Test 8
Rigor mortis (rigidity) happens __-__ hours after death.
6 8
____ reactions- severe, unpredictable, violent behavior, over stimulation
Catastrophic
In the first stage of death and dying, the most common reaction of a person who has a terminal disease is: a. anger b. denial c. depression d. bargaining
b
Which one of the following is NOT a stage of grieving a. denial b. euphoria c. bargaining d. anger
b
3 stages of Alzheimer's- mild, ____ and severe
moderate
Falls are ___ common in the elderly If ordered in care plan- use bed ___ rails
more side
Biggest goal for hospice-____ ____.
pain control
Delirium is a ___ Dementia is a ___
symptom disorder
End of life- if patients are still "with it" and wanting to die instead of being in pain- ready to _____.
transition
____- privacy and confidentiality. Discuss patient info only with appropriate people, places
HIPPA
____ dementia- totally dependent
Severe
___ care Facility is for patients needing specialized nursing cares.
Skilled
Life _______ Treatment- patient wants CPR to maintain life (ventilator, oxygen, nutrition, surgery, blood transfusions).
Sustaining
T/F Residents have the same legal rights as other citizens.
T
Reality orientation helps dementia patients in stage __- time, place, and environment
2 (moderate)
Disrobing in public- lack of ___
judgment
Financing: private pay, Medicaid (___ or old), Medicare (___ program)
young Government
CNA- changes position of dying person every __ hours (unless in pain)
2
Sundowning happens in stage _ dementia
2 (moderate)
Nurse assistant performs __-__% of care for residents. They are the eyes and ears.
75 85
trying to make deals with God.
Bargaining
___ standards- moral behavior
Ethical
whole team of professionals _____. Physician, nurses, caregivers, social worker, pharmacist.
Hospice
Why are skilled care/nursing home patients called residents? Facility __ their home
IS
___ requires CNA's to complete a course of at least 75 hours of schooling to get license.
OBRA
____ ____-address financial concerns
Social worker
someone wanting this does not want to be prolonged artificially - ____ care= DNR or No Code. He just wants ____ care (oxygen, food and fluids, pain meds, personal care and hygiene).
Supportive Comfort
life ending (diagnosis)
Terminal
Mr. Roll's wife is dying. He realizes that she is going to die and nothing more can be done for her. He understands this and is at peace with the situation. The stage of grief he is showing is a. acceptance b. bargaining c. denial d. depression
a
To help a dying resident who is in pain a. avoid repositioning every two hours b. keep the room brightly lit c. administer mouth care every two hours d. turn the TV on and leave the room
a
Living Will and Durable Power of Attorney- are ___ ___. (after death)
advance directives
Common fears of dying- being ____, severe ____, inability to complete personal _____.
alone pain business
5 stages of grieving-______, _____, _____, ____, _____. (bad ad)Not necessarily in this order. Not a linear process- can go back and forth. Can happen to both patient and family.
bargaining anger denial acceptance depression
All of the following are signs of approaching death EXCEPT a. cold extremities b. low blood pressure c. circulation increases d. breathing is labored
c
People who are allowed to get their affairs in order have _____ vs. sudden death (accident).
closure
Always assist residents to obtain highest level of care. Allow patients to make their own choices- this helps patients feel like they have some ___
control
Nutritional needs- ___ appetite, ___ eating habits, malnutrition, and dehydration. (always offer fluids)
decreased poor
Validation therapy helps residents regain ___ and self-control
dignity
When caring for ____ patients- protect for injury, provide physical and mental activities
Alzheimers
_____- change in structure and function of brain
Alzheimers
be aware that family and patient relationships can become stained- _____.
