EAQ Palliative Care

A registered nurse is educating a licensed practical nurse (LPN) about providing palliative care to a dying child. Which statement by the LPN indicates a need for further teaching?

"I'll advise the parents not to discuss death with the child."

A nurse is caring for a client who has undergone colostomy as a palliative treatment for advanced-stage rectal cancer. A family member of the client asks the nurse, "What's the expected outcome of this surgery?" Which is the most appropriate response by the nurse?

"The client will experience relief or reduction of intensity of disease symptoms."

A nurse is caring for a client who is scheduled to undergo radiation therapy as a palliative treatment for advanced-stage breast cancer. A family member asks the nurse, "What is the expected outcome of the therapy?" Which is the most appropriate response by the nurse?

"This therapy will reduce the pain caused by local recurrence and metastasis."

A client who has reached the stage of acceptance in the grieving process appears peaceful, but demonstrates a lack of involvement with the environment. How should the nurse address this behavior?

Accept the behavior the client is exhibiting.

A terminally ill client is coping with feelings regarding impending death. The nurse bases care on the theory of death and dying by Kubler-Ross. During which stage of grieving should the nurse primarily use nonverbal interventions?

Acceptance

A nurse is reviewing the data of four clients with esophageal cancer who are undergoing treatment in the palliative care unit. Which client does the nurse anticipate being at risk for tracheoesophageal fistula?

Client 2

A nurse is providing palliative care to four clients with cancer. The nurse reviews the clients' medical data and learns that different treatment measures have been prescribed to the clients. Which client does the nurse anticipate will have an increased incidence of thrombophlebitis, pulmonary embolus, and stroke?

Client 3

A client reaches the point of acceptance during the stages of dying. What response should the nurse expect the client to exhibit?

Detachment

A nurse is assisting a health-care provider in providing palliative care to a client with lung cancer who has just undergone surgery. The provider instructs the nurse to assist the client with frequent position changes. Which complication is this intervention intended to prevent?

Ineffective airway clearance

A client in a debilitated state is admitted for palliative treatment of cancer of the liver. Which objective information collected by the nurse is most helpful for future monitoring of the client's condition?

Present weight

A nurse is caring for a client with esophageal cancer. The primary health-care provider prescribes surgery as a palliative measure for the client. Which postsurgical outcome does the nurse anticipate in the client?

Relief from dysphagia and restoration of continuity of the alimentary tract

A primary health-care provider prescribes radiotherapy, chemotherapy, and laser therapy as a palliative treatment measure for a client with lung cancer. What does the nurse infer from this?

The client is in stage 4 of lung cancer

What is the most important factor relative to a therapeutic nurse-client relationship when a nurse is caring for a client who is terminally ill?

The nurse's personal feelings about terminal illness

A registered nurse is educating a licensed practical nurse (LPN) about the palliative procedure used to manage tetralogy of Fallot in infants. Which statement made by the LPN indicates effective teaching?

"It is a temporary procedure that creates an artificial connection between the pulmonary artery and the aorta."

After caring for a terminally ill client for several weeks, a nurse becomes increasingly aware of a need for a respite from this assignment. What is the best initial action by the nurse?

Seeking support from colleagues on the unit

A client with a terminal illness reaches the stage of acceptance. How can the nurse best help the client during this stage?

Stay nearby without initiating conversation.

The significant other of a client who is dying of acquired immunodeficiency syndrome (AIDS) tells the nurse, "Life is not worth living without my partner." What should the nurse plan to do to help the significant other cope with the impending death?

Involve the significant other's support system

The partner of a primigravida who has been in active labor for about 6 hours asks the nurse, "How much longer will this take? She's having a lot of back pain, and she's so uncomfortable." How should the nurse respond?

"Let me show you how to apply back pressure."

A nurse is learning about palliative care and curative care. Which statement by the nurse indicates effective understanding of the difference between the two types of care?

"Palliative care emphasizes the control of pain and relief of symptoms, whereas curative care is intended to cure the disease and prolong life at all costs."

A registered nurse is educating a licensed practical nurse (LPN) about the importance of palliative care in clients with HIV disease. Which statement made by the LPN indicates a need for further teaching?

"While palliative care is being provided to a client with HIV disease, intravenous therapy, blood transfusions, and radiation therapy should be considered."

A registered nurse is educating a licensed practical nurse (LPN) about involving assistive personnel in providing palliative care to a dying client. Which statements made by the LPN indicate effective understanding of the role of assistive personnel? Select all that apply.

*"I'll ask assistive personnel to inform me when the client's family members arrive." *"I'll ask assistive personnel to inform me when the client expresses anger or loss of appetite." *"I'll ask assistive personnel to inform me about change in the nature of the client's symptoms."

A nurse is caring for a child with sickle cell anemia. During the child's hospital stay, edema, impaired range of motion, and pain in the hands and feet develop. The primary health-care provider tells the nurse that the child will require palliative care and management. Which palliative management therapies does the nurse anticipate will be beneficial for the child? Select all that apply.

*Hydration *Analgesics *Oxygen therapy

An adolescent child is in the terminal stage of cancer. The parents ask how they will know when death is imminent. The nurse discusses the physical manifestations with the parents. What are the signs and symptoms of approaching death? Select all that apply.

*Weak pulse *Difficulty swallowing *Loss of bladder control

A client with cancer is informed that the chemotherapy is no longer working and that death is inevitable. Arrange in order the nursing interventions associated with each stage of Kubler-Ross's stages of death and dying, beginning with denial.

1.Avoid confronting the client. 2.Redirect negative feelings constructively. 3.Help the client identify realistic versus unrealistic goals. 4.Help the client celebrate the simple pleasures in everyday life. 5.Provide maximal comfort measure

A female client in the terminal stage of cancer is admitted to the hospital in severe pain. The client refuses the prescribed intramuscular analgesic for pain because it puts her to sleep and she wants to be awake. One day, despite the client's objection, a nurse administers the pain medication saying, "You know that this will make you more comfortable." The nurse in this situation could be charged with what?

Battery