Pathology and Impending death
A nurse caring for a dying client notes increased sleeping, decreased appetite, and cognitive changes. Which stage of death is the client most likely experiencing?
Early stage of death
What is the primary goal of palliative care?
Improve quality of life through symptom control while continuing curative treatment.
Which advance directive names a person to make healthcare decisions when a client cannot?
Durable Power of Attorney for Health Care.
What does DNR stand for?
Do Not Resuscitate.
A nurse is caring for a client receiving end-of-life care who is unable to verbalize discomfort. Which assessment finding should the nurse recognize as a possible sign of distress?
A. Restlessness
B. Stable vital signs
C. Increased appetite
D. Deep sleep without movement
A. Restlessness
The nurse observes pooling of secretions and noisy respirations often referred to as the "death rattle." Which stage of death is this?
Middle stage of death
A client with advanced cancer continues chemotherapy while receiving pain management and symptom relief. Which service is the client receiving?
Palliative care
A nurse ensures all clients receive equal access to end-of-life care regardless of socioeconomic status. Which ethical principle is being upheld?
Justice.
A client has a DNI order. Which intervention should NOT be performed?
Intubation
When assessing spirituality using the HOPE tool, what does the "H" represent?
Hope
Which assessment finding is most indicative of impending death?
A. Increased urine output
B. Cheyne-Stokes respirations
C. Increased appetite
D. Warm pink skin
Cheyne-Stokes respirations
A client is expected to live 6 months or less and chooses comfort-focused care only. Which type of care is appropriate?
Hospice care.
A nurse explains treatment risks, benefits, and limitations so a client can make informed decisions. Which ethical principle is demonstrated?
Fidelity
True or False: A DNR order means the client should receive no treatment.
False. A DNR only limits resuscitation efforts and does not stop other treatments or standards of care.
A dying client refuses food. What is the nurse's best response?
A. Force small amounts of food.
B. Insert a feeding tube immediately.
C. Respect the refusal because anorexia is a natural part of dying.
D. Tell the family the client is giving up.
C. Respect the refusal because anorexia is a natural part of dying.
A client exhibits mottling of the skin, periods of apnea, and dyspnea. What stage of death is occurring?
Late stage of death
What is respite care?
Temporary admission to a facility or support service that gives caregivers a break from providing care.
What is the primary purpose of terminal sedation?
To relieve intolerable suffering when death is inevitable, not to cause death.
A nurse is preparing a client with a DNR order for surgery requiring temporary intubation. What action is appropriate?
Temporarily modify the code status for the procedure and restore it afterward.
Which nursing intervention helps prevent skin breakdown in dying clients?
Turn and reposition regularly, provide incontinent care, apply lotion, and use pressure-relieving mattresses.
What is the difference between brain death and clinical death?
Brain death occurs when heart and lung function have permanently stopped. Clinical death occurs when heart and lung function have ceased but may be reversed with CPR.
Which statement by a nursing student indicates understanding of hospice care?
A. "Curative treatments continue."
B. "The focus is comfort and quality of life."
C. "Only pain is treated."
D. "Care can only occur in a hospital."
B. "The focus is comfort and quality of life."
A client becomes incapacitated and cannot communicate treatment wishes. Which document provides directions regarding CPR, ventilators, and artificial nutrition?
Living Will.
According to end-of-life standards, when may treatment be ethically withdrawn?
When it aligns with the client's wishes, the burdens outweigh the benefits, or it does not support the client's goals of care.
A client requests a religious leader from a faith not commonly represented at the facility. What is the nurse's priority action?
Collaborate with the healthcare team and family to provide access to a religious leader of the client's faith.