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25 Cards in this Set
- Front
- Back
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What are the two phases that arise
prior to actual time of death? |
1. Pre-Active Phase
2. Active Phase |
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On average, Pre-active phase may last how long?
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May last approximately two weeks
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How long does active phase of dying last?
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Lasts about three days
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Give the 11 signs of Pre-active Phase of Dying?
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1. Temperature Changes
2. Alertness and Sleep changes 3. Disorientation and Unusual Communication 4. Breathing changes 5. Incontinence 6. Urine decreases 7. Liquid and Food Decrease 8. Congestion 9. Restlessness 10. Vision-like experiences 11. Pain changes |
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Explain S/S of Temperature change,
during pre-active phase |
- As the body's heating regulating system fails , the person's extremities may become
increasingly cool to touch - At the same time , skin may become pale or bluish in color - BP may also gradually decrease - In some instances they may feel feverish and appear flushed |
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If the patient's extremities are Increasingly cool to touch and the skin is pale.
what does this indicate? |
This is a normal indication that the circulation of blood is decreasing to the body's extremities and being reserved for the most vital organs
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If patient is cold to touch and skin is pale, what is your nursing intervention?
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Keep person warm with a blanket
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If the patient appears feverish and flushed,
what is your nursing intervention? |
You can use cool cloths to sponge them off
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Describe Alertness and Sleep changes , during Pre-active phase?
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- Some people are alert and mentally clear
until the moment of death - Others are confused , restless, sleep heavily, may be difficult to arouse, or may go in and out of consciousness - Hearing is usually last to go |
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What would be a nursing intervention for
Alertness and sleep changes / losing hearing? |
Familiar sounds and soft touch bring comfort
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Describe
Disorientation & unusual communication during pre-active phase ? |
- As oxygen levels decrease and metabolism changes they may become confused about:
1. time 2. place 3. identity of people |
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What is the nursing intervention ,
when the patient becomes confused about time, place and identity of people? |
- Speak softly , clearly and truthfully when you need to communicate something important
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Describe of Breathing Changes
of Pre-active phase? |
- You may notice difficulty with breathing and you may notice changes in their
breathing pattern - Cheyne- Stokes breathing - Periods of Rapid shallow pant-like breathing |
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Define Cheyne-Stokes breathing
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- Shallow breaths with periods of no breathing
* 5-30 seconds and up to a full minute |
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What does Cheyne Stokes or
rapid shallow pant-like breathing indicate? |
decrease in circulation in the internal organs
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What are some nursing interventions
for breathing changes in patients? |
1. Elevating the head
2. Turning the person onto his or her side may bring comfort 3. Sometimes oxygen is used for comfort measures |
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Describe Incontinence
Nursing intervention? |
- The person may lose control of urine and
bowel matter as the muscle in the area relax - NSG Intervention: The hospice nurse can assist in keeping the client clean |
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Describe Urine Decrease
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- As the amount of the clients intake and
circulation through the kidney's decreases , = there will be less urine output - the urine may also become concentrated and tea colored |
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Describe Liquid and Food decrease
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- As the client declines , they may have a
decrease in appetite and thirst , wanting little to no foods or liquids |
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What are your nursing interventions , when a client has decrease in appetite and thirst?
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- Do not try to force food or drink , instead offer
ice chips - If they are able to swallow , use small amounts of liquid - If patient is unable to swallow use glycerin swabs and a cool moist washcloth on the forehead |
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Describe Congestion , during pre-active phase?
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- Congestion is a normal change due to the
decrease of fluid intake and inability to cough up secretions |
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During Congestion , you may hear?
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You may hear gurgling , which can sound
unsettling , but usually does not cause any discomfort |
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What is the Nsg intervention for Congestion
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- Gently turn the person's head to side and
allow gravity to drain the secretions - the hospice nurse should evaluate the need medication to help reduce these secretions as death becomes near |
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Describe Restlessness, during pre-active phase?
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- You may notice they will be restless and
repetitive motions such as pulling at bed linen or clothing - this is often due in part of decreased oxygen circulation to the brain and to metabolism changes |
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Name 4 nursing interventions to use on a
patient's restlessness? |
1. Speak calm and quietly
2. Lightly massage the forehead 3. Read something comforting 4. Play soothing music |
