End-of-Life Basics
This type of care focuses on comfort, dignity, and quality of life during the final stage of a serious terminal illness.
What is end-of-life care?
As death approaches, this happens to blood pressure and cardiac output.
What is decreased blood pressure and cardiac output?
The nurse should assess this symptom regularly because it is one of the most important indicators of patient comfort.
What is pain?
This opioid medication can be used to manage both pain and dyspnea at the end of life.
What is morphine?
Name two healthcare professionals who may be part of an interdisciplinary hospice team.
What are a nurse and healthcare provider?
This type of care focuses on serious illness and can occur at any stage, even while disease-directed treatment continues.
What is palliative care?
As renal perfusion decreases, urine output progresses from oliguria toward this condition.
What is anuria?
Name three things the nurse should assess when evaluating respiratory status in a dying patient.
What are respiratory rate/pattern, dyspnea, and secretions?
This medication is a benzodiazepine that may be used to manage anxiety and agitation in end-of-life care.
What is lorazepam?
Name two settings where hospice care can occur.
What are the patient's home and an inpatient hospice setting?
This type of care focuses primarily on comfort when a patient is nearing the end of life.
What is hospice care?
During the months before death, the patient may experience increasing weakness and fatigue. Name two other common changes that may occur.
What are decreased appetite and increased social withdrawal/isolation?
or
What are decreased interest in usual activities?
A dying patient becomes confused and restless. The nurse should assess for changes in this assessment area.
What is neurological status/LOC?
A dying patient develops increased respiratory secretions. Name two nonpharmacologic nursing interventions that can help promote comfort.
What are repositioning and oral care?
This type of support may be provided to family members after the patient's death.
What are bereavement services?
or Grief counseling
or Support groups
or Hospice bereavement follow-up
True or False: Hospice and palliative care are exactly the same thing.
What is False?
Hospice is a form of palliative care, but palliative care can begin much earlier in serious illness.
A patient is minimally responsive, has irregular respirations with periods of apnea, a weak/irregular pulse, and very little urine output. The patient is also having difficulty clearing secretions.
What stage of the dying process does this presentation most closely represent?
What are the hours before death?
What are skin integrity, oral mucosa, elimination, and nutrition/hydration?
What are psychosocial, emotional, spiritual, and family/support needs?
A dying patient is experiencing discomfort and has become increasingly restless. What should the nurse do first before administering additional medication?
What is assess the patient for the cause of discomfort, including pain, positioning, respiratory distress, elimination needs, and other physical or emotional needs?
A hospice patient is experiencing increased anxiety and discomfort. Which environmental intervention should the nurse prioritize to promote comfort?
What is creating a calm, quiet environment while reducing unnecessary noise, interruptions, and stimulation?
Name four areas of need addressed by end-of-life care.
What are physical, emotional/psychological, social, and spiritual needs?
Name three respiratory changes that may occur during the dying process.
What are irregular breathing, apnea, and accumulation of respiratory secretions?
Name four physical needs the nurse should assess in a patient receiving end-of-life care.
What are skin integrity, oral mucosa, elimination, and nutrition/hydration?
A dying patient is no longer able to verbally report pain. What should the nurse do to assess the patient's pain?
What is use a validated behavioral/nonverbal pain assessment tool and observe for signs such as grimacing, moaning, guarding, restlessness, or changes in behavior?
A hospice patient is nearing death and the family wants to remain at the bedside. What should the nurse do to promote a supportive environment while maintaining patient-centered care?
What is provide privacy, allow family presence according to the patient's wishes, reduce unnecessary disturbances, and respect the patient's cultural and spiritual practices?