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end life

QuestionAnswer
What is end life? When a disease or illness is deemed incurable by health care provider
What is the goal of end life? -maintain comfort -maintain quality of life -provide all means for a dignified death (respect their wishes)
What does DNR stand for? Do Not Resuscitate
Full code aka code blue; do anything to resuscitate
Chemical code no cpr, meds are administered
What are the two types of loss? -actual loss -anticipatory loss
What is actual loss? -can be recognized by others (i.e. death, amputation, job loss)
What is anticipatory loss? Loss that has yet to take place (i.e. hospice care, terminal illness)
Grief emotional reaction to loss
Bereavement state of grieving during which a person goes through the grief process (normal, essential for good health)
Mourning acceptance of loss and grief during which a person learns to deal with the loss
What are Kubler-Ross' five stages of Grief? 1) Denial & Isolation 2) Anger 3) Bargaining 4) Depression 5) Acceptance
Definitions of death irreversible cessation of respiration & circulation, functions of entire brain, loss of all "higher" brain function
Clinical signs of impending death: Cardiovascular -Hypotension -Change in pulse (increase, decrease,irreg, weak) -Poor circulation
Clinical signs of impending death: Respiratory -Change in breathing patterns (agonal, cheyne stokes, irregular, -death rattle (accumulation of secretions) -dyspnea
Clinical signs of impending death: Gastrointestinal -decreased GI motility -nausea, bloating, flatus, anorexia -bowel incontinence
Clinical signs of impending death: Genitourinary -decreased urinary output (oliguria-->anuria) -Incontinence
Clinical signs of impending death: CNS -confusion/delirium -out of body experiences
Clinical signs of impending death: Sensory system -decreased sensation -pain -glazed eyes -eyelids remain half open -hearing believed to be last sense to disappear
Clinical signs of impending death: Musculoskeletal -difficulty speaking -sagging of jaw from loss of facial muscle tone -gradual loss of ability to move
Interventions for Dyspnea -provide oxygen -nebulized medications (morphine, bronchodilators -place in comfortable position -suction as needed
Interventions for pain -meds (around the clock and breakthrough) -massage, aromatherapy, music therapy, relaxation techniques -minimize irritants (wetness, cold, pressure) -do not deny pain relief measures
Interventions for nutrition/hydration -ice chips, sips of fluids, mouth swabs, moist cloths to suck -assess nausea: c/o, contributing causes -provide frequent mouth care -provide antiemetics before meals -offer culturally appropriate foods
Restlessness -assess for spiritual distress as a cause of restlessness and agitation -do not restrain -use soothing music, slow soft touch & voice -limit persons at bs
Confusion/disorientation/delirium -reorient -keep personal and familiar items within reach -clock -comfort pt, speak in soft soothing voice -family members at bs -identify cause if possible (pain, discomfort, urinary retention)
Elimination -keep skin clean from incontinence -urinary catheters may be used
Therapeutic communication -open environment for expression -nonjudgmental -just be there -life review -be yourself -empathize -show human kindness -keep it simple
Advance directives documents that state end of life wishes specifically or designate the person who will make those decisions (i.e. living will, durable power of attorney)
Living will this document states specific wishes regarding kinds of healthcare that should be delivered or withheld in certain situations
Durable power of Attorney designates someone to make any decisions for you, when you are no longer to make those decisions for yourself
Hospice care concept of care when disease is no longer curable ( less than 6 months to live)
Palliative care symptom management (appropriate across lifespan of disease prognosis) no time frame, kind of like home health
End of life care time frame is last few weeks of life
Created by: kimtu05