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365 Exam 1
365 CH End of Life
Term | Definition |
---|---|
palliative care | interdisciplinary specialty focused on improving quality of life |
palliative care principles | decrease pain and suffering, increase adherence to advanced directives, increase patient and family satisfaction |
who can make decisions | patient as long as they are alert and oriented, can communicate wishes |
durable power of attorney | named by patient |
surrogate decision maker | who can make a decision, follow state guide |
living will | the patient's wishes |
allow natural death (DNR) | do not resuscitate, allow natural death is an order written in the hospital or on a legal form to respect wishes of patient; can be revised or revoked at any given time |
hospice care | provides service to patients in their last phase of terminal disease; helps in preparation of death; prognosis of survival is 6 months or less |
end of life | there is no typical death, unique to culture; rule out reversible or treatable causes of distress; focus on patient how they feel |
physiological signs of approaching death | cool, mottled extremities, increased sleeping, inability to regulate temperature, fluid and food intake decrease, incontinence, congestion and gurgling, apnea |
apnea | patterns of breathing and not breathing |
bereavement | state of loss |
grief | reaction to loss |
anticipatory grief | starts ahead of time, knowing death is coming |
adaptive grief | over time, healthy grief response, realistic coping |
prolonged grief | more than 6 months, seek referral |
shock stage | initial paralysis of the news |
denial stage | avoid inevitable |
anger stage | frustrated outpouring of bottled up emotion |
bargaining stage | seeking in vain for a way out |
depression stage | final realization of the inevitable |
testing stage | seeking realistic solutions |
acceptance stage | finding a way to move forward |
post mortem care | after patient is deceased; turn off monitors, notify physician they must examine |
death | irreversible cessation of cardiovascular, respiratory and brain function |
brain death | irreversible loss of all brain function |
comfort focused care | mouth swabs, adjust room temperature, avoid distressing actions |