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Ch. 17, 22
End of Life/Laryngectomy
Question | Answer |
---|---|
what is health care profs attitudes towards death | hope pt would discover on own |
what is closed awareness? suspected awareness? mutual presence awareness? open awareness? | closed: guard secret, pt not able to cope suspected: pt suspects mutual: all aware but pretend otherwise open: acknowledge pt is dying |
what is key factor in pt and family accepting and planning for death | prognosis |
what are barriers to end of life care | cure focused by health care, money, culture, pshychological coping responses, denial |
what is assisted suicide | providing person means to end his own life. Oregon(Death wtih Dignity Act)/Washington only states. Nurses can't assist violate Code for Nurses |
what is interdisciplinary collaboration? Multidisciplinary are? | comm and cooperation among disciplines to single care plan. Multi: w/o coordination and integration |
All hospice care is | palliative, but not all palliative is hospice |
what is hospice vs palliative care | hospice: in home to terminally ill and fams, pt have irreversible illness and must opt for palliative, not cure care. Last 6mos of life Palliative: can be in hospital/long term/ hospice |
what are 4 levels of hospice care covered by medicare/caid | routine home care, inpatient respite care(5 day inpt stay), continuous care(mg med crisis), general inpt care(symptom mgmt) |
Spiritual assessment FICA | Faith/belief Importance/influence Community Address in care: addressing spirituality, maintain hope |
what are advance directives | written docs allow competent people to document prefs of med tx at end of life. Pt Self-Determination Act: requires health care ask if pt has adv directives |
what is durable power of atty | signer appoints/authorize ind to make med decisions on behalf |
what is living will | type of adv directive which pt documents tx prefs |
Nsg response to "Am I dying?" | eye contact and say, "This must be very difficult for you." "Tell me more about what's on your mind." |
Breaking bad news SPIKES | S-setting: private, sit down P-perception: identify with I-Invitaiton: to share K-Knowledge: give news in small chunks, warn, tailor rate given E-Empathy S-Strategy/Summary: ck for understanding |
what are hope fostering categories? Hope-hindering? | fostering: love of fam/friends, spiritual/faith, goals, maintain ind, humor, memoris Hindering: isolation, pain, devalue |
Signs of approaching death | refuse food/fluid, decr UO, week, confused, impaired vision/hearing, secretions in throat, incontinence, decr temp control |
what is palliative sedation | eliminate signs of discomfort |
how help noisy gurgling, breathing, moaning | reposition, fam reasurrance |
how does body change on death? | dusky/bluish, waxen, cool |
What is the Kubler Ross stages of grieving | denial, anger/bargaining, depression, acceptance |
what are six key processes to allow people to accept loss | recognition, reaction, recollection, relinquishing, readjustment, reinvestment |
What kind of cells is usually associated wtih head and neck Ca? what are categories: supraglottic, glottic, subglottic? | sqamous cell supra- false vocal cords above vocal cords, aspiration, preserves voice glottic- true vocal cords sub- below vocal cords |
what is early sign of larynx cancer | affected voice, not enlarged cervical nodes |
what should be included in nsg planning for larynx ca? | teaching for post op communication, humidification, |