Concept 53 - Palliative Care
One of the biggest challenges facing current nursing practice is a. the number of aging Americans living with chronic disease. b. the number of patients entering into hospice programs. c. the number of cancer patients receiving supportive care. d. reduced length of stay in hospice care.
ANS: A Millions of Americans are living with one or more chronic debilitating diseases, and 7 out of 10 can expect to live with their diseases several years before dying. When coupled with the advancing age of the eight million baby boomers who now qualify for Medicare, this will soon create a huge demand on health care resources and community-based services.
The most prominent goal of palliative care is to a. integrate into chronic disease management sooner rather than later. b. enroll the patient into the Medicare Hospice Benefit. c. ensure that the patient has a 6-month prognosis. d. reserve this type of care until the patient is actively dying.
ANS: A The goal of palliative care is to integrate symptom management interventions earlier into the course of chronic disease sooner rather than later. This helps to promote optimal quality of life.
The interprofessional core team includes members from a. nursing, medicine, pharmacy, and nutrition. b. medicine, nursing, social work, and clergy. c. medicine, nursing, physical therapists, and volunteers. d. nursing, home health aides, volunteers, and clergy.
ANS: B An interprofessional team approach involving health care professionals from different disciplines is central to optimal palliative care practice and quality outcomes. The interdisciplinary core team includes members from medicine, nursing, social work, and clergy. Ancillary disciplines are also included.
Palliative care used in the management of a patient with symptomatic chronic obstructive pulmonary disease (COPD) is an example of which of the following? a. Palliative care is used when the patient is beginning to die. b. Palliative care is used to help manage the symptoms that often accompany COPD. c. Hospice nurses must be involved to provide palliative care in a cancer patient. d. Patient must be enrolled into the Medicare Hospice Benefit to receive palliative care.
ANS: B Palliation is the relief or management of symptoms without providing a cure. To palliate is to reduce the severity of an actual or potential life-threatening condition or a chronic debilitating illness. Palliation is not equivalent to cure, but it is the reduction of undesirable effects resulting from the incurable disease or condition.
When considering the trajectory of a specific disease, what is the most important concept? a. Hospital admissions b. Physical functioning c. Quality of life d. Symptom management
ANS: B The disease trajectory occurs from the onset of a life-limited diagnosis until death. Physical functioning determines the decline in the patient's physical status. Decline in status is used to determine when to intervene with palliative and end-of-life care.
Palliative care does everything except a. promote comfort. b. reduce disease exacerbations. c. decrease acute care hospital admissions. d. promote a cure for chronic disease.
ANS: D Palliation is the reduction of symptoms without elimination of the cause. Palliative care refers to the provision of care for patients who are diagnosed with a disease or condition without a cure.
Today most patients are living for several years before dying with multiple chronic conditions, such as COPD, congestive heart failure, diabetes, and obesity. These concomitant diseases contribute to multiple symptoms that interfere with the patient's quality of life. What type of care would you consider for this patient? a. End-of-life care b. Supportive care c. Comfort care d. Palliative care
ANS: D Palliative care provides optimal symptom management in the setting of multiple chronic conditions. The relief and management of these symptoms help to promote improved quality of life for the patient and help to maintain physical functioning.