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end of life nursing
pn 141 test 2 book burke pg 307
| Question | Answer |
|---|---|
| def of loss | occurs when a valued object, person, body part or situation that was formerly present is lost or changes and can no longer be seen, felt, heard, known or experienced |
| only the person experiencing loss can determine the ___________ of it | meaning |
| most common fears of loss | health, social status, possessions, lifestyle, sexual functioning, body part, death, marital relationship, reproductive functions |
| people must resolve their feelings of loss through a process called ___________ | gried work |
| def of grief | an emotional response to loss and its accompanying changes |
| def of mourning | the actions or expressions of the bereaved that make up the outward signs of grief |
| def of death | an irreversable cessation of circulatory and respiratory function, or cessation of all functions of the brain |
| charecteristics of someone to be declared dead | lack of responsiveness, lack of movement or breathing, lack of reflexes, flat encephalogram |
| who came up with the stages of grief etc | kubler-ross |
| what are the stages of greif | denial, anger, bargaining, depression, acceptance |
| ex of denial | this can't be happening to me" |
| ex of anger | "acting out" |
| ex of bargaining | plea to extend persons life |
| ex of depression | what cannot be |
| ex of acceptance | come to terms |
| what are factors that may delay greif work | lack of a social support system, perceived inability to share loss, lack of social recognition of loss, ambivalent relationships prior to loss, traumatic circumstances of loss |
| what are the principles of hospice care | that people live until the moment they die, that care until death may be offered by a varieity of health care workers, care is cordinated, sensitive to diversity, offered around the clock and incorperates the physical, psychological, social and spiritual |
| what are advanced directives | they are legal documents that allow a person to plan for health care and or financial affairs in the event of incapacity |
| what is a durable power of attorney for health care | it is a legal document written by a compenent adult that gives another compenent adult the right to make health care decisions on his or her behalf if they cannot |
| what is a living will | a legal document that formally expresses a person's wishes regarding life sustaining Tx in the event of a terminal illness or permanent unconsciouness |
| what is DNR order | MD writes this based on clients wiskes who is near death (no rescecitation) |
| what is a comfort measures only order | no further life sustaining interventions are necessary and that the goal of care is comfort, dignified death |
| what is euthanasia | used to signify a killing that is prompted by some humanitarian motive |
| voluntary euthanasia def | the competent adult client and md, nurse or firend make the decision to terminate life |
| what is hospice | a model of care (rather than a place for care) for clients and their families when faced with a limited, life expectancy |
| what does it emphasize | the quality rather than quanitiy of life |
| what is palliative care | focused of the relief of physical, mental, and spiritual distress for individuals who have an incurable illness |
| s/s of impending death | difficulty talking or swallowing, M, flatus or abdominal distention, urinary and or bowel incontinence, constipation, decreased sensation, taste andsmell, weak, slow, and irregular pulse, decreased BP, decreased irregular respirations, chagens in LOC< res |
| what is the last sense to go when a pt is dying | hearing |
| is there a maximum amount of opiods in the end of life for a pt | no |
| s/s of death | absence of respirations, fixed and dilated pupils, release of stool and urine, pallow as blood settles to dependant areas, drop in nody temp, lack of reflexes, |
| what is the nurses responsibility after death | documents time of death, notifies MD and fam, assists fam in choice of funeral home, all jewelry ecept wedding ring is removed |
| stages of dying: early s/s | no energy, bed bound, withdrawal, sleepi, delirium, |
| stages of dying: middle s/s | continued decline, death rattle, swallowing, fever |
| stages of dying: late s/s | coma, DCr, circulation, cool extremities, resp decline, fever, death |
| meds to treat dyspnea | MSO4, albuterol, lasiks, ativan, scopolamine, atropine, anti-tussives |
| meds: compazine use | N/V |
| meds: phenergen use | N/V |
| meds: reglan use | N/V |
| meds: what will kaopectate do to help | add bulk if pt has diarrhea |
| meds: what will loperamide do to help | sloww motility if diarrhea |
Created by:
jmkettel
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