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Certification for Hospice and Palliative Nursing questions with answers.
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Certification for Hospice and PalliativeNursing questions with answers.
xerostomia ANS -Dry mouth syndrome, leads to decreased swallowing ability, increased dental caries,
gum, tongue and oral lesions, infections, bad breath, changes in taste and alterations in speech and
voice functions. Social decline pyschosocial complication.
xerostomia non-pharmacological treatments ANS -oral swabs, peppermint water, vitamin c, chewing
gum/mints, acupuncture, diet modification, humidity
Percentage of HIV infection related pain ANS -50% directly related to infection of 30-97% of AIDS patient
experiencing pain
Post stroke pain ANS -32-42% experienced at 4-6 months post cva
11-21% experienced at 12-16 months post cva
Types of common post CVA pain ANS -Mechanical shoulder pain-common
Allodynia= Painful response to normally innocuous stimuli
Hyperalgesia =Decreased temperature sensation deep, superficial, and or severe
-coxib drugs ANS -withdrawn from market due to adverse effects associated with cardiovascular system
Conversion method from oral dose long acting to oral dose short acting ANS -24 h total of long acting
divided by q4h administration plus breakthrough dose of 10-15% of 24 hour total given q2h prn
Medication dosage alteration based on increased use of PRN dosage ANS -Add total dosage for PRN use
by patient and divide by 2 for amount of increase needed to long acting med
Primary factors for subcutaneous infusion ANS -1. Circulatory status
2. Patient monitoring
,3. Infusion site- amount of subcutaneous tissue
Calculating breakthrough dose of short acting medication ANS -10-20% of daily total q2h prn
Treatment for neuropathic pain ANS -Tricyclic antidepressants
Anticonvulsants
SSRI
Serotonin-norepinephrine reuptake inhibitors
Anti-convulsants
Starting dose nortryptiline and desipramine ANS -10-25 mg at hs titrated up by 10-25 mg every few days
to max of 75-150 mg qd. May take 3-7 days to see effects.
To prevent double effect ANS -When changing opioid decrease dose of new drug by 25% to account for
incomplete cross tolerance.
Duloxetine ANS -SSRI for treating neuropathic pain and depression
Side effects of Tricyclic antidepressants ANS -Sedation, orthostatic hypotension, urinary retention,
cardiovascular impairment
Gabapentin- normal dosing range for effectiveness ANS -900-1800 mg/d in 3 divided doses
Side effects of anticonvulsants ANS -Ataxia, dizziness, sedation. Gabapentin specifically has increased
incident of dependent edema.
Conversion of morphine oral to morphine IV ANS -30 mg oral = 10 mg parenteral. Conversion for hourly
iv rate = 24h oral total divided by 3 then divide by 24.
Morphine to hydromorphone conversion ANS -10 mg of morphine to 1.5 mg hydromorphone
,5 domains of alternative medical systems ANS -1. mind-body interventions
2 energy therapies
3. biologically based therapies
4. manipulative and body based therapies
5. electromagnetic therapies
Classifications of Pruritis according to Bernhard ANS -1. Systemic
2. Dermatological
3. Neuropathic/neurogenic
Elements of Sleep Hygeine ANS -Limiting time in bed, removing clocks from room, avoiding alcohol,
nicotine, and caffeine, taking a hot bath, limiting liquids before bed, regulating room temperature,
regulating bedtime, limiting daytime napping
Categories of sleep disorders ANS -1. Disorders of excessive somnolence
2. Dysfunctions associated with sleep stages or partial arousal
3. Disorders of sleep wake cycle
4. Disorders of initiating or maintaining sleep.
Themes of nearing death awareness ANS -Describing a place, needing reconciliation, talking to or being
in the presence of someone who is not alive, knowledge or statements of when death will occur,
choosing time of death, preparing for travel or change, being held back, and symbolic dreams.
ANA Code of Ethics Provision 1. ANS -The nurse, in all professional relationships, practices with
compassion and the recognition of human dignity and worth that is present in every individual.
ANA Code of Ethics- Provision 2. ANS -The primary commitment of the nurse is to the patient, whether
the patient is defined as an individual, group, or community.
ANA Code of Ethics- Provision 3 ANS -The nurse seeks to protect the health, safety, and
, rights of the patient.
ANA Code of Ethics Provision 4 ANS -The nurse has authority, accountability, and responsibility for
nursing practice; makes decisions; and takes action consistent with the obligation to promote health and
to provide optimal care.
ANA Code of Ethics Provision 5 ANS -The nurse owes the same duties to self as to others, including the
responsibility to promote health and safety, preserve wholeness of character and integrity, maintain
competence, and continue personal and professional growth.
ANA Code of Ethics Provision 6 ANS -The nurse, through individual and collective effort, establishes,
maintains, and improves the ethical environment of the work setting and conditions of employment that
are conducive to safe, quality health care.
ANA Code of Ethics Provision 7 ANS -The nurse, in all roles and settings, advances the profession through
research and scholarly inquiry, professional standards development, and the generation of both nursing
and health policy.
ANA Code of Ethics Provision 8 ANS -The nurse collaborates with other health professionals and the
public to protect human rights, promote health diplomacy, and reduce health disparities.
ANA Code of Ethics Provision 9 ANS -The profession of nursing, collectively through its professional
organizations, must articulate nursing values, maintain the integrity of the profession, and integrate
principle of social justice into nursing and health policy.
National Consensus Project 8 Domains of Palliative Care ANS -1. Structure and processes of care
2.Physical aspects of care
3. Psychological and psychiatric aspects of care. The domain also specifically describes elements of
bereavement services.
4. Social aspects of care
5. Spiritual, religious and existential aspects of care.
6. Cultural aspects of care.
7. Care of patients at the end of life
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