NURS 431 End-of-Life Care

What is the American Nurses Association (ANA) position on assisted suicide and nursing?

They acknowledge the complexity of the assisted-suicide debate but clearly states that nursing participation in assisted suicide is a violation of the Code for Nurses

___________ refers to providing another person the means to end their own life

Assister suicide

Durable power of attorney for health care

a legal document through which the signer appoints and authorizes another individual to make medical decisions on the signers behalf when the signer is no longer able to speak for himself or herself. This is also known as a health care power of attorney, medical power of attorney, or a proxy directive.

A dying pt states to the nurse, "I know I'm dying, aren't I?" What would an appropriate nursing response be? a. This must be very difficult for you b. tell me more about whats on your mind c. I'm so sorry. I know how you must feel d. You know you're dying?

a. This must be very difficult for you

A pt near the end of life is experiencing anorexia-cachexia syndrome. What characteristics of the syndrome does the nurse recognize? SATA a. alternations in carbohydrate, fat, and protein metabolism b. endocrine dysfunction c. anemia d. neurologic dysfunction e. bladder incontinence

a. alternations in carbohydrate, fat, and protein metabolism b. endocrine dysfunction c. anemia

A pt is diagnosed with a terminal illness and has been given less than 6 months to live. What type of referral should the nurse make to assist this pt and family at home? a. a rehabilitation center b. hospice c. adult day care d. physical therapy

b. hospice

A terminally ill pt in pain asks the nurse to administer enough pain medication to end the suffering forever. What is the best response by the nurse? a. I can't do that, I will go to jail b. I am surprised that you would ask me to do something like that c. I will see if the physician will order enough for that to occur d. I will notify the physician that the current dose of medication is not relieving your pain

d. I will notify the physician that the current dose of medication is not relieving your pain

A pt's family member asks the nurse what the purpose of hospice is. What is the best response by the nurse? a. It will hasten the death of the pt b. it will prolong life in a dignified manner c. it will use artificial means of life support if the pt requests it d. it will enable the pt to remain home if that is what is desired

d. it will enable the pt to remain home if that is what is desired

A pt authorizes an adult child to make medical decisions and brings the completed forms for the nurse to place on the chart. What form does the nurse understand this is? a. advance directive b. living will c. standard addendum to a will d. proxy directive

d. proxy directive

A pt with end-stage chronic obstructive pulmonary disease is admitted to a hospice facility and asks the admitting nurse, "How long will I be allowed to stay here?" What is the best response by the nurse? a. you will be able to stay only for approximately 1 month and then you will be discharged b. you will be able to stay for 2 months before being discharged c. there is no time limit for your stay. You can stay until you die d. when your stay reaches 6 months, you will be recertified for a continued stay

d. when your stay reaches 6 months, you will be recertified for a continued stay

The two most common hospice diagnoses for Medicare patients are ______________ and ______________

Neurodegenerative diseases (dementia & parkinson's) Cardiovascular diseases

Name the eight key domains underlying a more comprehensive and humane approach to care of the dying as identified by the National Consensus Project for Quality Palliative Care

Structure and process physical aspects psychological and psychiatric social cultural care of the imminently dying ethical and legal spiritual/religious/existential

Living will

A type of advance directive in which the individual documents treatment preferences. It provides instructions for care in the event that the signer is terminally ill and not able to communicate his/her wishes directly and not often is accompanied by a durable power of attorney for health care. This is also known as a medical directive or treatment directive

Three medications that are commonly used to stimulate appetite in anorexic patients are ______________, _____________, and _____________

Decadron (dexamethasone), Megace (megestrol acetate), and Marinol (dronabinol)

How did Dr. Kubler-Ross's work help the medical and nursing community view the dying process in a more personalized way?

His work revealed that, given open discussion, adequate time, and some help in working through the process, patients could reach a stage of acceptance in which they were neither angry nor depressed about their fate

Define the terms palliative care and hospice care

Involve coordinated programs of interdisciplinary services provided by professional caregivers and trained volunteers to patients with serious, progressive illnesses who are not responsive to curative treatments. Palliative care does not focus primarily on preparation for death, as does hospice care

Dr. ____________, who spearheaded a movement to increase an awareness of the dying process among healthcare practitioners, published a landmark book, ________________, in 1969

Kubler-ross On death and dying

____________ involves the prescription by a physician of a lethal dose of medication for the purpose of ending someones life

Physician assisted suicide

Two types of medications routinely used to treat the underlying obstructed pathology associated with dyspnea are ______________ and ____________, improving overall lung function

bronchodilators and corticosteroids

A pt is diagnosed with stage II breast cancer. For the pt to use the medicare hospice benefit, her life expectancy needs to be what length of time? a. 2 months b. 4 months c. 6 months d. 8 months

c. 6 months

A terminally ill pt is admitted to the hospital. The pt grabs the nurse's hand and asks, "Am I dying?" What response would be I am no best for the nurse to give? a. Why do you think that? b. Did someone tell you that you are dying? c. Tell me more about what's on your mind d. I am not at liberty to disclose that information

c. Tell me more about what's on your mind

A pt is diagnosed with terminal pancreatic cancer is unaware of the diagnosis and the family has requested that the patient not be told. What awareness context does the nurse determine this is? a. suspected awareness b. mutual pretense awareness c. closed awareness d. open awareness

c. closed awareness