Support
-Allow Permission to verbalize fears
-Provide tools to gain control
What are the expectations of the receiver of information?
-Be Empowered by understanding
-Absorb only as much as can handle
-Comprehend according to energy level and development
What percentage of communication is non-verbal?
80%
What are some examples of non-verbal communication?
Body Posture
Eye contact
Gestures
Tone of voice
What are the three parts of the Holistic Client?
Physical - Cellular Level
Emotional - Self and Enviroment
Spiritual - Higher/Greater State
A client at EOL with little family support would have which piece of the pie larger?
Spirit
A client at EOL with good family support would have which piece of the pie larger?
Emotional
What are some commonalities of spiritual definations?
Another Source of Strength
An interaction or relationship
Trancends physical
Can be deep within
Greater than physical self
When are people most likely to examine their spiritual self?
When life threatening or termal illness
How is allopathic care defined in this course?
Western Medicine.
When did Western medicine take spirituality out of healing?
1600's
Do all cultures separate allopathic and spiritual care?
No, and Western trying to Integrate again.
What are laws?
Body of rules to guide societys actions
What are ethics?
Moral rules used to guide basic principles of our actions.
What happens when Laws and morals collide?
Dillemmas.
What guides our actions with regard to law and ethics?
Nurse Practice Acts
Institutional Policies
Educated Critical Thinking Skills
Name two types of Advance Directives.
Living Will
DPOA
Name three components of an AD.
-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
What is the Patient Self Determination Act?
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.
What is a Utilitarian Framework?
What is good for the greatest number is right.
What is a Egoism Framework?
What is best for the individual is right.
What is a Relativism Framework?
What is best for the situation is right.
What is a Naturalism Framework?
If it is positive, it is good
What is beneficence?
1. An ethical principle that emphasizes doing what is best for the patient. 2. Choosing to do good; acting kindly or charitably.
What is nonmaleficence?
The principal of not doing something that causes harm.
What is Justice?
Be fair and treat people equally.
What is Fidelity?
Respect our duty to clients.
What is Autonomy?
The respect for the client's freedom and rights.
How much spent yearly on CAM?
$21.2B
What percentage tell PCP that they are using CAM?
Only 40% because of Fear of negative reaction.
What is any Non-Western Tx Called?
Complementary
What is a Tx called when it is used IN PLACE of traditioal Western TX?
Alternative
What is a Tx called when it is used IN TANDEM of traditioal Western TX?
Integrated
What would MASSAGE THERAPY be considered?
Complementary
What would MACROBIOTIC DIET in PLACE OF CHEMO be called?
Alterntative
Acupunture/Herbs to help turn a breech baby?
Integrated
Why do people choose CAM?
CAM Page 2
Who are people choosing? for PCP?
Naturopaths
Chiropractors
Culture Specific Medical Providers
Who are people choosing for Complimentary Providers?
Massge Therapists
PT
Assorted Practionors
What is Allopathic Medicine?
Cure By Opposites. Used to describe conventional Western Medicine.
What does the term Homeopahty mean?
Cure by Same
Three methods to plan CAM (Non Allopathic) Care.
CAM Perspective
NIH Definations
Client Safety Categories
Four Poles of the Medicine Wheel used for both Western and Non Western Medicine.
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
What are the three SAFETY CATEGORIES for CAM?
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.
Can NATUROPATHIC PHYSICIANS delegate orders to nurses?
Yes, according to State Law.
What NATUROPATHIC medicine?
Natural Cure

Dx and Tx or disease based on whole person

Non-Toxic, Natural remedies used to Tx illness

Provider is partner with client.
Tenets of NATUROPATHIC PRACTICE.
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.
Definition of Suffering by Casssell 1992
State of Distress induced by the threat of loss of intactness or the disintegration of a person from whaever cause.
Define SUFFERING
Emotional component to physiological painful experiences.
Which patients are at risk fo UNDER TREATMENT?
-Children and Elderly
-Cognitively Impainred
-Patients who Deny Pain
-Non English Speaking
-Different Cultures
-Hx of Substance Abuse
Pain Medication Routes
Pain Slide 9
Non Pharmacological Techniques
Pain Slide 12
-Interdisciplinary colleagues
-Cognitive Relax, Imagery, Distraction, Prayer
-Physical Measures Heat/Cold/Massage
-CAM
Other Pain Relieving Tx.
-Radiation
-Ca+ Lowering Drugs
-Palliative Chemo
DEPRESSION
Pain Slide 14-15
ANXIETY
Pain Slide 16-17
ANOREXIA & CACHEXIA
Pain Slide 18-19
DYSPNEA
Pain Slide 20-21
COUGH
Pain Slide 22-23
PAIN & Sx Management Overview
-Multiple Sx are Common
-Interdisclipinary Coordination is Key
-Use Drugs and Non Drugs
-Patient/Family Teaching is Paramount
When TEACHING Time of Death issues, what Grade Level should be taught to?
5th or 6th Grade
What health care provider is exposed to death more than any other?
NURSE
There is no TYPICAL DEATH.
-
COMMON FEARS
-Time of Death
-Painful Death
-Giving Last Dose
Education Stratagies about TIME OF DEATH.
-Verbal and Written
-Simple and Repetative
-Small Incriments - Avoid Too Much Information
Give Concrte Facts.
What will be:
-SEEN
-HEARD
-FELT
-SMELL
Dying is a SLOWING DOWN PROCESS.
-
ACTIVE DYING
Dying Slide 11-13
When does RIGOR MORTIS happen?
2-4 Hours /p death.
When does EMBALMING happen?
Withing 12 Hours
What are some follow up issues AFTER DEATH?
-Help with Notification Calls
-Destroy Medication
-Assist with Arrangments
-Initiate bereavement support
What kind of SUPPORT FOR THE NURSE might be necessary after a death?
-Ask for Help
-Verbalize
-Post Clinical Debriefing
Does the ANA support OR Right to Die Law?
No.
DEFINATIONS OF HOPE
-Active Behavior
-Has Future/Forward Orientation
-Gives meaning and purpose to oneself/actions
FALSE HOPE vs UNREALISTIC HOPE
Hope slide 9
How can a dying person be wreckless?
Physical or Financial. Driving a car too fast or loosing thousands at the Emerald Queen.
REALITY SEEPAGE
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
Difference between HOPE and WISH
Hope set in Reality

Wish is more Fantasy