Gerontological Nursing
Exam 2 | Study Guide,
Practice Questions &
Exam Review
|Guaranteed success|
,What does the right to self determination include? Covers all decisions about one's care and treatment, including:
-Removal of life support or life-sustaining treatments
-Life-prolonging or lifesaving measures
Right to self determination: Competence Refers to the ability to understand proposed treatments/ procedures enough
to be able to make an informed decision
Advance Medical Directives (AMDs) Documents that permit people to set forth in writing their wishes and
preferences regarding health care
-States wishes and preferences for future care that healthcare professionals
can follow
-Can appoint a surrogate decision maker
When are advance medical directives active? Not operational until the person is no longer able to speak for themselves
T/F: If you are under the age of 25, your surrogate FALSE
decision maker (DPOA-HC) is automatically your
parents if you are unable to speak for yourself
Durable Power of Attorney for Health Care (AKA Legal document that designates an individual (health care agent or proxy) to
Medical Power of Attorney) make medical decisions for you in the event that you are unable to do so
Different from a power of attorney authorizing someone to make financial
transactions for you
Living will Legal document
Has vague terminology ("terminal illness", "pervasive vegetative state")
-References future events
Do not require involvement of appointed surrogate decision maker-POA-HC
Not available at time of healthcare crisis
T/F if a patient has a DNR order on file, that means they FALSE
do no want any further treatment
DNR orders Do not resuscitate does NOT mean do not treat
-Facility specific
-Does not advise on how to treat a patient that has a pulse and is breathing
Out of hospital DNR- not honored by EMS
Limited for pediatric patients
, Dignified death -A good death
-Dying well
-Natural part of life
-Opportunity for growth
-A profoundly personal experience
-Different for every individual
Aspects of Quality of Life Physical
Social
Psychological
Spiritual
Physical aspects of Quality of Life Functional Ability
Strength/Fatigue
Sleep & rest
Nausea
Appetite
Constipation
Pain
Psychological aspects of Quality of Life Anxiety
Depression
Enjoyment/Leisure
Pain distress
Happiness
Fear
Cognition/ attention
Social aspects of Quality of Life Financial burden
Caregiver burden
Roles and relationships
Affection/ Sexual function
Appearance
Spiritual aspects of Quality of Life Hope
Suffering
Meaning of pain
Religiosity
Transcendance
POLST Physician Orders for Life-Sustaining Treatment
-Started in Oregon in 1991
-Turns health care preferences into medical orders
-Is more comprehensive than a DNR/CPR order*
Advance Care Planning Focus on conversation, not document
-Verifies that discussion done well in advance of a healthcare crisis
-Ongoing conversations with changes in health- ACP is a process, not a one-
time decision
-Include patient, POA, family, and friends
-Based on patients' values, beliefs, and culture
-Active listening helps identify themes of living well
Exam 2 | Study Guide,
Practice Questions &
Exam Review
|Guaranteed success|
,What does the right to self determination include? Covers all decisions about one's care and treatment, including:
-Removal of life support or life-sustaining treatments
-Life-prolonging or lifesaving measures
Right to self determination: Competence Refers to the ability to understand proposed treatments/ procedures enough
to be able to make an informed decision
Advance Medical Directives (AMDs) Documents that permit people to set forth in writing their wishes and
preferences regarding health care
-States wishes and preferences for future care that healthcare professionals
can follow
-Can appoint a surrogate decision maker
When are advance medical directives active? Not operational until the person is no longer able to speak for themselves
T/F: If you are under the age of 25, your surrogate FALSE
decision maker (DPOA-HC) is automatically your
parents if you are unable to speak for yourself
Durable Power of Attorney for Health Care (AKA Legal document that designates an individual (health care agent or proxy) to
Medical Power of Attorney) make medical decisions for you in the event that you are unable to do so
Different from a power of attorney authorizing someone to make financial
transactions for you
Living will Legal document
Has vague terminology ("terminal illness", "pervasive vegetative state")
-References future events
Do not require involvement of appointed surrogate decision maker-POA-HC
Not available at time of healthcare crisis
T/F if a patient has a DNR order on file, that means they FALSE
do no want any further treatment
DNR orders Do not resuscitate does NOT mean do not treat
-Facility specific
-Does not advise on how to treat a patient that has a pulse and is breathing
Out of hospital DNR- not honored by EMS
Limited for pediatric patients
, Dignified death -A good death
-Dying well
-Natural part of life
-Opportunity for growth
-A profoundly personal experience
-Different for every individual
Aspects of Quality of Life Physical
Social
Psychological
Spiritual
Physical aspects of Quality of Life Functional Ability
Strength/Fatigue
Sleep & rest
Nausea
Appetite
Constipation
Pain
Psychological aspects of Quality of Life Anxiety
Depression
Enjoyment/Leisure
Pain distress
Happiness
Fear
Cognition/ attention
Social aspects of Quality of Life Financial burden
Caregiver burden
Roles and relationships
Affection/ Sexual function
Appearance
Spiritual aspects of Quality of Life Hope
Suffering
Meaning of pain
Religiosity
Transcendance
POLST Physician Orders for Life-Sustaining Treatment
-Started in Oregon in 1991
-Turns health care preferences into medical orders
-Is more comprehensive than a DNR/CPR order*
Advance Care Planning Focus on conversation, not document
-Verifies that discussion done well in advance of a healthcare crisis
-Ongoing conversations with changes in health- ACP is a process, not a one-
time decision
-Include patient, POA, family, and friends
-Based on patients' values, beliefs, and culture
-Active listening helps identify themes of living well
