Test 8

Rigor mortis (rigidity) happens __-__ hours after death.

6 8

____ reactions- severe, unpredictable, violent behavior, over stimulation

Catastrophic

In the first stage of death and dying, the most common reaction of a person who has a terminal disease is: a. anger b. denial c. depression d. bargaining

b

Which one of the following is NOT a stage of grieving a. denial b. euphoria c. bargaining d. anger

b

3 stages of Alzheimer's- mild, ____ and severe

moderate

Falls are ___ common in the elderly If ordered in care plan- use bed ___ rails

more side

Biggest goal for hospice-____ ____.

pain control

Delirium is a ___ Dementia is a ___

symptom disorder

End of life- if patients are still "with it" and wanting to die instead of being in pain- ready to _____.

transition

____- privacy and confidentiality. Discuss patient info only with appropriate people, places

HIPPA

____ dementia- totally dependent

Severe

___ care Facility is for patients needing specialized nursing cares.

Skilled

Life _______ Treatment- patient wants CPR to maintain life (ventilator, oxygen, nutrition, surgery, blood transfusions).

Sustaining

T/F Residents have the same legal rights as other citizens.

T

Reality orientation helps dementia patients in stage __- time, place, and environment

2 (moderate)

Disrobing in public- lack of ___

judgment

Financing: private pay, Medicaid (___ or old), Medicare (___ program)

young Government

CNA- changes position of dying person every __ hours (unless in pain)

2

Sundowning happens in stage _ dementia

2 (moderate)

Nurse assistant performs __-__% of care for residents. They are the eyes and ears.

75 85

trying to make deals with God.

Bargaining

___ standards- moral behavior

Ethical

whole team of professionals _____. Physician, nurses, caregivers, social worker, pharmacist.

Hospice

Why are skilled care/nursing home patients called residents? Facility __ their home

IS

___ requires CNA's to complete a course of at least 75 hours of schooling to get license.

OBRA

____ ____-address financial concerns

Social worker

someone wanting this does not want to be prolonged artificially - ____ care= DNR or No Code. He just wants ____ care (oxygen, food and fluids, pain meds, personal care and hygiene).

Supportive Comfort

life ending (diagnosis)

Terminal

Mr. Roll's wife is dying. He realizes that she is going to die and nothing more can be done for her. He understands this and is at peace with the situation. The stage of grief he is showing is a. acceptance b. bargaining c. denial d. depression

a

To help a dying resident who is in pain a. avoid repositioning every two hours b. keep the room brightly lit c. administer mouth care every two hours d. turn the TV on and leave the room

a

Living Will and Durable Power of Attorney- are ___ ___. (after death)

advance directives

Common fears of dying- being ____, severe ____, inability to complete personal _____.

alone pain business

5 stages of grieving-______, _____, _____, ____, _____. (bad ad)Not necessarily in this order. Not a linear process- can go back and forth. Can happen to both patient and family.

bargaining anger denial acceptance depression

All of the following are signs of approaching death EXCEPT a. cold extremities b. low blood pressure c. circulation increases d. breathing is labored

c

People who are allowed to get their affairs in order have _____ vs. sudden death (accident).

closure

Always assist residents to obtain highest level of care. Allow patients to make their own choices- this helps patients feel like they have some ___

control

Nutritional needs- ___ appetite, ___ eating habits, malnutrition, and dehydration. (always offer fluids)

decreased poor

Validation therapy helps residents regain ___ and self-control

dignity

When caring for ____ patients- protect for injury, provide physical and mental activities

Alzheimers

_____- change in structure and function of brain

Alzheimers

be aware that family and patient relationships can become stained- _____.

