Prep U end of life care

The parents of a 9-year-old girl who is dying from cancer are distraught and guilt-ridden when they find that treatment is no longer successful. What is the best way for the nurse to respond? Ask the parents if they wish to fill out a DNR order Tell the parents there is no more than can be done Assure the parents that expert care of their child will continue Explain that it is not fair to the child to continue present treatment

Assure the parents that expert care of their child will continue

The nurse is aware of the special needs of children related to pain assessment. What is the priority for the nurse to consider when completing a pain assessment? Chronological age of child Reason for the pain Developmental age of child Pain medications used and last dose administered

Develpomental age of child

During unplanned, spontaneous moments, dying clients usually discuss fears or concerns that nurses should not ignore or rush. What is the nurse's best response in such situations? Communicate interests and a willingness to listen by sitting down, leaning forward in the client's directions and making direct eye contact Offer the client a sedative to help them rest more easily Change the subject and talk about other things to distract the dying client Call the client's family members and ask them to sit next to the client to listen

Communcate interest and a willingness to listen by sitting down, leaning forward in the client's direction and making direct eye contact

A patient on the medical unit is dying and the nurse has determined that the family's psychosocial needs during the dying process need to be addressed. What is a cause of many patient care dilemmas at the end of life? Limited visitation opportunity for friends and family Poor communication between fam and care team Denial of imminent death on the part of the family or patient Conflict between family members

Poor communcation between the family and care team

A 12-year-old girl needs a lumbar puncture to collect cerebrospinal fluid for a laboratory exam plus injection of medication into the central nervous system. She expresses great fear of the procedure because of anticipated pain and the inability to hold still. The nurse contacts the physician to make which suggestion? Include the child's parents and a child life specialist in the procedure room Delay the procedure until the child can achieve better understanding and acceptance The use of Conscious sedation for th lumbar puncture Administration of an oral anti anxiety med prior to administration

The use of conscous sedation for luimbar puncture

Which of the following nursing interventions is appropriate with regard to pain control in the dying client? Explain that morphine will be avoided bc of its sedative effects Give pain meds on a routine schedule Explain that narcotics can cause addiction Explain that o2 will eventually be used

Give pain med on a routine schdeule

The best way for a nurse to assess pain in an 18-month-old client is to Tell the caregiver to call if client has pain Check the client's pupil Observe for behavioral changes Ask the client "are you feeling any pain"

Observe for behavioral changes

A client with a terminal illness has feelings of rage toward the nurse. According to Kubler-Ross, the client is in which stage of dying? Depression Barganining Denial Anger

Anger

The nurse is talking with the parents of a dying child. The child's mother confides she is afraid to be with her child at the time of death. Which response by the nurse is appropriate? "These fears are not uncommon" "You will need to find a way to overcome this obstacle for your child" "If you cannot handle being child, your child will understand" "If you nee to leave your child at the time of death that will be fine"

These fears are not uncommon

The nurse is caring for a critically ill child. The family is tearful. When speaking with the child's family, which is the best statement by the nurse? Everything will work out fine Miracle happen all the time in this unit This use be a horrible time for you right now You must pray for him to get better

This must be a horrible time for your right now

A client 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 patient and family at home? A rehab center Adult day care Hospice Physical therapy

Hospice

What barrier to end-of-life care does a dying client demonstrate with the statement, "I don't need hospice. Hospice is for people who are dying." Anger Denial Acceptance Bargaining

Denial

The nurse is assessing the pain level of a child newly admitted to the pediatric orthopedic unit with a fractured femur. The client denies pain, but the nurse suspects the child is having leg pain based on what observations? The child guards the leg when the nurse reaches to touch it The child is lying on one side and drawing his kneed up to abd The child's oxygenation sat level is at low end of Normal The child has elevated pulse and RR The child has not smiled during the entire conversation and assessment

The child gaurds the legs when nurse touches it The child has elevated puse and rr rate The child has not smiled during the entire conversation and assessment The childs o2 level is at the low end of normal

The nurse is using blowing bubbles during a procedure with a child as an alternative pain-management technique. What type of alternative pain management is this considered? Distraction Thought stopping Hypnosis Imagery

