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Ch. 17, 22

End of Life/Laryngectomy

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,
Created by: palmerag