NRS 321 ELNEC Mod 1

7. A client with end-stage liver cancer and multiple organ failure is approaching the end of life and may have about 6 weeks to live. They express the goal to be home and comfortable. Which intervention would be most appropriate to offer?

Hospice services

3. You are asked to describe palliative care to a family member. Which of the following statements would be BEST to include in your discussion?

Palliative care supports the patient's goals of care.

5. A client tells you that he thinks God is punishing him with pain. Which domain of quality of life is being affected by his serious illness?

Spiritual

Serious Illness

a health condition that carries a high risk of mortality and either negatively impacts a person's daily function or quality of life or excessively strains their caregiver any disease or event (such as an accident) that is unlikely to be curable and is life-limiting.

Reginia, Psychological?

anxiety and fear about her disease, stress related to the tension in her relationship

Bereavement Support

- Assess grief reactions and risk factors for complicated grief - Provide follow up bereavement support and referrals - Encourage parents to hold a deceased infant or child

2. Which of the following patients should the nurse advocate for obtaining a palliative care referral?

32-year-old with advanced breast cancer

For which of the following patients should the nurse advocate for a palliative care referral?

A 72-year-old female, newly diagnosed with Parkinson's disease, who is being seen in the neurology clinic for frequent falls

Kidney Disease

A chronic disease, where kidneys gradually lose function. Kidneys are responsible for filtering waste and excess fluids from the blood, which are excreted through urine.

Diabetes

A condition in which the body is unable to produce enough insulin, the hormone required for the metabolism of sugar over 90% of the adult populations is affected

Covid-19

A contagious viral respiratory disease that may cause serious complications, especially in people who are more than 60 years old and/or who already have serious health concerns.

Alzheimer's disease (AD)

A progressive disease that destroys the brain's neurons, gradually impairing memory, thinking, language, and other cognitive functions, resulting in the complete inability to care for oneself; the most common cause of dementia.

What is Regina experiencing within each domain of quality of life?

Alopecia treatment and disease related fatigue, pain and nausea

Philosophy and Delivery

Appropriate at any stage of a serious illness and beneficial when provided along with curative or life-prolonging treatment(s). Provided to patients based on their needs and not their prognosis. Palliative care is NOT end-of-life care. Offered in all care settings and by various outpatient clinics, hospital/healthcare systems, home health agencies, hospices, and long-term care providers. Provided by an interprofessional team in order to attend to the holistic care needs of the patient and their identified family and caregivers. Focused on what is most important to the patient, family, and caregiver(s), and is congruent with their goals of and preferences for care.

10. What is an important way nurses can improve palliative care access for those who should receive it?

Being knowledgeable of the benefits of palliative and hospice care

Learning Objectives

Define and differentiate the philosophy and principles of palliative care and hospice. Identify populations of patients appropriate for palliative and hospice care. Describe the role of the nurse, as a member of the interprofessional team, in providing quality palliative care for patients with serious illness(es) and their families (chosen and of origin).

hospice team members

Hospice aides Homemaker service aides (who help with household tasks) Nurses Physicians Chaplains Social workers Bereavement counselors Speech, occupational, and physical therapists Volunteers

6. Jack, a 6-year-old hospice patient, just died at home from an aggressive type of brain cancer. His parents and his 12-year-old sister are having a very difficult time dealing with this terrible loss. Which of the following will likely be the MOST helpful to this entire family after Jack's death?

Hospice bereavement care

Regina, Social?

Inability to cook or care for children, Inability to participate in activities

Unintentional Injuries

Injuries resulting from an unexpected event these include falls, motor vehicle traffic deaths, and poisoning.

You are talking to a patient with end-stage liver failure and his partner about what is important to them. Based on their goals, you talk about considering hospice. His partner says, "Isn't that just for people who are dying in the next few days or weeks?" What is your BEST response?

Many people think that, but hospice is actually intended for those who may die in the next 6 months if the disease takes its usual course.

Current Status of Palliative Care Programs

Ninety-four percent of hospitals with 300 beds or more and 96% of teaching hospitals have palliative care teams (CAPC, 2019). Seventy-two percent of U.S. hospitals with 50 or more beds have palliative care programs. However, there are regional variations with only 17% reporting access to palliative care services in rural hospitals. Eighty-six percent of the 56 freestanding children's hospitals with 50 or more beds have a pediatric palliative care program.

1. What is one of the nurse's MOST important roles in caring for seriously ill patients and their families?

Providing listening and presence

Stroke

Stroke-related care needs can be physical, psychological, social, spiritual, and functional.

Continuum of Care (CoC)

The continuum of care matches ongoing needs of the individuals being served by the case management process with the appropriate level and type of health, medical, financial, legal and psychosocial care for services within a setting or across multiple settings.

4. What should be MOST important in driving decision-making in palliative care?

The patient's goals of care

Module Summary

The philosophy and principles of palliative care and hospice Populations of patients appropriate for palliative and hospice care The role of the nurse, as a member of the interprofessional team, in providing quality palliative care for patients with serious illness and their families

9. Where is most hospice care delivered?

The private home

Respiratory Disease

These include COPD, emphysema, and chronic bronchitis; all of these are considered long-term lung diseases and represent the leading cause of disability in the U.

Sudden death

This trajectory involves deaths that occur suddenly and unexpectedly, such as from a myocardial infarction, car accident, COVID-19, natural disaster, homicide, or suicide

Chronic Illness

This trajectory involves patients with chronic illness(es) who have periodic crises and eventually die

Steady Decline

This trajectory involves the steady, progressive decline of a patient in the terminal phase of illness, such as pancreatic cancer

Progressive Deterioration

This trajectory represents the course for a person with an illness that causes a prolonged decline ending in death.

8. A client has been offered hospice care for her end-stage cardiac disease. Which statement reflects a need for the nurse to provide further education?

Why would I get hospice? I thought hospice was really for patients with cancer.

Heart Disease

any coronary heart disease including hypertension, myocardial infarction, heart failure, and cardiomyopathies. Heart disease-related healthcare needs represented 7.2% of emergency department visits in 2018

Cancer

any malignant growth or tumor caused by abnormal and uncontrolled cell division

Cirrhosis

chronic degenerative disease of the liver

Regina, Spiritual?

doubt about her faith, A lack of peace among all the pain and suffering

Hospice Care

holistic, compassionate care given to dying people and their families

Chronic Liver Disease

jaundice, ascities, pedal edema, muscle atrophy, decreased clotting, petechiae, varicose veins

What is Palliative Care?

manages symptoms, provide psychosial support, coordinate care to relieve suffering and improve quality of life for pts with serious illnesses Palliative care is the active holistic care of individuals across all ages with suffering due to severe illness or injuries, including at the end of life

Life-long Prolonging Treatment

ongoing treatments at the time of diagnosis and throughout the disease trajectory

Quality of Life Model

physical, psychological, social, spiritual

The Nurse's Role

provide presence develop and use communication skills participate in care coordination utilized evidence-based practice