Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Chapters 10 & 32
Loss, grief, & dying/ Care of elderly patients
| Question | Answer |
|---|---|
| When you assist a patient with suicide it is known as | euthanasia |
| Response to loss is known as | grief |
| when you arrange care for a patient to allow caregivers time away form strain and worry | respite |
| Occurs when children become caregivers for their parents | role reversal |
| curative care | are tests to make diagnosis, assess improvement or deterioration, administration of meds, treatments, and various therapies. All provided with the intent of healing or curing the patients illness |
| Palliative Care aka Comfort Care | is health-care provider directed but not intended to cure the patient's disease |
| A patient can only entered Palliative Care at end stages | False, a patient can be admitted to palliative care at any stage of an illness whether terminal or not |
| Hospice Care | focuses on patient comfort and dignity; available for patients in the later stages of terminal illness and does not commonly include measures ment to cure or stop the natural process of dying |
| what type of care relieves fear and anxiety as death nears, provides support to both pts and family and includes respite care | Hospice Care |
| what is not an issue in terminally ill patients? | addition |
| Durable Power of Attorney | legal document that does not require an attorney, can be completed anywhere, with the aide of a notary, this grants the authority to make health care decisions. this person acts as a proxy for the patient should the patient become disabled |
| what is the legal hierarchy of family relationships? | legal guardian with healthcare decision making authority: spouse, adult children of patient, parents of patient, adult siblings of patient |
| what is a Living Will | a written document prepared by a mentally competent patient, indicating which procedures and measures the patient does or does not want should an end of life condition or disability occur |
| What is the CPR success rates of all hospitalized patients? | 10-15% |
| What is the standard of care for all patients in hospitals and nursing homes unless there is a DNR order? | CPR |
| What are the 5 stages of grief? | Denial, Anger, Bargaining, Depression, Acceptance |
| According to Ira Byock, MD what are the 5 end of life conversations? | Forgive me, I forgive you, Thank you, I love you, Food-bye |
| These five brief statements represents reconciliation and closure, not only with family and friends but often with the patient's concept of God and the Spiritual | End of life conversation |
| What does the term Cachexia mean | wasting away |
| What are the Psychological, Emotional changes prior to death | life review, introspection and reflection, need to communicate with family and friends, confusion, conversing with dead loved ones and loss of interest in food |
| Postmortem Care | Care of the patient's body after death. |
| An aspect of self no longer available to a person is known as | Loss |
| Pattern of physical and emotional responses to bereavement is known as | Grief |
| Actual Loss is | easily identified (A women who has a mastectomy) |
| Perceived Loss | is less obvious. ( Loss of confidence) A women who hopes to give birth to a female child delivers a male child instead; perceived loss is easily overlooked or misunderstood, yet the process of grief involved is the same as an actual loss |
| what is the fundamental principle when making your ethical decisions for practice? | respect for human dignity |
| Most can tell you what they do NOT want at the time of their death: | They do not want to die in pain, die alone, and do not want to burden their family |
| What is the 1st stage of grief and dying? | Denial: key phrases are Not me! This isn't happening to me! It can't be happening to me! |
| What is the 2nd stage of grief and dying? | Anger: Why is this happening to ME? Why me? It's not fair? |
| What stage of grief and dying would you use these phrases : I promise I'll be a better person IF.... Just let me live to see my children graduate If I could have one more change | 3:Bargaining |
| What stage of grief and dying is when you don't care anymore, you are sad, and you don't bother with anything | Stage 4 Depression |
| What is the 5th stage of grief and dying? | Acceptance: It's going to be okay; I am ready for whatever comes |
| What are nonpharmacological Interventions for pain | Distraction, Heat/cold applications, massage, meditation/prayer, movement and range of motion, music therapy, positioning, relaxation and breathing techniques |
| What are nonpharmacological for Nausea | cool compresses to face and forehead, deep breathing, meditation/prayers, music therapy, relaxation techniques, small sips of clear liquids at the patient's temp preferences |
