Ch 40

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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


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