Palliative Care Fundamentals
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Questions and Answers

According to the provided information, what is the central focus of palliative care?

  • Extending the patient's life at all costs.
  • Relief of suffering. (correct)
  • Ensuring the patient is in optimum physical health
  • Providing the most advanced treatments

    • What is the primary focus of the National Hospice and Palliative Care Organization (NHPCO)?

  • Providing direct patient care
  • Improving the quality of palliative care (correct)
  • Developing new palliative care medications
  • Certifying palliative care professionals

    • Which of the following is NOT listed as a strategy for family caregivers?

  • Setting realistic goals
  • Isolating the patient (correct)
  • Having difficult discussions
  • Finding help

    • What is a common barrier to palliative care?

    <p>Lack of payment for services (A)</p> Signup and view all the answers

    What is the designation for a nurse who is certified at the generalist level?

    <p>CHPN (C)</p> Signup and view all the answers

    Which area of expertise is NOT listed for hospice and palliative care nurses?

    <p>Financial planning (D)</p> Signup and view all the answers

    Besides avoiding unwanted CPR, the National Hospice and Palliative Care Organization (NHPCO) is also committed to avoiding what?

    <p>Unwanted hospitalizations (D)</p> Signup and view all the answers

    What does the acronym TJC stand for, in the context of certification for palliative care?

    <p>The Joint Commission (D)</p> Signup and view all the answers

    Which of the following best describes the primary focus of hospice care?

    <p>Providing symptom control and comfort care. (B)</p> Signup and view all the answers

    A key difference between palliative care and hospice is that palliative care:

    <p>Allows patients to receive curative treatments. (D)</p> Signup and view all the answers

    According to the HPNA standards, which of these is a key responsibility of palliative care nurses?

    <p>Educating patients/family to identify appropriate settings and treatment options. (A)</p> Signup and view all the answers

    When should palliative care ideally be introduced in the course of a serious illness?

    <p>At the initial diagnosis of a serious illness. (A)</p> Signup and view all the answers

    Which factor primarily drives the need for transitioning from palliative care to hospice?

    <p>Disease progression to an end-stage condition and comfort becomes the primary focus. (B)</p> Signup and view all the answers

    Which tools are used to assess a patient’s functional decline?

    <p>The Palliative Performance Scale (PPS) and Karnofsky Scale. (B)</p> Signup and view all the answers

    What is an essential step after gathering data to determine a patient's prognosis?

    <p>Meeting with the patient and family to discuss findings. (B)</p> Signup and view all the answers

    What is a key focus of palliative care nurses related to information management?

    <p>Protecting patient confidentiality. (A)</p> Signup and view all the answers

    Which of the listed options is NOT a common hope expressed by individuals at the end-of-life phase?

    <p>To have more time with loved ones (D)</p> Signup and view all the answers

    What is the purpose of asking the 'surprise question' within the context of palliative care?

    <p>To assess the likelihood of mortality within six months to a year (B)</p> Signup and view all the answers

    Which factor is LEAST likely to trigger a palliative care consult according to the information provided?

    <p>The age of the patient being over 70 years of age (C)</p> Signup and view all the answers

    Which of the following topics is included in the End-of-Life Nursing Education Consortium (ELNEC) core curriculum?

    <p>Bereavement practices of various cultures (A)</p> Signup and view all the answers

    Which organization is NOT a member of the National Consensus Project (NCP) task force?

    <p>American Medical Association (AMA) (C)</p> Signup and view all the answers

    According to the NCP Practice Domains, which aspect of care is directly addressed in Domain 2?

    <p>Physical aspects of care (B)</p> Signup and view all the answers

    Which of the following best represents the focus of NCP Practice Domain 5?

    <p>Spiritual, religious and existential aspects of care (D)</p> Signup and view all the answers

    What is one of the primary goals of the National Consensus Project (NCP)?

    <p>To improve the quality of palliative care (D)</p> Signup and view all the answers

    A palliative care model prioritizes which definition of 'family'?

    <p>The unit of care as defined by the patient. (A)</p> Signup and view all the answers

    What is a crucial role of a nurse in palliative care?

    <p>Advocating for the needs and wishes of patients and their families. (C)</p> Signup and view all the answers

    Within the context of palliative care, what importance is given to a patient's culture?

    <p>It is an important aspect to be honored during care. (B)</p> Signup and view all the answers

    Which of the following populations are specially focused on within palliative care?

    <p>Vulnerable individuals, prisoners, and substance abusers. (A)</p> Signup and view all the answers

    Which statement accurately reflects the reach of palliative care?

    <p>It is applied to all life-threatening illnesses. (C)</p> Signup and view all the answers

    What is one of the physiological consequences of unrelieved pain?

    <p>Interference with the ability to sleep. (B)</p> Signup and view all the answers

    A palliative nurse would use which question when assessing a patient's pain?

    <p>Is your pain hindering your sleep? (D)</p> Signup and view all the answers

    What is one of the benefits of palliative care?

    <p>Optimization of bodily function. (D)</p> Signup and view all the answers

    Study Notes

    Palliative Care

    • Hospice is an interprofessional approach to end-of-life (EOL) care, focusing on aggressive pain and symptom control, spiritual and psychological care for the patient and family.
    • Symptom management is prioritized over curative treatment.
    • The disease is considered an end-stage condition progressing to death.

