Client Centered Care Final Exam Questions With Complete Solution

CLIENT CENTERED CARE FINAL EXAM QUESTIONS WITH
COMPLETE SOLUTION

Normal EOL symptoms
- Accessory muscle use
- Rapid breathing
- Slow, irregular breathing
- Agonal respirations
- Low SpO2
Why is dyspnea subjective
- Pt may look fine, but feel distress
- Pt may look dyspneic, but feel no distress
What does the BTF model represent
Breathlessness and how thinking, functioning and breathing correlate to it
Why is a fan useful for breathlessness
Stimulates facial receptors to reduce feeling of dyspnea
What positions help breathlessness
- High fowlers
- High side-lying
Why does pursed lip breathing help dsypnea
- Generates PEEP
- Stents open airways
What are the two breathing techniques that help with dyspnea
- Pursed lip breathing
- Diaphragmatic breathing
Environment changes to help with dyspnea
- Decreased temperature
- Cold cloth on forehead
- Comfortable clothing
Components of pt and family education
- Breath control
- Conserve energy
- Puffer technique
- Use medications
- Provide support
Does supplemental O2 prolong life or is it comfort care
- Both but it can also prolong the disease process
why use O2 towards end of life
- Help awake pt's with symptomatic hypoxemia
- Increase pt comfort
Instead of deep suctioning, consider using
medications
When do we use bronchodialtors

,- COPD
- Asthma
- Salbutamol, Ipratropium Bromide
When do we use Corticosteroids
- Severe COPD
- Radiation
pneumonitis
- IPF
- Dexamethasone
When do we use diuretics
- CHF
- Pulmonary Edema
- Lasix
What opioids help with secretion management
Atropine, Scopolamine, Glycopyrrolate
What opioids help with anxiety management
Lorazepam, Benzodiazepines
What are the fears around opioids
- Will it shorten pt life
- Will the pt be overly sedated
- Will the pt get addicted
What can you do to ensure you take care of yourself during EOL care
- Attend debriefs
- Counselling
- Adequate self-care
if you don't know ______
ASK
Why does UNINTERRUPTED sleep matter
- Critical to think clearly, consolidate memories, regulate emotion
- Improves health, decreases mortality, mood
Consequences of sleep deprivation
- Accidents
- Human Error
What is sleep debt
If you don't sleep enough, you "owe" more sleep to yourself.
12 rules of healthy sleep
1. Sleep in silence and dark
2. Do not eat much before going to sleep
3. Do not smoke + do not use alcohol
4. Take a walk before going to bed
5. Give up caffeine and energy
6. Sleep on firm, level, comfortable bed
7. Slightly colder temp for sleeping
8. Go to bed and wake up at the same time
9. Do not put working electrical appliances near your head
10. Do not watch tv or play video games

, 11. Do not focus on insomnia
12. Develop a routine
What is sleep hygeine
Recommendations of change to get a better sleep
Starting 2 hrs before bed, what is recommended you do
- Slow down, disengage
- Limit screens
- Set alarm
- Do wind down activities
- Consider bedroom environment
What to avoid before sleeping
- Caffeine
- Alcohol
- Healthy meals
- Fluid intake
- Apps
- CBT for insomnia
What % of total sleep do we spend in Non-REM 1
5%
What % of total sleep do we spend in Non-REM 2
45%
What % of total sleep do we spend in Non-REM 3
25%
What % of total sleep do we spend in REM
25%
Characteristics of Non-REM 1 sleep
- Wakefulness to light sleep
- HR slow
- RR slow
- Eye movements slow
- Muscles relax/twitch
Characteristics of Non-REM 2 sleep
- Light sleep
- HR slow
- RR slow
- Muscles relax
- Temp lowers
- Brain wave activity slows
Characteristics of Non-REM 3 sleep
- Slow wave
- Deep restorative sleep
Characteristics of REM sleep
- Dream sleep
- Brain activity
- Vitals change
OSA is the (most/least) common SDB