Anger
Wandering and pacing- they are seeking a state of __
security
When helping with ADL's- use ___, simple directions
short
OBRA- Omnibus Budget Reconciliation Act- Each ___ is responsible for implementing this legislation
state
Rigor Mortis starts at ___, then neck and works downward.
head
Last sense to go-
hearing
Elderly are more susceptible to ___- encourage proper fluid intake
infection
___ ___ care is for patients that need minimal assistance- no medical issues.
Assisted living
Documents that give instructions about consumers wishes for treatment if the consumer is terminally ill or unable to communicate.
Advance directives
post mortem examination.
Autopsy
In the nursing home, most patients are ____'s.
DNR
___- acute state of confusion.
Delirium
___- symptom of acute illness
Delirium
Most common form of Alzheimer's is ____
Dementia
___- brain disorder- Declined thinking
Dementia
not accepting info about dying- _____. "I've got a clean bill of health".
Denial
full realization that life is ending.
Depression
___ ___ ___ ___ (DPoA)- others are able to make decisions of wishes and rights of dying person.
Durable Power of Attorney
_____ care is for patients that need assistance with ADL's- not independent patients.
Intermediate
___standards- lawful and moral practice
Legal
Advance Directives = _____ ____. (In advance you are able to direct the end of life cares that you want.)
Living Will
__ __ care facility- care for patients with chronic health problems (monitoring care)
Long term
___ ____ care is for elderly patients with chronic illness/disability, or young patient with chronic illness/disability or severe injury.
Long term
___- pays according to what level of facility they are in
Medicare
___ ___- may be temporary periods of mental confusion or dementia
Mental decline
___ dementia- *unkempt appearance*, short term memory loss, indifference, poor judgment
Mild
____ dementia- short-term memory loss gets worse, incontinent, complete disorientation, inappropriate repetition, confusion, restlessness at night.
Moderate
patients are able to write up their Advance Directives. (psda)
Patient self determination act
___ rule- treat others the way they want to be treated
Platinum
___ ___ care- dead body.
Post mortem
Nursing Assistant responsibility with patients approaching death- be ___, ____, ____ (ROR). Inform nurse of anything uncommon. Mouth care, fluid intake.
responsive open respectable
Euthanasia- assisted ___
dying
People who learn they are dying have different ____ reactions.
emotional
Hospice provides supportive services for patient and _____.
family
Ethical standards and legal standards are rules that help ___
govern
Report any behavioral changes to nurse (could be indication of ___)
illness
Bed rails ___ risk of accidents if patient tries to climb over them
increase
If a resident becomes combative and has a slight runny nose- suspect an ____. Report to nurse.
infection
Delirium is medical problem that needs corrected. Can be due to acute illness or dehydration. Can be from low sodium, medications, changes in environment or anesthesia. *Is/is not Reversible*
is
Psychological changes- anger, depression, hostility, complaining, emotional needs are __ likely to be met
less
Physical changes of aging- *sleeps __ during day*, stores less fluid in body tissue (dehydration), less muscle mass, general debilitation, slower response, smell and taste decreased, pain not perceived, vision, hearing, joints less flexible, prolonged reaction time, bones brittle, blood pressure increases, *lung capacity ____*, ___ urination at night*, *___ incontinence (may be related to inability to communicate)*,
less decreases increased urinary
If death is from natural causes on an elderly person, an autopsy is ___ normally performed- unless family requests one.
not
Mental deterioration is ___ a normal part of aging
not
If patient informs you about spiritual needs- tell ____.
nurse
Harvested- ____ ____. After death, body will be brought into surgery.
organ donation
Hospital- ___ Skilled Care- ____ Home health- ___ Geriatrics- ____(Gerontology)
patient resident Client elderly
Understand dying is a lonely process- provide ___, not total solitude.
privacy
Physical changes in death- less responsive, body functions slow down, sleeps more. Has moments of alertness, but loss of muscle control, extremities are cold, pulse ___ but ___, eyes stare forward.
rapid weaker
Legislation affects Long term care facilities- Nursing home ___ act
reform
Reminiscing, pet therapy, validation and music therapy helps ___ dementia patients
relax
