Exam 3 - Palliative Care & EOLWh

What is decisions about treatment in the even thath the patient is unable to make decision or communicate wishes? who can over rule this?

advanced care planning healthcare proxies (POA) or next of kin

Does palliative mean hospice?

it can but not always

The _______________ the stay in the ICU, the __________ likely mortality will be.

longer more

Occurs when the nurse knows proper course of action but constraints make it impossible to pursue.

moral distress

What are the main s/s being managed? - 6

pain dyspnea anxiety/agitation depression delirium N/V

What is defines as goals related to chronic conditions, because we know chronic conditions are going to progress, want to increase quality of life and treat s/s.

palliative care

What are the 5 recommendations to improve EOL care?

1. person-centered, family-oriented 2. client Pt communication and advanced care planning 3. professional education and development 4. policies and payment systems to support high quality EOL care 5. public education and engagement

What is included in EOL care? - 4

CODE palliative comfort care hospice

What is a principle most commonly applied to the administration of pain medications to patients who are dying, focuses on "intention" of the opioid to relieve pain, recognition that the patient may die, but is morally and legally permissible to administer the opioid.

Principle of Double Effect

What did death use to look like in the ICU?

Pt's have died in ICU surrounded by healthcare providers and not family

Priority purpose of palliative care? A.Symptom management and improve quality of life B.Time to educate patient and family about the chronic disease process C.Provide care when patient/family can not

a

Which of the following would not be consistent with promoting nutrition in terminally ill patients? A.Maintaining a balanced diet B.Avoiding arguments at meals C.Offering small portion of favorite foods Offering cool foods rather than hot foods

a

Which of the following is the most accurate statement regarding family presence during resuscitation? A. Families report more anxiety after the experience B. There are a greater number of litigations after witnessing the resuscitation C. A dedicated staff member should attend to the family during the resuscitation D. The experience has not been found to help the bereavement process of the families

c

What are the 6 main factors for family centered care?

care conferences - early and repeated shared decision making honesty open, flexible visitation family support spiritual support

T/F: A health care proxy designated by the patient should make decisions based on his/her own desires for the patient?

false

True or False: Advanced Care planning discussion is outside the scope of practice of a registered nurse?

false

What is informed refusal?

giving the option to say no knowing what they are saying no to

What is the focus of palliative care? - 3

goals improving quality of life treating s/s to help achieve goals

What are the core principles of palliative care? - 4

goals symptom management family-centered care communication

What supports the dignity of life, care for terminally ill with prognosis of <6 months to live.

hospice

For Palliative/EOL care the delivery of care should be? What is one way to achieve this?

person-centered family-oriented multidisciplinary rounds

What are the core principles of hospice? - 4

symptom management family centered care bereavement care and counseling to survivors change from cure to care

T/F: Technology, urgency, and conflict in critical care practice may interfere with efforts aimed to provide good EOL care.

true - the focus is to save lives but can interfere with the quality of EOL care

EOL sedation: when should it be used? what is the indication? what is the goal?

when all other interventions have failed to control s/s pain or approaching last hours produce a level of obtundation to relieve suffering w/o hastening death