Euthanasia 227

A paradigm is

distinct set of concepts or thought patterns that guides decisions and actions

The dominant medical paradigm is ___, ___, ___, ___

diagnose, treat, heal, prevent

When doing euthanasia causes a medical paradigm ___

shift

An end-of-life paradigm is ___, ___, ___, and ___of ___

comfort, support, understanding, focus of care

When doing euthanasia, understand and accept that it isn’t ___ or ___ ___

failure, giving up

Education during end-of-life discussion: ask ___-___ questions, listen ___ to clients, and respond ___. Also ask advanced directives like what is wanted after the euthanasia like ___ or ___ ___

open-ended, generous, empathetically, after-care, memorial

When discussing euthanasia talk about: ___ assessment, the “ line in the sand” or ___, ___ ___, and the ___ itself

QOL, limits, owner’s prescence, procedure

If a natural death is preferred: they will need ___ ___, and the goals are ___ ___, ___ and ___

hospice support, pain control, hygiene, comfort

Some ___ ___ vary with the legalilty if a veterinary nurse is allowed to administer euthanasia and if they can under what circumstances

state guidelines

When preparing for death: the patient should be ___ with bedding or blankets, ___ confirms if they wish to be present or not, and how close they wish to be, and the ___ of the procedure

comfortable, client, location

When placing a catheter the client may be ___ which is why catherters shouldn’t be placed by someone who is ___, and they should be well prepared and always have ___ within reach

present, inexperienced, equipment

Aftercare includes if the owner wants “___ ___“, ___, ___ or ___

alone time, preparation, burial, cremation

Preparation can include: ___/___ prints, ___ ___, removing the ___, ___ blood or waste

paw/hoof, hair clipping, catheter, cleaning

Always ___ for patients, client’s directives/wishes, and self standard of care

advocate

QOL is based is ___, and ___

assessments, suffering

The assessment of QOL is can be ___ or based on the ___ ___ which is the best source

scored, client’s input

A patient’s QOL is ___. It looks to sees if living has negative effects on ___ ___ of the patient, and if they ___ ___ currently

individualized, essential functions, pleasant experiences

A “convenience” euthanasia is when their isn’t ___ ___ or ___ ___

terminal disease, intractable suffering

“concenience” euthanasia can be due to ___ of ___ like unwilling or unable

lack of care

When a client wants a “convinience” euthanasia offer ___, like ___ or ___ ___

options, rehoming, rescue organization

In some cases ___ become conflicted and “convinience” euthanasias can be refused

ethics

In some cases, shelter euthanasias take place due to ___ control, and public ___ due to aggressive or diseased dogs

population, protection

Occassionally animals are used for ___ and to prevent suffering they are euthanized

research

A welfare euthanasia happens with ___ animals

neglected

Maintaining standard by having ___ ___ can help avoid burnout

proper techniques

The 6th freedom is:

freedom to die a good death

euthanasia is the ___ ___ of life

humane termination

Euthanasia is done with the belief that death is ___ to the present condition, and all ___did their best

preferable, caregivers

The prefix eu- means ___ and thanatos refers to ___

good, death

AVMA accetable euthanasia methods

benzocaine

carbon dioxide

carbon monoxide

Inhalant anesthetics

microwave irradiation

penetrating captive bolt

2-phenoxyethanol

potassium chloride

tricane methane sulfonate

AVMA conditionally acceptable euthanasia methods

cervical dislocation

chloral hydrate

decapitation

nitrogen, argon

pithing

electrocution

gunshot

thoracic compression

Common methods for euthanasia: __-___ ___

non-inhalant pharmaceuticals

A barbiturate overdose causes the ___ ___ to ___ which is life sustaining

brainstem neurons, depress

A barbituate overdose can be done ___ ___ or ___ ___

one step, two step

One step euthanasia is when there is a ___ ___

sole agent

two step euthanasia is when there is a ___ that is used

combination

for a barbiturate overdose _-__ is used, and has a classification of ___ or ___

Na-pentobarbital, CII, CIII

Other methods of non-inhalant pharmaceuticals: ___ ___, ___ ___, ___ all are done during ___

potassium chloride, magnesium chloride, lidocaine, anesthesia

When potassium chloride is used for euthanasia it is administered ___ or ___

IV, IC

When magnesium chloride is used for euthanasia it is administered ___ or ___

IV, IC

When using lidocaine for euthanasia it is administered ___

intrathecal

When doing a small animal one step with Na-pentobarbital, if they’re awake give it ___ or ___ but the latter isn’t lethal generally

IV, orally

Na-pentobarbital has a high pH so doing it ___ is ___/___

extravascularly, painful/irritating

Using an IV catheter with Na-pentobarbital avoids ___

extravasation

Advantages to one-step Na-pentobarbital in SA is there is only ___ ___, and process is ___

one agent, efficient

Disadvantages to one step na-pentobarbital in SA is that it may or may not increase ___ ___

involuntary effects

SA two step euthanasia utilizes a combination of drugs usually a _-___ or ___ first than the euthanasia drug

pre-anesthesia, sedation

agents that can be used in a two step euthanasia:

• alpha2 agonist

• opiods

• acepromazine

• ketamine

• benzodiazepine

• inhalants

routes to administer pre-sedation/anesthesia during two step anesthesia: ___, ___ which includes ___, ___, ___, and ___ but the last three require an increased dose

