Interventions
The patient is experiencing pain 30 minutes after their last medication ingestion. What is the intervention?
Contact clinical staff immediately for every pain intervention.
A caregiver exhibits stress and strong emotions after her brother has been enrolled in hospice care for three months. This intervention may be a short term solution for the burnout she is experiencing.
What is respite / respite care?
Symptoms like dry skin, chapped lips, and bad breath are indications of what?
Dehydration.
This symptom differs from dementia and hallucination in that it is related specific to physiological effects of the disease process.
What is delirium?
The patient refuses food for the first time since being under hospice care. What is the intervention? [Hint: There can be more than one correct answer.]
- Confirm onset of new symptom from patient or caregivers.
- Assess other symptoms for indications of a change in status.
- Encourage caregivers to watch and wait for any further changes to appetite.
Your patient has been asking his family to play old home movies for the past few days. You have seen some of the home movies several times, but your patient wants you to join in again and listen to the same stories you have heard before. What process is your patient undergoing?
What are the observable side effects of opioids tx for most patients? [List as many as you can.]
Constipation
Coordination / Motor function impairment
Fatigue
Hallucination
Decrease in respirations
Nausea
The opposite of a full code, or, a legal document most states require that hospice patients have in place.
A DNR, Do Not Resuscitate Order, or an advanced directive.
The patient has been nonverbal for more than 12 hours, but is still able to communicate through gestures. They indicate trouble swallowing. What is the intervention? [Hint: There may be more than one right answer.]
- Encourage small amounts of fluids, ice chips, and moisture around the mouth.
- Reposition patient to best enhance comfort and drainage of any congestion.
- Reassure patient that no one will allow them to choke; advise caregivers to closely monitor for choking or gagging indicators.
Your patient has been declining for weeks, but on your latest visit has been full of energy, eating again, and asking to see visitors. What is your assessment? [Hint: There may be more than one right answer.]
- Ask the patient and caregiver(s) about any medication changes.
- Encourage the patient and caregiver(s) to enjoy all of the good days they have together.
Nervous disposition, hallucinations, extreme mood swings, picking at the air, their skin, or the sheets, are all expressions of what?
Terminal agitation.
The physical and emotional state of being of the patient to which a care team works to maintain.
Comfort.
A patient begins talking to someone who isn't there. What is the intervention?
No intervention necessary. Or, ask the patient about the person they are speaking to. Assess emotional and physical comfort. Report any changes in status to care team.
Your patient is alert but has been declining, with increased fatigue and lower intake of foods. Your patient's youngest child and older brother have been arguing about the care plan in front of your patient. You have already asked them to step outside and tried other ways to de-escalate the tension. What is your next step? [Hint: There may be more than one answer.]
- Assess whether the patient is actually distressed. They may be used to their family members communicating this way, and there's nothing to be 'fixed.'
- Ask the care team for support and suggestions in addressing the caregiver dynamic.
May refer to a disinterest in people, food, or things one previously enjoyed, as part of the dying process.
What is ambivalence?
An infection or illness that would not be terminal under normal circumstances, but can more easily develop in dying patients.
Opportunistic.