ch.5 The Therapeutic Approach to the Patient with a Life-threatening Illness
What is the T?
to accept the reality of loss
your patient has just been diagnosed with a life threatening illness, she tells you that she would much rather die quickly than to suffer. she asks you not to say anything about her comment to the doctor. what is the best response?
you have had quite a shock, I believe Dr king would like to talk to you about those feelings, may i go get him for you?
the health care directive and power of attorney are legal in how many states?
50
What is the A?
adjust to what was lost
Durable Power of Attorney
allows a patient to make decisions related to whether life-prolonging medical or surgical procedures are to be continues, with held, or withdrawn, as well as artificial feeding and fluids are to be used or stopped
5 stages of dying (Kubler-Ross)
denial, anger, bargaining, depression, acceptance
What is the E?
experience the pain
what do patients fear more than anything else when facing a life threatening illness?
pain and loss of independence
the range of psychological suffering a patient may experience can lead to which of the following?
tachycardia, anorexia, agitation, insomnia (ALL)
Age and grief
•Infants- only know that there is a loss if someone is not there to feed •Toddlers- confused, anxious •Children 3-5-believe death is reversible. Think the person is sleeping •Children 6-10- curious.. may dig up a dead pet •adolescentes- fascination and fear about death
Aggressive care
Doing everything possible to save them
Health Care directive
Allows an individual to make decisions related to health care when the patient is no longer able to do so
five issues appropriate to discuss with patient focusing on life threatening illness:
Alternative methods, pain management and treatment, health are directives, finances, emotional needs of family.
Life threatening Illness
An illness that potentially may cause the patient's death.
which of the following would be considered the strongest influence in managing the life threatening illness of a patient?
Family and those closest to the patient
Palliative care
Given antibiotics for pain and suffering instead of disease focus treatment.
the slowing of physical and mental responses, decreased alertness, withdrawal, apathy, and diminished interest in work are referred to be what?
Psychomotor retardation
Meaning of TEAR:
T: to accept the reality of loss E: experience the pain A: adjust to what was lost R: reinvest in new reality
What is the R?
reinvest in new reality
your patients culture influences which of the following?
views about illness, pain and treatment, death (all of the above)
