Palliative Care Nursing exam
questions fully solved &
updated(100% accuracy)
What is Palliative Care? - answer - An approach that aims to relieve
suffering and improve the quality of living and dying in those patients
diagnosed with like threatening and life limiting illnesses
- Includes addressing their physical, psychological, social, and spiritual
needs
- Focus on optimizing living as fully as possible in the time remaining,
while preparing for dying
Evolution of Palliative Care - answer - Recent shift toward treatment that
will improve quality of life in people that have a life limiting disease
- Consult to palliative care DOESN'T ALWAYS MEAN PATIENT IS DYING - ex.
consult may be useful during pain crisis
Hospice vs Palliative Care - answer - Hospice is more concerned with end
of life (e.g., usually 6 weeks to 6 months before death)
- THERE IS NO TIMELINE regarding death for palliative care
Involvement of the Palliative Care Team - answer - Palliative care team
tends to be more heavily involved as illness becomes terminal and death
becomes nearer
Facts About Palliative Care - answer - IS ACTIVE CARE: palliative care does
not mean that we are no longer providing active care
,- Just because someone is receiving palliative care DOES NOT MEAN THEY
ARE DYING
- Requires a set of knowledge, attitudes, and skill-based competencies
- Acknowledges the interdependence of various causes of suffering: e.g.,
physical pain, emotional suffering
- Acknowledges the illness experience of the patient and the impact on
and the role of the family
- MOST EFFECTIVE when delivered by INTERDISCIPLINARY COLLABORATION
(e.g., doctors, extramural, palliative nurses, social workers, psychology,
physiotherapists)
- Is an APPROACH and a SPECIALTY
- Grief and bereavement care is an integral component of palliative care
Palliative Assessments/Forms - answer - Edmonton Symptoms Assessment
(ESA)
- Palliative Performance Scale: helps determine progression and estimate
of how much longer the patient is going to live (100% is full life, 0% is
death)
- Palliative Admission Form (will give us indication of if we need to do
vitals, assessments, etc. and how often)
Considerations for Palliative Assessments - answer - Can be helpful to
complete ESA and PPS after the patient has had some time to get up, get
moving, and eat (if possible)
, - Ask patient to participate in ranking different criteria if possible
- If patient is not able to respond, can ask family members, or can make
own judgements as HCP (just need to indicate on form who completed it
e.g., P - patient, H/P - HCP and patient, F - family, etc.)
- Don't typically do mini assessments with palliative patients because a lot
of the time, we are not going to treat the findings we discover - too
invasive, doesn't make sense to complete
Barriers to Good Pain Control - answer - Patients denying pain - don't ask
for pain medications, don't want to admit something is wrong: leads to the
need to play catch up and chase with pain meds (much more difficult and
will require higher dose) instead of allowing for preventative pain
treatment
- Fear of narcotics
- Family: doesn't want pt. to have decreased LOC because hinders their
ability to talk to them
- Physicians: concerns about respiratory depression and/or addiction
Breakthrough Pain Meds and Dosage Adjustments - answer Rule of thumb:
if patient is having MORE THAN 3 breakthrough pain meds (PRNs) in 24
HOURS, the scheduled dose needs to be adjusted
Increase daily total dose by the sum of all BTP doses over the preceding
24 hours
Causes of Pain in Palliative Patients - answer 1) The disease itself
2) Treatment of the disease (e.g., radiation caused burning pain, chemo
causes pain in hands and feet)
questions fully solved &
updated(100% accuracy)
What is Palliative Care? - answer - An approach that aims to relieve
suffering and improve the quality of living and dying in those patients
diagnosed with like threatening and life limiting illnesses
- Includes addressing their physical, psychological, social, and spiritual
needs
- Focus on optimizing living as fully as possible in the time remaining,
while preparing for dying
Evolution of Palliative Care - answer - Recent shift toward treatment that
will improve quality of life in people that have a life limiting disease
- Consult to palliative care DOESN'T ALWAYS MEAN PATIENT IS DYING - ex.
consult may be useful during pain crisis
Hospice vs Palliative Care - answer - Hospice is more concerned with end
of life (e.g., usually 6 weeks to 6 months before death)
- THERE IS NO TIMELINE regarding death for palliative care
Involvement of the Palliative Care Team - answer - Palliative care team
tends to be more heavily involved as illness becomes terminal and death
becomes nearer
Facts About Palliative Care - answer - IS ACTIVE CARE: palliative care does
not mean that we are no longer providing active care
,- Just because someone is receiving palliative care DOES NOT MEAN THEY
ARE DYING
- Requires a set of knowledge, attitudes, and skill-based competencies
- Acknowledges the interdependence of various causes of suffering: e.g.,
physical pain, emotional suffering
- Acknowledges the illness experience of the patient and the impact on
and the role of the family
- MOST EFFECTIVE when delivered by INTERDISCIPLINARY COLLABORATION
(e.g., doctors, extramural, palliative nurses, social workers, psychology,
physiotherapists)
- Is an APPROACH and a SPECIALTY
- Grief and bereavement care is an integral component of palliative care
Palliative Assessments/Forms - answer - Edmonton Symptoms Assessment
(ESA)
- Palliative Performance Scale: helps determine progression and estimate
of how much longer the patient is going to live (100% is full life, 0% is
death)
- Palliative Admission Form (will give us indication of if we need to do
vitals, assessments, etc. and how often)
Considerations for Palliative Assessments - answer - Can be helpful to
complete ESA and PPS after the patient has had some time to get up, get
moving, and eat (if possible)
, - Ask patient to participate in ranking different criteria if possible
- If patient is not able to respond, can ask family members, or can make
own judgements as HCP (just need to indicate on form who completed it
e.g., P - patient, H/P - HCP and patient, F - family, etc.)
- Don't typically do mini assessments with palliative patients because a lot
of the time, we are not going to treat the findings we discover - too
invasive, doesn't make sense to complete
Barriers to Good Pain Control - answer - Patients denying pain - don't ask
for pain medications, don't want to admit something is wrong: leads to the
need to play catch up and chase with pain meds (much more difficult and
will require higher dose) instead of allowing for preventative pain
treatment
- Fear of narcotics
- Family: doesn't want pt. to have decreased LOC because hinders their
ability to talk to them
- Physicians: concerns about respiratory depression and/or addiction
Breakthrough Pain Meds and Dosage Adjustments - answer Rule of thumb:
if patient is having MORE THAN 3 breakthrough pain meds (PRNs) in 24
HOURS, the scheduled dose needs to be adjusted
Increase daily total dose by the sum of all BTP doses over the preceding
24 hours
Causes of Pain in Palliative Patients - answer 1) The disease itself
2) Treatment of the disease (e.g., radiation caused burning pain, chemo
causes pain in hands and feet)
