Ch 40
Spiritual coordinator
Seminary degree
Which member of the interdisciplinary team assist with assessing community resources and filing insurance papers, and also supports the patient and caregiver with emotional and grief issues
Social worker
What are the three main types of pain
Somatic pain, visceral pain, neuropathic pain
As part of the hospice program, the patient has a court interdisciplinary team that manages his care what members may take up the core interdisciplinary team (Select all that apply)
Spiritual coordinator Nurse coordinator Social worker Medical director
Primary spiritual leader
Supports patient and caregiver and coping with fears and uncertainty about spiritual issues
Hospice aide
Administer his personal care and assistance with bathing
curative care
Aggressive care where the goal is curing the disease in prolonging life at all costs
Bereavement coordinator
Assesses and supports the brave survivor facilitates support groups
What is one of the most common problems of the terminally ill patient
Constipation
Interdisciplinary team
Works together in caring for the terminally ill patient
The narcissist guessing hospice with the spouse of a patient who has been diagnosed with dementia. During the session, which statement by the patient spouse indicates the need for further discussion?
" my wife does not meet the criteria for using hospice."
Pain Assessment
Evaluation of factors that Alleviate or exacerbate a patient's pain
The patient is experiencing a decreased appetite invoices concerns that about his weight loss. What action by the hospice nurse is most appropriate?
Explain to the patient that decreased appetite is normal
The patient is nearing death. His wife, who is the primary caregiver, ask the nurse if it is still appropriate to turn the patient every two hours even as it creates discomfort and causes him to become restless. What would the nurses best response be?
" position changes at this stage can be limited and performed only when he appears to be uncomfortable."
The healthcare provider is explaining to a 74-year-old patient that his prostate cancer is progressing and that curative treatment is no longer feasible. The healthcare provider has recommended hospice to the patient and his wife. What information may be included with the recommendation to hospice?
" we can provide support and control your symptoms and discomfort so that you have a good quality days"
Dementia - related
18%
Cardiac and lung diseases
18.7%
When and where it was hospice renewed?
1960s in London
When did the first hospice program open in Connecticut
1971
Cancer
27. 2%
somatic pain characteristics
Arises from the musculoskeletal system Aching, stabbing, or throbbing Nonsteroidal anti-inflammatory drugs, no opioid drugs, or opioid drugs used
The patient's wife tells the hospice aide that she is having problems meeting their financial obligations. What action by the hospice aide is most appropriate
Ask her permission to report this to the inter-disciplinary team, and have the social worker make a visit to see whether it is possible to provide assistance
The patient is complaining of pain at a five on a pain scale of 0 to 10. What action by the nurse is indicated?
Ask the patient what he wants his pain goal to be if it is below five, then you'll have to notify the healthcare provider
The patient's wife called the hospice nurse and reports that her husband is complaining of pain in his leg and is not able to get comfortable. What action by the hospice nurse may be implemented?
Ask your wife how the patient rates his pain whether he has taken any medications for breakthrough pain
The patient is complaining of constipation. He has had very little food intake the past four days. What action by the nurse must be appropriate?
Assess for Bow sounds, abdominal distention, and possible impaction
The patient's wife is exhausted and expresses a need to get away for a short time. How can the volunteer coordinator help in the situation?
Assign a volunteer to sit with the patient for a couple of hours two or three times a week so that the wife is able to either take a nap or to leave for a short time to do errands
social worker
Bachelors in social work
What is the most common primary disease process served by hospice?
Cancer
The patient has never intended charge and on hospital admission requested no spiritual support. Now he is within days of death and voiced some spiritual concerns to the nurse. What action by the nurse is indicated?
Contact the interdisciplinary team to ask that the spiritual coordinator make a home visit.
The patient died peacefully and with dignity, but his wife is still having problems dealing with the death. What services by the hospice team can be anticipated?
Continued bereavement support for her for the next year
What are the goals for hospice
Controlling or alleaving the patient's symptoms Allowing the patient and caregiver to be involved in the decisions Encouraging the patient and caregiver to live life to the fullest Provided continuous support to maintain patient/family confidences Educating and supporting the primary caregiver
__________ is aggressive care in which the goal and intent is curing the disease and prolonging life at all cost
Curative care
What nurse and physician, realize that a different kind of care was needed for the terminally ill?
Dame Cicely Saunders
What is often heard 24 to 48 hours before death
Death rattle
What is a nursing intervention and patient teaching about dyspnea or air hunger
Educate on positioning, use a fan to circulate air, use of morphine to decrease respiratory effort, use of tranquilizers to ease anxiety, and maintaining good oral hygiene
palliative care
Emphasizes pain control, symptom control and provide psychological, social, and spiritual assistance
What nursing intervention and patient teaching should be done about nausea and vomiting
Encourage patient to take the antiemetic 30 minutes before meals and bedtime
Where did hospice originate?
England
primary nurse
Evaluate patient response to treatment
What elements are included in the definition of palliative care according to the world health organization? (Select all that apply.)
Focusing on controlling pain and other symptoms, as well as reducing his psychological, social and spiritual distress for the patient in the family The active total care of patient whose disease is not responsive to curative care The framework for hospice care
When did the philosophy of hospice migrate to the United States
In the early 1970s
Neuropathic pain Characteristics
Initiated from the nerves in nervous system Tingling, burning, or shooting pains Anticonvulsants maybe given as an adjuvant to assist with pain control
cachexia
Is malnutrition March by weakness and emaciation
Advanced directive provides guidance for patient's wishes that are
Life support measures and to organ donation
Medical Director
Mediator between the team and the medical provider
The ___________is the mediator between the hospice team and the attending healthcare provider
Medical director
What is the drug of choice by hospice patients
Morphine
The pain assessment should be
Ongoing
visceral pain characteristics
Originates from the internal organs Cramping, pressure, dull , or squeezing Anticholinergic medications alone or as adjuvants
What assessment scale should be used
Pain
What is the most feared and dreaded symptom
Pain
What serves as a bridge between curative care and hospice
Palliative care
What other inter-disciplinary services are there not for rehabilitation services, but to assist with improving the quality of life and care for the patient caregiver
Physical therapist Speech - language pathologist l Occupation therapist Licensed medical nutritionist
Hospice pharmacist
Provides a drug consultations
Hospice volunteer
Provides companionship for patient caregiver available for short periods of respite care
Nurse coordinator
RN
Volunteer coordinator
Recruits and trains the volunteers coordinators assignments of volunteers
Primary healthcare provider
Responsible for medical aspect of symptom and control for patient
For the patient to qualify for assistance from Medicare or Medicaid for hospice care, which criteria are necessary? (Select all that apply.)
The healthcare provider statement that the patient has less than six months to live Two health care providers verification that the patient is dying The patient or caregiver's understanding of the plan of care
What is the criteria for hospice medication under the Medicare and Medicaid rules
Two healthcare providers must verify that illness is terminal and six months or less to live
The bereavement coordinator on the hospice team follows a plan of care for the bereaved caregiver for what length of time after the death of the patient?
Up to 13 months
Which type of pain originates from the internal organs
Visceral pain
