Palliative and End of Life Care

These flashcards cover key concepts regarding palliative and end-of-life care, including distinction between palliative and hospice care, manifestations at end of life, grief processes, nursing management, cultural and ethical considerations.

What is the main goal of palliative care?

Reduce suffering while maintaining quality of life.

What is the difference between palliative care and hospice care?

Palliative care can be provided while receiving curative treatment, hospice care is for patients with 6 months or less to live.

What are the 8 domains of palliative care?

Structure and Process, Physical, Psychologic and Psychiatric, Social, Spiritual, Cultural Care, Care of the patient nearing end of life, Ethical and Legal.

What focus does hospice care emphasize?

Symptom management, advance care planning, spiritual care, and family support.

What are common physical manifestations at the end of life?

Increased respiratory rate, tachypnea, irregular respiratory patterns, mottling of skin, and decreased urine output.

What is Cheyne-Stokes respiration?

A pattern of breathing characterized by cyclic changes in depth of breathing followed by periods of apnea.

What psychological manifestations may occur at the end of life?

Increased confusion, hallucinations, impaired cognition, and emotional changes like anger and depression.

What is the term for the period of mourning after the death of a loved one?

Bereavement.

What are the phases of grief?

Shock, Denial, Anger, Bargaining, Depression, Acceptance.

How should a nurse manage urinary incontinence in a dying patient?

Use absorbent pads, barrier cream, and follow catheter management protocols.

What is anticipatory grief?

Grief experienced prior to an impending loss, such as terminal illness.

What recommendations are there for managing pain at end of life?

Assess pain regularly, administer medications around the clock, and do not delay pain relief measures.

What does cultural care involve in palliative settings?

Understanding values and traditions related to health, illness, caregiving, and decision making.

How can caregivers support a patient in palliative care?

By providing emotional, physical, and logistical support as required.

What types of comfort measures can be employed in end-of-life care?

Small frequent meals, oral hygiene, and proper pain management.

What is the focus of ethical and legal considerations in palliative care?

Honoring patient's preferences and advanced care planning.

What kind of support can families expect during hospice care?

Emotional and spiritual support to help navigate the dying process.

What is the purpose of advance directives?

To outline a patient's choices regarding medical treatments and interventions.

Why is hydration important in end-of-life care?

To manage discomfort and maintain dignity while recognizing that hydration needs may change.

What are common psychological coping strategies at end of life?

Meaning-making, emotional expression, and preparing for death.

Why might a patient's vital signs change towards end of life?

Due to decreased organ function and the body’s slowing processes.

What does the term 'death rattle' refer to?

Noisy breathing caused by the accumulation of secretions in the throat.

What is the role of palliative treatment such as paracentesis in end-of-life care?

To alleviate symptoms and improve patient comfort.

How does spirituality play a role in palliative care?

Addressing beliefs and practices that impact care and comfort for patients.

What is myoclonus as it relates to end-of-life care?

The sudden, involuntary muscle jerks that may occur due to high opioid doses.

What should be monitored when providing care for terminal secretions?

Assess respiratory status and educate on breathing techniques.

How can caregivers assist with physical symptoms like anorexia?

By providing small, frequent meals and avoiding force feeding.

What is the significance of pain management in palliative care?

To enhance the quality of life and minimize suffering.

What are legal documents like 'POLST' used for?

To guide healthcare providers on a patient's preferences for treatment in emergency situations.

How can social factors impact quality of life at end of life?

Access to medications, transportation issues, and financial constraints.

What is a common respiratory manifestation as death approaches?

Irregular respiratory patterns and Cheyne-Stokes respirations.

What are some signs of impending death?

Changes in vital signs, decreased consciousness, and mottling of the skin.

What emotional responses might family members experience during bereavement?

Anger, guilt, sadness, anxiety, and depression.

What influence does culture have on end-of-life care?

Cultural beliefs shape perceptions of death, caregiving roles, and decision making.

What is the importance of caregiver support in hospice care?

To relieve caregiver stress and enhance the quality of care provided to the patient.

What practical steps can be taken to manage weakness and fatigue in dying patients?

Provide regular rest periods and create a calm environment.

How can delirium be addressed in dying patients?

Reorienting the patient and administering prescribed medications.

How does the loss of sphincter control manifest at the end of life?

Incontinence may occur as body functions decline.

What role does family communication play in palliative care?

It helps in understanding the patient’s wishes and providing collective support.

What is the relevance of ethical considerations for organ donation?

To ensure that patients' preferences are respected and followed in life-saving situations.

Why is managing social environment crucial in end-of-life care?

Social support impacts patients' emotional well-being and overall quality of life.

What are common gastrointestinal manifestations at end of life?

Hypoactive bowel sounds, constipation, and loss of appetite.