Distraction

The mother of a child who just had abdominal surgery holds his hand and smooths his hair. When the nurse appears to administer a scheduled analgesic, the mother says she believes the child has been in pain the last hour or more. The nurse's best response is: His vital signs are stable, telling me he must be comfortable Please tell me and all of the nurses when you believe he is in pain We will check q4 hrs to see if he needs pain meds This is the educations he gets every 4-6 hours. It will control his pain for that period of time He loos comfortable to me and was sleeping each time i checked. The medications given earlier seems adequate

Please tell me and all the nursed when you bleieve he is in pain

The nurse is caring for a client with terminal cancer who is experiencing dyspnea and increasing levels of pain. What would be the priority for pain management with this child? Preventing addiction to the opioid med Preventing and alleviating pain Following the health care providers rigid guideline regarding dosages Monitor child vital signs frequently

Preventing and alleviating pain

The nurse is caring for a burn client with orders for oral ibuprofen and morphine PRN to control pain. Which nursing interaction is the most beneficial for the nurse to implement for pain management? Alternate these med around the clock to diminish peaks and valley in pain control Give only the ibuprofen until the client reports higher pain levels Give morphine as little as possible to prevent unwanted side effects Give medications when client asks for it

Alternate these med around the clock to dimish oeaks and vallers in pain control

The nurse is assessing the abdomen of a preschooler admitted for lower right quadrant pain. Which assessment questions provide helpful data? Select all that apply. "Is your Hurt getting better" Does your tummy ache The hurt, is it sharp or dull Choose the face that shows how you feel now Touch the spot on your tummy where it hurts

Tuoch the spot on your tummy where it hurts Choose the face that shows how you feel now

The nurse is listing physiologic indicators of pain in children while teaching a pain management class for peers. Which of the indicators will be included? Select all that apply. Oxygen sat level Facial expression Body movements Change in bp Palmar sweating

Chenges in bp O2 lvl Palmar sweating

Which is a true statement regarding hospice care? It is cure focused It encourages the prolongation of life through artificial means Clients have a life expectancy of 6 months or less Patient have an acute illness

Clients have a life expectancy of 6 months or less

The nurse is caring for an infant who will have surgery. What type of pain assessment would the nurse use? Observation of facial and body actions A self pain rating scale from 1-10 None bc infants do not feel pain None bc infants do not remember pain

Observation of facial and body actions

A nurse is caring for a terminally ill client who is receiving chemotherapy and radiation for an aggressive lung cancer. The treatment success is limited in shrinking the tumor, and the treatments are making the client very ill. The client states, "I feel that I would like to stop treatments. I would like to enjoy the time that I have remaining with my family." Which emotional reaction does the nurse recognize that the client is experiencing? Anger Acceptance Bargaining Denial

Acceptance

The nurse is caring for an infant who was injured in a severe automobile accident. The child experienced several fractures and is in significant pain. The child's mother questions if this will impact her child later in life. What information should be provided by the nurse? There are no studies that consider the impact of pain on the child later in life Although the pain is severe at this time a child under the age of 2 will not be able to recall the event Pain that is short in duration in infancy will not influence the child later Experiences with pain even in infancy can influence an individuals response to pain later

Expereinces with pain even in infancy can influence an individuals respone to pain later

A young child is hospitalized with pneumonia. Upon admission the client states not having pain but just a bad cough. A few hours later, the child he begins reporting pain in the right lower back. This first report of feeling pain refers to: Pain duration Pain threshold Pain tolerance Pain peak

Pain threshold

The nurse is caring for a child with a terminal illness who is dying. The parents are concerned that their child will be in pain. What can the nurse do to help the parents understand that pain control needs are being addressed? Select all that apply. The nurse explains that pain medications will be given at scheduled times rather than on only a prn basis. The nurse explains that the staff offers back massages to the child in an effort to help with pain and relaxation. The nurse explains that care, such as turning and repositioning, will only be done as frequently as tolerated by the child. The nurse explains that the staff will keep the client distracted by playing video games and board games with the child. The nurse explains that the staff will be sure to assess the child's pain level both by verbal and nonverbal cues.

The nurse explains that pain medications will be given at scheduled times rather than on only a prn basis. The nurse explains that care, such as turning and repositioning, will only be done as frequently as tolerated by the child. The nurse explains that the staff offers back massages to the child in an effort to help with pain and relaxation. The nurse explains that the staff will be sure to assess the child's pain level both by verbal and nonverbal cues.