    Palliative Care

    • Palliative care focuses on maximizing quality of life during diagnosis, treatment, and life with serious illness.
    • Unlike hospice, patients in palliative care can receive curative treatment.
    • Early identification of physical, psychological, and spiritual problems is crucial.

    HPNA Standards of Practice for Palliative Care Nurses

    • Nurses provide age-appropriate, culturally, ethically, and spiritually sensitive care.
    • Safe environments are maintained.
    • Patients and families are educated about appropriate settings and treatment options.
    • Care continuity and safe transitions are ensured.
    • Care is coordinated across settings and among caregivers.
    • Information is managed and confidentiality is protected.
    • Communication is prompt and effective.

    The Natural Course of Serious Illness

    • Palliative care helps guide therapy at the initial diagnosis stage.
    • Hospice becomes an option for care as the disease progresses to an end-stage condition.
    • Hospice care and bereavement services are introduced when aggressive therapies are no longer effective and comfort care increases.

    Prognostication

    • Prognostication is based on laboratory findings and diagnostic test results.
    • A meeting with the patient and family after gathering data is essential.
    • Tools like the Palliative Performance Scale (PPS) and Karnofsky Scale can assess functional decline.

    Hope

    • Hopes for a cure, more time, pain relief, and a good death.

    Triggers for Palliative Care Consult

    • A positive response to the question "Would I be surprised if this patient died within 6 months to a year?"
    • Patients requiring multifaceted care (e.g., ventilator support, feedings).
    • Patients residing in long-term care facilities (nursing homes).
    • The patient's age, cognitive impairment, current or past hospice enrollment, and lack of an advance care plan.

    End of Life Nursing Education Consortium (ELNEC)

    • Core curriculum includes nursing care at the end of life, pain management, symptom management, ethical/legal issues, cultural considerations, communication, loss/grief/bereavement, and the final hours.

    National Consensus Project (NCP)

    • A task force of organizations (AAHPM, CAPC, HPNA, NHPCO) focused on improving palliative care.

    NCP Practice Domains

    • Practice domains include:
      • Structure and Processes of Care,
      • Physical Aspects of Care,
      • Psychological/Psychiatric Aspects of Care,
      • Social Aspects of Care,
      • Spiritual/Religious Aspects of Care,
      • Cultural Aspects of Care,
      • Care of the Patient at the End of Life, and
      • Ethical and Legal Aspects of Care.

    Palliative Care Model

    • The family is the unit of care, and the patient defines the family unit.
    • Nurses act as advocates for patients and families.
    • Culture is considered an important aspect of patient/family care.
    • Palliative care addresses special populations, including the vulnerable, prisoners, and substance abusers.
    • Serious illness impacts all systems of care.
    • Sensitivity to financial issues impacting patients' quality of life are crucial.
    • Palliative care extends beyond cancer and AIDS to all life-threatening illnesses.
    • Interprofessional care is essential for high-quality palliative care.

    Unrelieved Pain

    • Unrelieved pain exacerbates distress, hinders coping, increases vulnerability, and interferes with daily activities (eating, sleeping, thinking, interacting).
    • It is correlated with fatigue in cancer patients.

    Critical Thinking Question

    • An appropriate question for a palliative care nurse to ask a patient regarding pain is: "Is your pain interfering with your ability to sleep?"

    Benefits of Palliative Care

    • Relief of suffering, optimization of function, promotion of comfort, fostering of hope, genuine care coordination, and preparation for hospice.

    Suffering

    • Suffering is a state of severe distress associated with events threatening a person's well-being and is a central focus of palliative care.

    Strategies for Family Caregivers

    • Strategies include setting realistic goals, having difficult discussions, finding help, and negotiating expectations.

    Barriers and Challenges

    • Barriers and challenges include lack of understanding by healthcare professionals and consumers, limited numbers of trained professionals, and communication difficulties regarding palliative care services and payment.

    Areas of Expertise for Hospice and Palliative Care Nurses

    • Areas of expertise include clinical judgment, advocacy and ethics, professionalism, collaboration, systems thinking, cultural competence, facilitation of learning, and communication.

    Certification

    • Generalist level certifications include Certified Hospice and Palliative Nurse (CHPN), and Palliative Nurse Administrator (CHPA).
    • Advanced level certifications include Advanced Certified Hospice and Palliative Nurse (ACHPN).
    • Certifications are available through Institutional (e.g., TJC); or Voluntary certification.
    • Voluntary certification is aimed at high-quality palliative care.

    Quality Assessment and Improvement

    • Efforts are focused on multiple areas of quality improvement, including patient-centered pain management within 48 hours of admission, avoidance of unwanted hospitalizations/CPR, and patient safety.
    • NHPCO leads quality initiatives.
    • CAPC plays a role in quality assessment and improvement initiatives.

    Concerns

    • Ethical concerns include advance planning, double effect, palliative sedation, and medically futile care.
    • Legal concerns include the right to refuse treatment and landmark cases (e.g., Karen Ann Quinlan, Nancy Cruzan).

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    Related Documents

    Chapter 12 Palliative Care PDF

    Description

    Explore the core concepts of palliative care, including its distinction from hospice care and the importance of symptom management. Understand the role of nurses in providing holistic, culturally sensitive care to patients and families facing serious illnesses. This quiz covers standards of practice essential for palliative care professionals.

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