Chapter 40: Hospice Care Flashcards

A philosophy of care about providing support to patients with terminal illness and their families.

A disease in an advanced stage with no known cure and poor prognosis.

To promote comfort and use compassion, interest, and genuine concern to allow the patient to live a better lifestyle during the dying process.

<p>To maximize the quality of life and keep the patient as comfortable as possible in the home setting that he or she chooses.</p> Signup and view all the answers

<p>Dame Cicely Saunders</p> Signup and view all the answers

<p>Connecticut in 1971</p> Signup and view all the answers

<p>The active, complete care of a patient whose disease has not responded to curative therapy.</p> Signup and view all the answers

<p>The control of pain, relief of symptoms, and provision of psychological, social, and spiritual assistance.</p> Signup and view all the answers

<p>Palliative care is not curative in nature but aims to relieve pain and distress and to control symptoms of the disease.</p> Signup and view all the answers

<p>When active, curative treatment is no longer effective and supportive measures are necessary to assist the terminally ill patient through the dying process.</p> Signup and view all the answers

<p>Palliative care is not giving up hope; it is full of hope of a good, fulfilling life.</p> Signup and view all the answers

<ol> <li>The attending physician has to certify that the patient's illness is terminal and the patient has a prognosis of 6 months or less to live. 2. For Medicare/Medicaid, 2 physicians are required to state the dying patient's prognosis. 3. It is mandatory that the patient desires the services. The patient has to be willing to forgo any further curative treatment and be willing to seek only palliative care. 4. Patient and caregiver are required to understand and agree that hospice staff will plan the care according to comfort and that they will not necessarily perform life support measures. 5. The patient and caregiver are required to understand the prognosis and be willing to participate in the planning of care.</li> </ol> Signup and view all the answers

<ol> <li>Medical Director 2. Nurse Coordinator 3. Social Worker 4. Spiritual Coordinator.</li> </ol> Signup and view all the answers

<p>Licensed Physician, mediator between the hospice team and attending physician, provides consultation relative to the medical aspect of care.</p> Signup and view all the answers

<p>RN nurse, does initial assessment, manages the patient care, explains the service, admits the patients, assigns the primary team.</p> Signup and view all the answers

<p>Bachelor's Degree, evaluates the psychosocial needs, resource for potential community services, assists with counseling in grief issues.</p> Signup and view all the answers

<p>Seminary Degree, liaison between the patient and spiritual community, coordinates spiritual support.</p> Signup and view all the answers

<p>Experience in volunteer work, recruits and trains the volunteers, coordinates assignments of volunteers.</p> Signup and view all the answers

<p>Professional with grief experience, assesses and supports the bereaved survivor, facilitates support groups.</p> Signup and view all the answers

<p>Licensed registered pharmacist, provides drug consultation.</p> Signup and view all the answers

<p>Licensed physician, responsible for the medical aspect of symptom control for the patient.</p> Signup and view all the answers

<p>RN, liaison between patient and caregiver, physician, and interdisciplinary team, evaluates patient's response to treatment, educates the patient and family in disease process and care, assesses symptom management, provides emotional support to patient caregiver.</p> Signup and view all the answers

<p>Religious group, supports patient and caregiver to cope with fears and uncertainty of spiritual issues.</p> Signup and view all the answers

<p>Volunteer training, provides companionship, available for short periods of respite care.</p> Signup and view all the answers

<p>Home health aide, administers personal care and assistance with bathing.</p> Signup and view all the answers

<p>Mental Health provider</p> Signup and view all the answers

<p>A combination of psychological and social factors.</p> Signup and view all the answers

<p>A period of relief from responsibilities of caring for a patient.</p> Signup and view all the answers

<p>A common depressed reaction to the death of someone close.</p> Signup and view all the answers

<p>At least 1 year</p> Signup and view all the answers

<p>Physical therapist, speech language pathologist, occupational therapist.</p> Signup and view all the answers

<p>Morphine sulfate (pain), fentanyl (pain), droperidol (antiemetic), prochlorperazine (antiemetic), senna (constipation), lorazepam (antianxiety).</p> Signup and view all the answers

<p>Pain</p> Signup and view all the answers

<p>Pain</p> Signup and view all the answers

<p>Evaluation of the factors that alleviate or exacerbate a patient's pain.</p> Signup and view all the answers

<p>Any pain over 5 on the 1-10 scale.</p> Signup and view all the answers

<ol> <li>Somatic Pain 2. Visceral Pain 3. Neuropathic Pain.</li> </ol> Signup and view all the answers

<p>Arises from the musculoskeletal system and is described as aching, stabbing, or throbbing.</p> Signup and view all the answers

<p>Originates from the internal organs. Described as cramping, dull, or squeezing pain.</p> Signup and view all the answers

<p>Arises from the nerves and the nervous system. Symptoms include tingling, burning, or shooting pains.</p> Signup and view all the answers

<p>Slowly increase the amount of drug to find the therapeutic dose.</p> Signup and view all the answers

<p>Morphine</p> Signup and view all the answers

<p>Constipation</p> Signup and view all the answers

<p>Poor dietary intake, poor fluid intake, hypercalcemia, hyponatremia, tumor compression of bowel, use of opioids for pain control, decrease in physical activity.</p> Signup and view all the answers

<p>A decrease in oral intake will decrease the amount of stool expelled. A patient does not have oral intake; bowel movements will still be possible in some cases. Opioids pose a risk of constipation, so it is necessary to give laxatives. Comfort is the all-important factor.</p> Signup and view all the answers

<p>Anorexia and malnutrition.</p> Signup and view all the answers

<p>Nausea and vomiting, constipation, dysphagia, stomatitis, tumor invasion, general deterioration of body, depression, or infections.</p> Signup and view all the answers

<p>Malnutrition marked by weakness and emaciation.</p> Signup and view all the answers

<p>A variety of possible conditions such as heart failure, dysrhythmias, infections, ascites, or tumor growth.</p> Signup and view all the answers

<p>Tumor pressure, fluid and electrolyte imbalance, or anemia.</p> Signup and view all the answers

<p>Death Rattle</p> Signup and view all the answers

<p>The result of accumulation of mucus and fluids in the posterior area of the pharynx.</p> Signup and view all the answers

<p>Only when a patient is choking and unable to recover.</p> Signup and view all the answers

<p>Depression, the need to suffer, bitterness, anger, hallucinations, dreams of fire.</p> Signup and view all the answers

<p>Weight loss and dehydration.</p> Signup and view all the answers

<p>Increased weakness.</p> Signup and view all the answers

<p>Arms and legs of body sometimes become cool to the touch, spends more time sleeping during the day and difficult to arouse, increasingly confused about time, place, and identity of close/familiar people, incontinence of urine and bowel movement, oral secretions more profuse and collect in the back of the throat, clarity of hearing and vision decrease slightly, restlessness, decrease need for food and drink, breathing patterns change, changes in vital signs occur.</p> Signup and view all the answers

<p>Withholding nutritional support, right to refuse treatment, DNR.</p> Signup and view all the answers