Hospice Care Quiz PDF

HOSPICE ❖ Hospice Care: Qualifications Life expectancy is ≤ 6 months Support provided Compassion, interests, and genuine concern This promotes quality of life as the end approaches Hospice team...

HOSPICE ❖ Hospice Care: Qualifications Life expectancy is ≤ 6 months Support provided Compassion, interests, and genuine concern This promotes quality of life as the end approaches Hospice team Nurses, social workers, priests, dietitians, therapists, and wound specialists Pain medication Morphine (pain) Valium (anxiety) Grief counselling Keep in touch with family of the patient up to a year after death (do not speak to family without patient present, if alive) ❖ Palliative care, purpose, what assistance is given an approach that improves the quality of life of patients and their families facing the problems associated with life- threatening illness ❖ Emotional support for patient and for family Lessens the feeling of loneliness and isolation and help the client/family express and understand their feelings ❖ Nutritional needs, how are they met Reduced intake results in less lung secretions, coughing, edema, ascites, nausea, vomiting, and less urine output ❖ Narcotics, when are they used, complications/concerns  Morphine (pain) Haloperidol (treats severe agitation in end-stage dementia) Lorazepam (anxiety) Hydrocodone (pain) ❖ Cachexia Muscles/fat loss caused by malnutrition/anorexia ❖ Anorexia Lack of appetite ❖ Signs and symptoms of active the dying process Labored breathing and lowered BP and HR ❖ Psychological needs Emotional support Spiritual care Family support Compassion Communication ❖ Physiological needs Pain management Breathing issues Nutritional needs Temp regulation Skin integrity ❖ What is air hunger and how is it treated Low SPO2 levels and shortness of breath Treated with O2 therapy and meds such as inhalers and bronchodilators  ❖ Pain medications, when do you give them, what to do if the patient wants it earlier than ordered Most pain meds are PRN, speak with charge nurse or physician before administering, may result in overdose, in palliative care: comfort > safety ❖ Review stages of grief and resolution Denial: Acts as though nothing happened Anger: Resists loss and may strike out Bargaining: Postpones awareness of reality Depression: Withdrawals from interactions Acceptance: Accepts the loss ❖ What is passive euthanasia With holding meds Stopping ventilators Stopping tube feeding Different from active euthanasia: Administering drugs to speed up death CARDIAC ❖ What are the layers of the heart, what are their roles, what are the valves Endocardium: Thin connective tissue that is perfectly smooth to prevent blood cells from sticking to the wall of the heart Myocardium: Muscles of the heart Epicardium: Thin connective tissue that surrounds the heart Fibrous tissue: Thickest layer, covers the epicardium Pericardium: Both epicardium and fibrous tissue  Tricuspid valve: RT atrioventricular valve Bicuspid valve: LT atrioventricular valve Pulmonary valve: Valve that leads to the lungs Aortic valve: Valve that leads to the aorta ❖ CAD diagnostic tests: Tests for Coronary Artery Disease by using cardiac catheterization and angiography ❖ What is the PTCA test: Percutaneous Transluminal Coronary angioplasty, A device that is inserted into the coronary artery to widen an artery blocked with plaque ❖ What is a cardiac fluoroscopy, what are its advantages for diagnostic purposes: A type of x-ray that shows the heart and blood vessels in real time ❖ What is a stress test: A test that measure the activity of the heart when put through strenuous activity ❖ What is a stress echocardiogram: Non-invasive ultrasound of the heart used to diagnosis and monitor the heart ❖ What lab tests indicate a MI: Troponin test and EKG ❖ What is the troponin level, what is normal level and what is elevated: Protein in the heart and skeletal muscles that indicate heart damage when released into the bloodstream Normal levels: 0 - 0.04 ng/mL ❖ Cardiac monitoring of patient, what do you do when the alarm goes off, what do you check: Assess vital signs such as HR, RR, BP, and SPO2 ❖ Pacemaker placement, what is post-op care Placement is checked with an x-ray Keep site clean and dry, no strenuous activity, no heavy lifting, monitor for infection or drainage ❖ CAD modifiable risk: Smoking, hypertension, diabetes, high cholesterol, obesity, sedentary lifestyle, poor nutrition, hyperlipidemia, stress, psychological ❖ CAD nonmodifiable risks Family history, gender, age, ethnicity ❖ What is CHF, what are the s/s of right sided vs left sided: Congestive heart failure is a buildup of fluid in the feet, arms, lungs, and other organs RT side: Sudden weight gain, palpitations, chest discomfort, fluid retention, ascites, poor appetite, nausea and vomiting LT side: SOB, coughing, weakness in legs, Increased HR, fatigue, exercise intolerance, kidney problems ❖ What is angina, what are the s/s Pressure, tightness, squeezing, burning, cramping, dull or sharp pain, discomfort of the shoulders, jaw, neck, back, and stomach ❖ What is a MI, what are the s/s:  Myocardial Infarction is a heart attack, occurs when one of the arteries that supplies the heart muscles become blocked Angina, muscle pain and weakness, SOB, sweating, nausea, vomiting, lightheadedness, rapid or increased HR, and anxiety ❖ Cardiac catheterization, pre and post procedure care: A catheter that is inserted into a blood vessel to diagnosis several types of cardiac diseases ❖ Risks of cardiac catheter, nursing role in assessment and interventions: Bleeding, bruising, blood clots and rhythms issues ❖ What is coumadin: Another name for Warfarin, an anticoagulant to prevent blood clots ❖ What INR is the goal for a patient on Coumadin: 2-3 ❖ Blood tests-what are normal cholesterol, HDL, and LDL levels: HDL: 40-50 mg/dL LDL: 100 mg/dL ❖ Cardiac medication: Nitroglycerin oral/spray/sublingual, Nitro patch: Treats episodes of angina Beta-blockers Treats heart and circulatory system conditions Hypertension types: - Essential: No cause - Secondary: disorders (diabetes/cushings…) - Malignant: med reaction (psychiatric) NOTES ❖ Angina feels like chest pain and pressure, squeezing sensation in chest, indigestion, pain spreads to neck, jaw, arms, back, or belly ❖ Assessments: Pain Dyspnea Pallor Sweating Palpitations and tachycardia Dizziness HTN Digestive issues ❖ Immediate management: (in order) 1. Assess for pain 2. Administer Nitroglycerin (vasodilator)(0.4 mg)(give 3x, if still not effective, call 911) and prescribed and aspirin (blood thinner) 3. O2 at 3 L/Min as prescribed 4. Semi-fowlers 5. Monitor vitals 6. 12-lead EKG 7. Cardiac monitoring 8. Labs (troponin etc.) 9. Stay with client ❖ Types of angina: Stable: Not that bad, can take nitroglycerin Has an onset Steady and improves Variant: Can vary At random Artery spasm “Pre-MI” Unstable: Occurs suddenly and gets worse Lasts no more than 20 mins Intractable: Can become MI Constant ❖ After acute episode: Identify what happened Stop activity and rest Nitroglycerin Seek medical attention if pain persists ❖ Isometric activity: Activity that raises BP ❖ Percutaneous Coronary Interventions: A balloon catheter