NUR 221 (CRITICAL CARE - TEST 1) STUDY
NOTES WITH COMPLETE SOLUTIONS 100%
CORRECT | NEW UPDATE 2025
Medical futility - A situation in which therapy or interventions will not provide
a foreseeable possibility of improvement in the patient's health condition, or a
lack of attainable goals of care
**Is this treatment/surgery what is best for the patient if it is not going to help
them?
Nursing care in the critical care setting at the end-of life is focused on what 5
dimensions? - 1. Alleviation of distressing symptoms (pallation)
2. Communication and conflict resolution
3. Withdrawing, limiting, or withholding therapy
4. Emotional and psychological care of the patient and family
5. Caregiver organizational support
Palliation - Provision of care interventions that are designed to relieve
symptoms of illness or injury that negatively affect the quality of life
Palliative care - Care designed not to treat an illness but to provide physical
and emotional comfort to the patient and support and guidance to his or her
family
,Hospice care - Treatment of the terminally ill in their own homes, or in special
hospital units or other facilities, with the goal of helping them to die comfortably,
without pain
T/F: Palliative care should be implemented with ALL patients, not just the dying -
TRUE
What 10 symptoms are commonly seen at end of life in patients? - 1. Pain
2. Anxiety
3. Hunger
4. Thirst
5. Dyspnea
6. Diarrhea
7. Nausea
8. Confusion
9. Agitation
10. Sleep disturbance
An important part of palliative care consists of "simple" nursing interventions
which include: - 1. Frequent repositioning
2. Good hygiene
3. Skin care
4. Creation of a peaceful environment (to extent possible)
5. Pain relief
,Elements of palliative care include: - 1. Early identification of end-of-life
patients
2. Pain management
3. Pharmacological and nonpharmacological interventions
What is a key factor in improving the quality of care for the dying patient in the
critical care unit? - Clear, ongoing, and honest communication among the
members of the healthcare team, the patient, and the family
What are 4 guidelines for effective communication to facilitate end-of-life care
includes: - 1. Present a clear and consistent message to the family
2. Allow ample time for family members to express themselves during family
conferences
3. Emphasize that the patient will not be abandoned if the goals of care shift from
aggressive therapy to "comfort" care (palliation) only
4. Facilitate continuity of care
Most deaths in the critical care unit are preceded by what? - Some manner of
withholding, withdrawing, or limiting medical treatments, with significant
variation among different patient populations but does not constitute euthanasia
or assisted suicide
Withdrawal of treatment - Discontinuation of life-sustaining therapies in a
terminally ill or persistently vegetative patient
Withholding of treatment - Failure to initiate life-sustaining therapies in a
terminally ill or persistently vegetative patient
, What is the most commonly withheld or withdrawn medical intervention in the
critical care setting? - Mechanical ventilation (AKA: terminal weaning)
Terminal weaning - The gradual withdrawal of mechanical ventilation from a
patient with a terminal illness or an irreversible condition with a poor prognosis
that could include titration of ventilator support to minimal levels, removal of the
ventilator but not the artificial airway or extubation
During terminal weaning of ventilatory support, patient may exhibit symptoms of
respiratory distress which includes: - 1. Tachycardia
2. Dyspnea
3. Use of accessory muscles
What is the nurse's role during ventilator withdrawal/terminal weaning? -
Titrate pain medications and sedation as needed to relieve symptoms of
respiratory distress
T/F: Life-sustaining treatments should can be withdrawn on patients on paralytic
agents - FALSE
**should NOT be withdrawn on these patients
Other than mechanical ventilation what are some other commonly withheld
therapies during palliative care? - 1. Vasopressors
2. Antibiotics
3. Blood and blood products
NOTES WITH COMPLETE SOLUTIONS 100%
CORRECT | NEW UPDATE 2025
Medical futility - A situation in which therapy or interventions will not provide
a foreseeable possibility of improvement in the patient's health condition, or a
lack of attainable goals of care
**Is this treatment/surgery what is best for the patient if it is not going to help
them?
Nursing care in the critical care setting at the end-of life is focused on what 5
dimensions? - 1. Alleviation of distressing symptoms (pallation)
2. Communication and conflict resolution
3. Withdrawing, limiting, or withholding therapy
4. Emotional and psychological care of the patient and family
5. Caregiver organizational support
Palliation - Provision of care interventions that are designed to relieve
symptoms of illness or injury that negatively affect the quality of life
Palliative care - Care designed not to treat an illness but to provide physical
and emotional comfort to the patient and support and guidance to his or her
family
,Hospice care - Treatment of the terminally ill in their own homes, or in special
hospital units or other facilities, with the goal of helping them to die comfortably,
without pain
T/F: Palliative care should be implemented with ALL patients, not just the dying -
TRUE
What 10 symptoms are commonly seen at end of life in patients? - 1. Pain
2. Anxiety
3. Hunger
4. Thirst
5. Dyspnea
6. Diarrhea
7. Nausea
8. Confusion
9. Agitation
10. Sleep disturbance
An important part of palliative care consists of "simple" nursing interventions
which include: - 1. Frequent repositioning
2. Good hygiene
3. Skin care
4. Creation of a peaceful environment (to extent possible)
5. Pain relief
,Elements of palliative care include: - 1. Early identification of end-of-life
patients
2. Pain management
3. Pharmacological and nonpharmacological interventions
What is a key factor in improving the quality of care for the dying patient in the
critical care unit? - Clear, ongoing, and honest communication among the
members of the healthcare team, the patient, and the family
What are 4 guidelines for effective communication to facilitate end-of-life care
includes: - 1. Present a clear and consistent message to the family
2. Allow ample time for family members to express themselves during family
conferences
3. Emphasize that the patient will not be abandoned if the goals of care shift from
aggressive therapy to "comfort" care (palliation) only
4. Facilitate continuity of care
Most deaths in the critical care unit are preceded by what? - Some manner of
withholding, withdrawing, or limiting medical treatments, with significant
variation among different patient populations but does not constitute euthanasia
or assisted suicide
Withdrawal of treatment - Discontinuation of life-sustaining therapies in a
terminally ill or persistently vegetative patient
Withholding of treatment - Failure to initiate life-sustaining therapies in a
terminally ill or persistently vegetative patient
, What is the most commonly withheld or withdrawn medical intervention in the
critical care setting? - Mechanical ventilation (AKA: terminal weaning)
Terminal weaning - The gradual withdrawal of mechanical ventilation from a
patient with a terminal illness or an irreversible condition with a poor prognosis
that could include titration of ventilator support to minimal levels, removal of the
ventilator but not the artificial airway or extubation
During terminal weaning of ventilatory support, patient may exhibit symptoms of
respiratory distress which includes: - 1. Tachycardia
2. Dyspnea
3. Use of accessory muscles
What is the nurse's role during ventilator withdrawal/terminal weaning? -
Titrate pain medications and sedation as needed to relieve symptoms of
respiratory distress
T/F: Life-sustaining treatments should can be withdrawn on patients on paralytic
agents - FALSE
**should NOT be withdrawn on these patients
Other than mechanical ventilation what are some other commonly withheld
therapies during palliative care? - 1. Vasopressors
2. Antibiotics
3. Blood and blood products
