Free Hospice and Palliative Nurse Knowledge Questions and Answers
A patient with lung cancer reports abruptly having severe left side pleuritic discomfort. He displays The most likely diagnosis is: ""Auscultation reveals decreased breath sounds on the left, along with dyspnea, tachypnea, tachycardia, and a slight cough.
Tachycardia, dyspnea, tachypnea, abrupt acute unilateral pleuritic discomfort, and a mild cough, in addition to unilaterally reduced breath sounds are indicative of pneumothorax, a condition that can arise from lung cancer. If air escapes more as the tumor eats away at the lung's surface, a tension pneumothorax may result a little pneumothorax may heal with tracheal deviation and significant hemodynamic impairment. Naturally over a period of one to two weeks, while a bigger pneumothorax may require the insertion of a chest tube. Tension Pneumothorax necessitates chest tube placement and rapid needle decompression.
When the hospice caregiver shows up at the residence of a patient who is about to pass away, the daughter ""I can't stay in the room when Dad dies! I can't stand the thought!" is the finest way to react.
The nurse ought to continue being encouraging and impartial. The reply "I'll stay with him, and you can come and go as you please"" honors the daughter's expressed wish while allowing thechance for her to spend time with her father at the memorial service. Individuals respond differently toDeath is something that many individuals have never experienced firsthand, or have never seen a deceased person,and as a result could find the idea frightening. Although many find solace in the company of a dyingIt is never appropriate to force someone, friend or family member, to make this choice
When the nurse visiting a hospice patient at their residence, he states"I can't stand this pain anymore. I should just shoot myself and be done with it."The optimal first reaction is:
Since the patient's pain seems to be the cause of his suicide thoughts, it would be best to question him directly if he has any plans to harm himself in order to gauge the intensity of his thoughts. The nurse should identify strategies to mitigate the reason why this patient's by proposing to collaborate in order to discover more effective methods of pain management. More people fear pain than not. than death, and individuals have the moral and legal right to an agony-free dying. The caregiver ought to evaluate the kind, frequency, length, and state of pain as well as the existing pain treatment. Occasionally, an adjustment to adjuvant medicines or a harsher treatment, like an opioid, can be necessary. Notifying the attending physician and the caregivers about suicidal thoughts is important.
Patients receiving palliative care most frequently have the following types of pathological fractures:
It is true that patients receiving palliative care frequently suffer femur fractures, particularly if they have severe osteoporosis or metastatic bone disease. Palliative care measures may be necessary as a result of these fractures, which can cause substantial discomfort and immobility and damage the patient's quality of life. The fractures may be caused by decreased bone structure resulting from cancer metastases or other underlying diseases.
The most successful complementary therapy for pain management is likely the following:
Most likely the most popular and successful supplemental treatment for pain is acupuncture. The use of music therapy may assist the patient in relaxing to lessen the need for analgesics. Also, therapeutic touch has been applied extensively, Although despite new research suggesting it is ineffective, many people report that it improves their pain. Patients may find therapeutic touch comforting because it is passive and requires minimal active participation from them. A massage can ease sore muscles and encourage calmness.
All of the following, with one exception, describe chronic renal failure:
Hyperkalemia, as opposed to hypokalemia, is a hallmark of chronic renal failure. Chronic renal failure happens when the kidneys are unable to concentrate urine, filter and eliminate toxins, and preserve electrolytes equilibrium due to hypoxic circumstances, renal illness, or urinary tract blockage. It starts with azotemia, or a rise in nitrogenous waste in the blood, followed by uremia, which is caused by poisonous symptoms) include anemia, metabolic acidosis, and salt and fluid retention. When more than 50% of the kidneys' functional ability is lost, making the kidneys incapable of performing vital tasks and gradually worsening over several months or years.
Which of the following cardiac sounds in an older adult indicates heart failure?
When the patient is sleeping on their left side, the S3 heart sound rhythm may imply n adults with heart failure or left ventricular failure, an opening snap is an atypical high-pitched sound that is brought on by rheumatic heart disease-related mitral valve stenosis. An ejection click is a short, high-pitched a dry, grating sound that comes right after S1 and could be a sign of a septal defect. Friction rub heard with pericarditis in both diastole and systole.
A patient in hospice care experienced a left hemisphere stroke that resulted in paralysis on the right side. The nurse should be prepared for the following symptoms?
Left-hemisphere strokes frequently cause aphasia, paresis, or paralysis on the right side, which may include patients may also have trouble with short-term memory and be expressive, receptive, or global acquiring new content; cerebral strokes can affect heart and breathing; cerebellar strokes may result in headaches, nausea, vomiting, ataxia, and vertigo or dizziness. Right-hemisphere strokes cause left-sided neglect (a lack of awareness of items on the left side) and left paresis, or paralysis, as well as include despair and temporary memory loss.
"A patient describes experiencing a brief syncope episode that nearly caused her to pass out. When When assessing this patient, what information is most crucial to know at first?"
Comprehending the preceding activities of the episode can aid in further reducing the pool of possible explanations. If the jerky movements and tremors start right after taking the fentanyl medicine, opioid-induced myoclonus is a strong candidate for the etiology. However, other possible reasons like anxiety or neurological conditions like brain metastases may be indicated if the symptoms persist even after stopping opioid medication or if there is a specific trigger, like a change in position or activity. Therefore, in order to make a more accurate diagnosis, more information regarding the patient's behaviors and any triggers would be beneficial.
Which of the following best describes the duration of intravenous therapy needed for a patient receiving palliative care? For this length of time, central venous access devices are most frequently utilized.
Intravenous (IV) infusions sometimes need the use of peripherally implanted central catheters (PICCs) that will chemotherapy, PICC lines are used for several weeks or months (intermediate-term). Non-tunneled central catheters are used for short-term IV drips and are placed in one of the arms, typically above the elbow. Tunneled central catheters are implanted when patients require long-term therapy lasting less than six weeks. Intravenous therapy is another purpose for implantable ports, since these devices can stay in place for a long time mainly for extended IV therapy. After implantation, the ports are easily accessible and need little maintenance.
A hospice patient experiences a draining pressure sore infection that is severe and progressing, leading to noticeably elevated fever and discomfort; methicillin-resistant Staphylococcus aureus is detected in the culture. Infection with MRSA. The most effective treatment is:
Although infections may occasionally be permitted to progress in hospice patients who are close to passing away, this antibiotics should be given to relieve the patient's pain as the MRSA infection is making it worse. In addition, MRSA offers a risk for infection, thus pain management should be adjusted to make the patient more comfortable. hazard to caretakers due to its high contact transmission rate, hence lowering the danger to others can be When choosing how to treat the infection, caregivers should be instructed to employ both conventional and take care when in contact.