| What are some things that can be done to alleviate the fears of dying? | provide adequate info regarding the disease process, how it progresses, and that relief of pain and most symptoms is possible |
| What culture believes that remorse for the dead leads to more suffering of the soul and increases the soul's difficulty in leaving the earthy plane. prefer that those persons feeling loss think only happy thoughts of the dead to facilitate their journey | American Hindu |
| This culture has a specific person who cares for the body after death and only priests are to touch or prepare the body for burial | Jewish |
| These cultures may exhibit loud moaning and chanting during the last houses of a patient's life as a means of providing comfort to the patient and family members | African American, Hispanic |
| You can expect to see a patient's pulse increase up to ___ to bpm, especially if he or she is febrile | 140,150 |
| Just prior to death, the pulse rate may slow into the ___ and ____ | 30s,40s |
| A patients respirations may increase to between _____ and _____ breaths/min before decreasing to 6 to 8 breaths/ min | 40, 50 |
| What is Cheyne-Stokes | Shallow slow breaths before respirations become progressively deeper until the peek as very deep breaths. The respirations then begin to pregressively become shallower again, ending the cycle with a period of apnea |
| Conjunctival dryness and corneal irritation causes the patient to have | tearing |
| Mottling | patches of varying colors of pallor and cyanosis in the feet, legs, hands and dependent area of the body |
| An excessively high level of calcium in the blood is known as | hypercalcemia |
| Why are the symptoms of hypercalcemia? | nausea, vomiting, confusion, constipation, lethargy, decreased deep tendon reflexes, polyuria, and extreme thirst |
| In the past ____ was considered a "senior citizen" | 65 years |
| Young-Old | 65-75 years of age, diabetes, cholesterol issues, high BP, still active within their social circles, may still work or volunteer; |
| What age group just started experiencing more of the physiological changes that are brought on by the aging process gradual decline in health | Young-Old |
| Middle Old | 75-85 years old at risk of developing psychosocial disorders because implications of physical and social changes that affect their lives |
| Old-Old | 85 years and older 2/3 report functional limitations and require assistance with ADL, health has significantly declined; health needs are met related to personal culture |
| Elite-Old | 100 years and older; centenarians; 80 % female testimony to better medical management of chronic conditions |
| Health Resources and Services Administration projects that: | The supply of nurses will fall by more than 1 million below requirements by 2020 |
| Ageism | discrimination and prejudice against elders contributes to stereotyping, unequal treatment in the workplace, and denial of healthcare |
| National Institute on Aging states that by 2030: | 1 in 5 US citizens will be elderly |
| (T/F) " you are only as old as you feel" | True |
| As people age | They are less able to process information supplied by neurological system and sensory stems...reflexes slow because of sluggish nerve transmission, unable to react quickly while walking , reaching, and driving |
| The most common form of injury related to diminished neurological function | Falls |
| A temporary decrease in the blood supply to the brain; "ministroke" | Transient ischemic attack (TIA) |
| What are the symptoms of a Transient ischemic attack | dizziness, visual changes, weakness, numbness in one or more limbs, difficulty swallowing |
| What is cerebrovascular accident (CVA) | "stroke" or " brain attack'" can be caused by a clot or bleeding in a blood vessel in the brain |
| Hemorrhagic Stroke | a CVA caused by a bleeding blood vessel |
| What is a CVA caused by a blood clot | ischemic stroke |
| a state of mental confusion that is usually accompanied by hallucinations and illusions is known as | delirium |
| What is a hallucination | false perception having no relation to reality; the person may believe they hear, see or smell something that is not there |
| A misinterpretation of sensory stimuli is known as | A misinterpretation of sensory stimuli |
| Dementia | a decrease in intellectual functioning eventually resulting in the inability to care for onseself |
| the most common type of dementia; patient's slowly withdraw form their families, develop confusion, and eventually do not recognize their own family | Alzheimer's disease |
| Confusion | cannot think clearly; can occur form UTI, hypoxia or drug side effect |
| Falls and broken bones | assess patient's safety and institute ways to improve it |
