NSG 430 TOPIC 1
1. due to pt at EOL having increased difficulty swallowing, they are at higher risk for :
aspiration
2. due to pt at EOL having increased difficulty swallowing, they are at higher risk for
aspiration; which means they will need to have and : have thick fluids + soft food; and
eventually stop PO intake
3. EOL manifestations: CV: -initially increased HR that slows down + becomes
weak/thready
-irreg rhythm
-decreased BP
-delayed absorption of IM/SQ drugs
4. at EOL, HR will initially be but : increased; become slow, weak, thready
5. at EOL, BP will be : decreased
6. at EOL, pt will have decreased absorption of + meds: IM + SQ
7. EOL manifestations; psychosocial: -altered decision making
-anxiety + fear
-life review
-saying goodbye
-withdrawal
8. spirituality: broad; beliefs, values, + practices r/t existential meaning + purpose
9. helping meet pts spirituality needs at EOL will : decrease despair +
increase coping
10. in some cultures, pt may try to internalize their feelings like pain at EOL,so the nurse
should : pay attention to nonverbal pain cues
11. nonverbal pain cues: -grimaces
-body position
-decreased or guarded movement
12. full code: ALL heroic measures
13. do not intubate (DNI): no intubation OR mech vent
14. chemical code: use of drugs for resuscitation without use of CPR
15. DNR/AND: do not resuscitate/allow natural death; comfort measures only wheredeath isnt
delayed or prevented
, 16. can nurses adminster euthanasia?: no
17. palliative sedation: giving sedatives to decrease distressing s/s in dying pt
18. what is the intent of palliative sedation?: to relieve unmanageable pain/suf-fering
19. the intent of palliative sedation is to relieve unmanageable pain/suffering,NOT to :
hasten death
20. declares that palliative sedation is morally permissible for nurses: -
"priniciple of double effect"
21. during EOL assessment care, nurse should avoid : unnecessary
assess-ments
22. in the last hours of life, nurse should only assess for pt : comfort
23. in the last hours of life, nurse should only assess for pt comfort and
24. in the last hours of life, which assessments (besides comfort) are priori-tized?: pain +
breathing
25. what are the 4 common fears at the EOL?: -pain
-SOB
-loneliness/abandonment
-meaninglessness
26. how can the nurse combat PAIN fear at the EOL?: -tell the pt death isnt alwayspainful
-prompt pain meds
-manage drug side effects
27. how can the nurse combat SOB fear at the EOL?: -opioids
-bronchodilators
-o2
28. how can the nurse combat LONLIENESS/ABANDONMENT fear at theEOL?: provide
compansionship thru physical touch, listening, etc
29. how can the nurse combat MEANINGLESSNESS fear at the EOL?: lifereview (photo
albums, mementos while sharing thoughts, etc)
30. EOL: which med for dyspnea/SOB?: opioids
31. EOL: which med for anxiety?: benzos
32. EOL: which med to decrease secretions?: anticholinergics (atropine, glycopy-rrolate)
33. EOL avoid suction: deep; gentle only
1. due to pt at EOL having increased difficulty swallowing, they are at higher risk for :
aspiration
2. due to pt at EOL having increased difficulty swallowing, they are at higher risk for
aspiration; which means they will need to have and : have thick fluids + soft food; and
eventually stop PO intake
3. EOL manifestations: CV: -initially increased HR that slows down + becomes
weak/thready
-irreg rhythm
-decreased BP
-delayed absorption of IM/SQ drugs
4. at EOL, HR will initially be but : increased; become slow, weak, thready
5. at EOL, BP will be : decreased
6. at EOL, pt will have decreased absorption of + meds: IM + SQ
7. EOL manifestations; psychosocial: -altered decision making
-anxiety + fear
-life review
-saying goodbye
-withdrawal
8. spirituality: broad; beliefs, values, + practices r/t existential meaning + purpose
9. helping meet pts spirituality needs at EOL will : decrease despair +
increase coping
10. in some cultures, pt may try to internalize their feelings like pain at EOL,so the nurse
should : pay attention to nonverbal pain cues
11. nonverbal pain cues: -grimaces
-body position
-decreased or guarded movement
12. full code: ALL heroic measures
13. do not intubate (DNI): no intubation OR mech vent
14. chemical code: use of drugs for resuscitation without use of CPR
15. DNR/AND: do not resuscitate/allow natural death; comfort measures only wheredeath isnt
delayed or prevented
, 16. can nurses adminster euthanasia?: no
17. palliative sedation: giving sedatives to decrease distressing s/s in dying pt
18. what is the intent of palliative sedation?: to relieve unmanageable pain/suf-fering
19. the intent of palliative sedation is to relieve unmanageable pain/suffering,NOT to :
hasten death
20. declares that palliative sedation is morally permissible for nurses: -
"priniciple of double effect"
21. during EOL assessment care, nurse should avoid : unnecessary
assess-ments
22. in the last hours of life, nurse should only assess for pt : comfort
23. in the last hours of life, nurse should only assess for pt comfort and
24. in the last hours of life, which assessments (besides comfort) are priori-tized?: pain +
breathing
25. what are the 4 common fears at the EOL?: -pain
-SOB
-loneliness/abandonment
-meaninglessness
26. how can the nurse combat PAIN fear at the EOL?: -tell the pt death isnt alwayspainful
-prompt pain meds
-manage drug side effects
27. how can the nurse combat SOB fear at the EOL?: -opioids
-bronchodilators
-o2
28. how can the nurse combat LONLIENESS/ABANDONMENT fear at theEOL?: provide
compansionship thru physical touch, listening, etc
29. how can the nurse combat MEANINGLESSNESS fear at the EOL?: lifereview (photo
albums, mementos while sharing thoughts, etc)
30. EOL: which med for dyspnea/SOB?: opioids
31. EOL: which med for anxiety?: benzos
32. EOL: which med to decrease secretions?: anticholinergics (atropine, glycopy-rrolate)
33. EOL avoid suction: deep; gentle only
