Chapter 7 End of Life Care Evolve** – Flashcards

A client admitted with a non-life-threatening illness says, "I was asked to fill out an advance directive when I was admitted, but I was too stressed. What was it all about?" How does the nurse respond? "Advance directives are only for those individuals who are severely ill." "Advance directives allow a client to convey his or her wishes about health care ahead of time." "Most Americans have an advance directive in place; you will need to see a lawyer." "You should have completed the paperwork before you were admitted."

A dying client is having difficulty swallowing oral medications. Which intervention does the nurse implement for this client? Asks the pharmacy to substitute intramuscular (IM) equivalents for the medications Asks the provider if the medications can be discontinued or substituted Crushes the pills, opens the sustained-release capsules, and mixes them with a spoonful of applesauce Does not give the medications and documents: "Unable to swallow"

The family of an unconscious dying client realizes that their mother will die soon. The client's children are having a difficult time letting go. How does the nurse respond to the needs of this family? "Don't be upset; she wouldn't want it that way." "She will soon be in a better place." "Things will be fine, try not to worry so much." "This must be difficult for you."

A dying client says to the nurse, "I am afraid to die. I did a lot of wrong things in my life." How does the nurse respond? "Don't worry, God will forgive you." "I'm sure it is nothing to worry about." "Tell me more about that." "Why? What did you do wrong?"

A hospitalized client of the Islamic (Muslim) religion is dying. What concept does the nurse share with the health care team about this client's beliefs about death? Death is seen as the transition to the other side, with Islam as the vehicle. Life experiences do not affect the individual's preparation for "everlasting life." The timing of death is under the power of the person who is facing death. Plans for burial will take days, maybe even weeks, after the death.

A dying client becomes increasingly withdrawn and begins to refuse to eat and drink. What intervention does the nurse implement? Brings in the client's favorite Chinese takeout food Calls the family to come in right away Gives intravenous hydration Offers ice chips

The daughter of a dying client says, "I don't want my father to be uncomfortable." How does the nurse respond? "Do you want to talk to the bereavement nurse?" "Your father will be closely monitored and cared for." "Your father will be kept sedated." "We will send him to hospice when the time comes."

A dying client exhibits signs of agitation. The Foley catheter has drained 100 mL in the last 3 hours, and the client's last bowel movement was yesterday evening. What does the nurse do first? Administers an analgesic Arranges for a consultation with a bereavement counselor Assesses the client for impaction Changes the Foley catheter to ensure adequate drainage

Which condition, when assessed in a dying client, requires that the nurse take action? Alternating apnea and rapid breathing Anorexia Cool extremities Moaning

A client dying of cancer is receiving high doses of opioids. In addition, which intervention is the most effective for this client? Classical music Deep muscle massage More pain medication Short, light massage

A nurse who is skilled in complementary and alternative medicine (CAM) therapies works on a cancer unit with clients who are terminally ill. For which client symptom does the nurse use these therapies? Constipation Cool extremities Increased pain Memory loss

The nurse is coordinating interdisciplinary palliative care interventions for the dying client. Which goal is the nurse seeking to meet? Avoiding symptoms of client distress Ensuring an expedited death Meeting all of the client's needs Facilitating a peaceful death for the client

A client has died after a long hospital stay. The family was present at the time of the client's death. Which postmortem action does the nurse implement? Asks the family if they wish to help wash the client Asks the family to leave Raises the head of the bed and opens the client's eyes Removes dentures and any prosthetics

A client diagnosed with lung cancer 6 months ago is now ventilator-dependent and unresponsive. The family wants to remove the ventilator and stop antibiotics and IV fluids. What does the nurse do next? Facilitates a meeting with the family and health care team Removes the interventions, per the family's wishes Tells the family that removing the interventions is illegal Waits to obtain information on the client's wishes

The nurse recognizes signs and symptoms of depression in an 80-year-old client who is dying from metastatic breast cancer. What does the nurse do initially for this client? Assesses these behaviors as normal steps or stages in the grief process for the client Collaborates with the end-of-life (EOL) care team to manage these feelings in the client Documents these findings and continues to monitor the client Reduces the quantity of depression-causing opioids that are being administered to the client

The nurse is performing a spiritual assessment on a dying client. Which question provides the most accurate data on this aspect of the client's life? "Do you believe in God?" "Tell me about the history of religion in your life." "What gives you purpose and meaning in your life?" "Where have you been attending church for the past several years?"

In a comatose dying client's hospital room, the nurse overhears family discussing the memorial service. What action does the nurse take? Asks the family to speak in low tones or whispers so as not to disturb the client Offers to call and have a hospital chaplain come and discuss plans with them Shares some personal insights and experiences on planning a meaningful memorial service Suggests that the family leave the room to carry on their discussion

A client with terminal lung cancer is receiving hospice care at home. Which nursing action does the RN manager ask the LPN/LVN to do? Administer prescribed medications to relieve the client's pain, shortness of breath, and nausea. Clarify family members' feelings about the meaning of client behaviors and symptoms. Develop a plan for care after assessing the needs and feelings of both the client and the family. Teach the family to recognize signs of client discomfort such as restlessness or grimacing.

A client with terminal pancreatic cancer is near death and reports increasing shortness of breath with associated anxiety. Which hospice protocol order does the nurse implement first? Albuterol (Proventil) 0.5% solution per nebulizer Morphine sulfate (Roxanol) 5 to 10 mg sublingually as needed Oxygen 2 to 6 L/min per nasal cannula Prednisone (Deltasone) elixir 10 mg orally

A hospice client has just died. Which of these postmortem nursing tasks is most appropriate to delegate to a nursing assistant? Assessing the client for cessation of respiratory effort and lack of pulse Documenting the time of death and required assessment data on the chart Notifying the spouse and other family members about the client's death Removing or cutting all IV lines or tubes according to the hospice policy

The nurse manager for home health and hospice is scheduling daily client visits. Which client is appropriate for the nursing assistant to visit? Advanced cirrhosis of the liver; called the hospice agency reporting nausea Aggressive brain tumor; needs daily assistance with ambulation and bathing Inoperable lung cancer; considering whether to have radiation and chemotherapy Prostate cancer and bone metastases; has new-onset leg weakness and tingling

The nurse working on an inpatient hospice unit has received the change-of-shift report. Which client does the nurse assess first? A 26-year-old with metastatic breast cancer who is experiencing pain rated at 10 (0-to-10 scale) and anxiety A 30-year-old with AIDS-associated dementia and agitation who is asking for assistance with calling family members A 62-year-old with lung cancer who has cool, clammy, dusky skin and blood pressure of 64/20 mm Hg A 70-year-old with cancer of the colon who has a respiratory rate of 8 with loud, wet-sounding respirations

A hospice client becomes too weak to swallow. What does the nurse do initially to increase the client's comfort? Administers nutrition and fluids through a nasogastric tube Explains to the family that aspiration may be a concern Obtains a physician order to initiate an IV line Teaches the family how to provide oral care

A dying client cannot swallow and is accumulating audible mucus in the upper airway (death rattles). The nursing assistant reports that these noises are upsetting to family members. What does the nurse tell the assistant to do? Assist the family in leaving the room so that they can compose themselves. Place the client in a side-lying position so secretions can drain. Position the client in a high-Fowler's position to minimize secretions. Use a Yankauer suction tip to remove secretions from the client's upper airway.

A Christian client is struggling with a diagnosis of cancer and says, "Why is life so unfair?" What health care team member does the nurse ask to provide support? Client's family Physician Hospital chaplain Psychiatrist