Anger

Wandering and pacing- they are seeking a state of __

security

When helping with ADL's- use ___, simple directions

short

OBRA- Omnibus Budget Reconciliation Act- Each ___ is responsible for implementing this legislation

state

Rigor Mortis starts at ___, then neck and works downward.

head

Last sense to go-

hearing

Elderly are more susceptible to ___- encourage proper fluid intake

infection

___ ___ care is for patients that need minimal assistance- no medical issues.

Assisted living

Documents that give instructions about consumers wishes for treatment if the consumer is terminally ill or unable to communicate.

Advance directives

post mortem examination.

Autopsy

In the nursing home, most patients are ____'s.

DNR

___- acute state of confusion.

Delirium

___- symptom of acute illness

Delirium

Most common form of Alzheimer's is ____

Dementia

___- brain disorder- Declined thinking

Dementia

not accepting info about dying- _____. "I've got a clean bill of health".

Denial

full realization that life is ending.

Depression

___ ___ ___ ___ (DPoA)- others are able to make decisions of wishes and rights of dying person.

Durable Power of Attorney

_____ care is for patients that need assistance with ADL's- not independent patients.

Intermediate

___standards- lawful and moral practice

Legal

Advance Directives = _____ ____. (In advance you are able to direct the end of life cares that you want.)

Living Will

__ __ care facility- care for patients with chronic health problems (monitoring care)

Long term

___ ____ care is for elderly patients with chronic illness/disability, or young patient with chronic illness/disability or severe injury.

Long term

___- pays according to what level of facility they are in

Medicare

___ ___- may be temporary periods of mental confusion or dementia

Mental decline

___ dementia- *unkempt appearance*, short term memory loss, indifference, poor judgment

Mild

____ dementia- short-term memory loss gets worse, incontinent, complete disorientation, inappropriate repetition, confusion, restlessness at night.

Moderate

patients are able to write up their Advance Directives. (psda)

Patient self determination act

___ rule- treat others the way they want to be treated

Platinum

___ ___ care- dead body.

Post mortem

Nursing Assistant responsibility with patients approaching death- be ___, ____, ____ (ROR). Inform nurse of anything uncommon. Mouth care, fluid intake.

responsive open respectable

Euthanasia- assisted ___

dying

People who learn they are dying have different ____ reactions.

emotional

Hospice provides supportive services for patient and _____.

family

Ethical standards and legal standards are rules that help ___

govern

Report any behavioral changes to nurse (could be indication of ___)

illness

Bed rails ___ risk of accidents if patient tries to climb over them

increase

If a resident becomes combative and has a slight runny nose- suspect an ____. Report to nurse.

infection

Delirium is medical problem that needs corrected. Can be due to acute illness or dehydration. Can be from low sodium, medications, changes in environment or anesthesia. *Is/is not Reversible*

is

Psychological changes- anger, depression, hostility, complaining, emotional needs are __ likely to be met

less

Physical changes of aging- *sleeps __ during day*, stores less fluid in body tissue (dehydration), less muscle mass, general debilitation, slower response, smell and taste decreased, pain not perceived, vision, hearing, joints less flexible, prolonged reaction time, bones brittle, blood pressure increases, *lung capacity ____*, ___ urination at night*, *___ incontinence (may be related to inability to communicate)*,

less decreases increased urinary

If death is from natural causes on an elderly person, an autopsy is ___ normally performed- unless family requests one.

not

Mental deterioration is ___ a normal part of aging

not

If patient informs you about spiritual needs- tell ____.

nurse

Harvested- ____ ____. After death, body will be brought into surgery.

organ donation

Hospital- ___ Skilled Care- ____ Home health- ___ Geriatrics- ____(Gerontology)

patient resident Client elderly

Understand dying is a lonely process- provide ___, not total solitude.

privacy

Physical changes in death- less responsive, body functions slow down, sleeps more. Has moments of alertness, but loss of muscle control, extremities are cold, pulse ___ but ___, eyes stare forward.

rapid weaker

Legislation affects Long term care facilities- Nursing home ___ act

reform

Reminiscing, pet therapy, validation and music therapy helps ___ dementia patients

relax