IV, intraorgan, cardiac, hepatic, renal, intraperitoneal

Advantages to two step euthanasia is: ___ ___ and decreased ___ ___ like ___ or ___ ___

greater control, involuntary effects, excitement, agonal breaths

disadvantages to two step euthanasia is it may slow the action of ___ due to decreased ___

euthanasia, CO

With two step the anesthesia allows the animal to “___ ___”

die sleeping

When euthanizing large animals, the primary concern is ___ which is why ___ is important, and positioning to ___ can happen quickly

safety, location, recumbency

For two steps in LA pre-sedations that can be used includes:

alpha 2 agonists, opioids, acepromazine

For two steps in LA anesthesia agents can be used for a smooth ___ some agents that can be used includes: ___, and ___

smooth, ketamine, benzodiazepines

For large animals the euthanasia agent commonly used in _-___ via ___ through the ___ ___ in a ___ ___

na-pentobarbital, IV, jugular vein, rapid bolus

Verification of death can be done via ___ ___, ___ ___ or ___ ___

cardiac ausculation, pupillary response, corneal reflex

Death can be verified via cardiac auscultation due to ___ being the final stage

arrest

Pupillary response can used to verify death, when the pupil doesn’t ___

constrict

Corneal reflex can verify death when ___ ___ is applied without the patient ___

corneal pressure, blinking

Dysthanasia is ___ while dying

suffering

dysthanasia is typically ___, and can be due to ___ ___, or an ___ ___

unexpected, equipment malfunction, adverse reaction

an adverse reactions for dysthanasia includes: ___, signs of ___/___, ___ ___, ___

vocalizing, distress/pain, agonal respiration, opisthotonus

If dysthanasia can occur the client can ___ it

perceive

Dysthanasia can the reason for client ___/___

loss/anger

After dysthanasia cover the three C’s: ___, ___ and ___

compassion, control, confidence

after dysthanasia control both the ___ and ___

animal, situation

Also have the confidence in ___ ___ and have reliable ___/___

personal abilities, equipment/drugs

Reasons for preferring a natural death: ___, ___, ___/___

ethics, philosophical, religious/spiritural

Consequences of wanting a natural death is requiring ___ ___, of the patient, client, and it it labor intense

hospice support

patients on hospice support requires ___/___, ___ management, and ___ ___

nutrition/ hydration, pain, general nursing

For the client hospice support is ___, and has little ___

emotional, respite

clinical signs of pets 1-3 months before death: ___ ___ like withdrawl or attention seeking, decreased ___ which could cause weight loss or sarcopenia, ___, and ___ ___ to ease discomfort

behavioral changes, appetite, dehydration, endorphins released

Clinical signs 1-2 weeks before death includes: ___/___, severely decreased ___, decreased ___, and decreased ___

disorientation/confusion, appetite, temperature, BP

Clinical signs of days to hours before death includes: ___, ___ ___, ___, ___ ___, and ___ ___/___

resurgence, irregular respirations, incontinence, cool extremities, HR slows/irregular

clinical signs of minutes before death includes: ___ ___, ___ ___, and ___ ___

agonal breaths, limbs extended, neck arches

Clinical signs of death is ___ ___, ___ ___, and ___ ___

respiratory arrest, cardiac arrest, brain death

Options for aftercare is based on the ___ ___ which is what the owner requests

advanced directive

Burial is the most common however, it has ___ concerns due to ___ ___ and ___, and it requires at least ___ of earth on top

legal, euthanasia drugs, scavengers, 4’

Options for advanced directives includes: ___, ___, ___-___

burial, cremation, water-based

Cremation is ___ based, has an ___ ___, and results in ___ ___

flame, environmental impact, cremated remains

water-based disposal also called ___ utilizes ___ ___,

aquamation, alkaline hydrolysis

fluids used for aquamation includes: __-___, and _-___

Na-hydroxide, K-hydroxide

With aquamation the ___ remains which can be ___

bones, pulverized

There are many options for memorialization including a ___ ___/___ ___, ___, or ___

pet funeral/ memorial services, keepsakes, ashes

loss leads to ___, which is ___ to each person

grief, individualized

The expression of grief is ___

mourning

There is no ___ for grief, and it leads to the new reality of “___ to ___ ___”

timeline, learn to live with

There are two models of grief: _ __, and ___ ___

5 stages, dual response

The 5 stage grief response is: ___, ___, ___, ___, ___

denial, bargaining, anger, depression, acceptance

dual response states that grief is ___, and has both ___ and ___ response

nonlinear, cognitive, emotional

The cognitive portion of dual response includes: ___/___, ___ and ___, ___

disbelief/denial, disorganization and depenence, rationalization

The emotional portion of dual response includes: ___/___, ___, ___/___ and ___/___

anger/resentment, guilt, sadness/loneliness, relief/recovery

dealing with death is an ___ ___ which takes a load both ___ and ___, but steps can be taken to ___/___

occupational hazards, mental, emotional, prevent/combat

Compassion fatigue is when the ability for ___ decreases

empathy

exhausion from prolonged exposure of death can result in ___

burnout

Preventing or combating compassion fatigue, and burnout can be through: ___ ___, ___, and don’t ___ ___-___

coworker communication, breaks, sacrifice well-being