| Decreased sensation | big risk for diabetics; small injuries can lead to infection; bath water temperature must be monitored |
| For chronic respiratory conditions | encourage hand-washing; stand 3-6 feet away form sick residents; encourage them to receive flu and pneumonia vaccines |
| For patients with impaired hearing | teach them about available options like flashing lights for smoke detectors, phones, and doorbells |
| When a patient is incontinent | implement bladder training when appropriate; keep perineal area clean and dry; avoid calling adult waterproof underwear "diapers" |
| Signs of caregiver burnout | caregiver feels they must be the sole provider; withdrawing form friends, family, activities, anxiety about finances or patient safety; grief or sadness that the relationship is deteriorating; experiencing personal health problems |
| When the lens of the eye becomes cloudy and opaque it is known as | cataracts |
| Glaucoma is termed | eye disease characterized by increased intraocular pressure that affects the optic nerve can lead to blindness |
| degeneration of the area in the retina where the optic nerve attaches, leading to the loss of central vision | age-related macular degeneration |
| normal decrease in hearing associated with aging (lower pitch of voice to be heard better) | presbycusis |
| Changes in cardiovascular functioning are | heart muscle loses elasticity, blood vessels narrow, circulation decreases; complaints of feeling cold, at higher risk for developing CAD, hypertension, high cholesterol, MI, peripheral vascular disease |
| changes in respiratory functioning are | lung tissue loses elasticity, alveoli no longer fully expand, risk for pneumonia, bronchitis, complications of COPD; diminished sounds in bilatteral lower lobe |
| Changes in GI functioning are | peristalsis slows, risk of malnutrition and constipation; food digestion slows, constipation may result |
| What is also known as excessively dry mouth | Xerostomia |
| changes in endocrine functioning are | metabolism slows, leading to weight gain, DIABETIES |
| capacity of bladder decreased and more frequent urination are changes in | genitourinary functioning |
| Changes in reproductive functioning are | decline in testosterone, women go through menopause (osteoporosis) men can still produce sperm, women have usually gone through menopause, both sexes experience decreased hormone levels, elderly people still desire a sex life |
| Psychosocial problems of aging | loss and grief as friends and family die or leave; fear of dying, may struggle with spiritual beliefs, grief due to loss of friends/family, safety concerns and elder abuse, financial concerns about living arrangements |
| Caring for elder patients experience loss and grief | refer to support groups, encourage rest, educate about proper nutrition and exercise, encourage spirituality, allow patient to grieve |
| Elder abuse | older adults are often victims of schemes and being exploited; between - million seniors have been injured, exploited, or mistreated by a caregiver |
| Signs of elder abuse | neglect and exploitation, bruises in unexpected places in different stages of healing, bites, burns, fractures, malnourished, excessively poor hygiene, deliberate over-sedation |
| People living in long-term care facilities should be called residents, not patients but | Residents |
| Make sure resident's shoes have ______ to prevent falls. | non-skid soles; if not, tape can be applied to sole to provide traction |
| Disinfect ___, ___, and ___ after each use | shower chairs, tubs, mechanical lifts |
| Never leave a resident unattended while ____, | he or she is bathing |
| If a resident is on supplemental oxygen, ___ to allow oxygen levels to dissipate. | turn it off for at least 10 minutes before shaving with an electric razor. |
| Before using a safety razor, check if the patient is taking ____ to prevent the risk of excessive bleeding. | Coumadin (warfarin), an anticoagulant |
| A complete head-to-toe assessment is performed ___ in the long-term care setting. | monthly |
| Additional monthly assessments in LTC facilities: | general appearance, adaptive equipment, ability to communicate, LOC, general eating habits, special nutrition assistance, bowel and bladder status, sleep habits, medical equipment and activities |
| Polypharmacy | the ingestion of many medications |
| Which infection has a large risk of spreading? | C. Diff |
| Which type of question should you not ask in therapeutic conversation? | Yes/no questions |
| It is important that you...... | teach patients and family members to maintain a complete list of all medications and the dosages being taken; list should accompany patient when they go doctor or hospital |
| What could be a warning sign of a Big Stroke | Transient Ischemic Attack |
Created by:
Valadiece
Popular Nursing sets