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Ch. 9 - Palliative Care at End of Life (Lewis) fully solved & updated (100- accuracy).
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Ch. 9 - Palliative Care at End of Life (Lewis) fully solved & updated (100- accuracy).
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Ch. 9 - Palliative Care at End ofLife (Lewis) fully solved &
updated 2025-2026(100%
accuracy)
According to the World Health Organization, palliative care is an approach
that improves quality of life for patients and their families who face
problems associated with life-threatening illnesses. From the list below,
identify the specific goals of palliative care (select all that apply).
a. Regard dying as a normal process.
b. Minimize the financial burden on the family.
c. Provide relief from symptoms, including pain.
d. Affirm life and neither hasten nor postpone death.
e. Prolong the patient's life with aggressive new therapies.
f. Support holistic patient care and enhance quality of life.
g. Offer support to patients to live as actively as possible until death.
h. Assist the patient and family to identify and access pastoral care
services.
i. Offer support to the family during the patient's illness and their own
bereavement. - answer a, c, d, f, g, i. Table 10-1 lists the goals of palliative
care. Overall, goals of palliative care are to prevent and relieve suffering
and to improve the quality of life for the patient.
Priority Decision: The husband and daughter of a Hispanic woman dying
from pancreatic cancer refuse to consider using hospice care. What is the
first thing the nurse should do?
a. Assess their understanding of what hospice care services are.
b. Ask them how they will care for the patient without hospice care.
c. Talk directly to the patient and family to see if she can change their
minds.
d. Accept their decision since they are Hispanic and prefer to care for their
own. - answer a. The family may not understand what hospice care is and
,may need information. Some cultures and ethnic groups may underuse
hospice care because of a lack of awareness of the services offered, a
desire to continue with potentially curative therapies, and concerns about
a lack of minority hospice workers.
List the two criteria for admission to a hospice program.
a.
b. - answer a.
Patient must desire services and agree in writing that only hospice care
can be used to treat the terminal illness (palliative care)
b. Patient must meet eligibility, which is less than 6 months to live,
certified initially by two physicians
For each of the following body systems, identify three physical
manifestations that the nurse would expect to see in a patient
approaching death.
Respiratory
a.
b.
c.
Skin
a.
b.
c.
Gastrointestinal
a.
b.
c.
Musculoskeletal
a.
b.
c. - answer Respiratory
, a. Cheyne-Stokes respiration
b. Death rattle (inability to cough and clear secretions)
c. Increased, then slowing, respiratory rate
(Also: irregular breathing, terminal gasping)
Skin
a. Mottling on hands, feet, and legs that progresses to the
torso
b. Cold, clammy skin
c. Cyanosis on nose, nail beds, and knees
(Also: waxlike skin when very near death) Gastrointestinal
a. Slowing of the gastrointestinal tract with accumulation
of gas and abdominal distention
b. Loss of sphincter control with incontinence
c. Bowel movement before imminent death or at time of
death
Musculoskeletal
a. Loss of muscle tone with sagging jaw
b. Difficulty speaking
c. Difficulty swallowing
(Also: loss of ability to move or maintain body position, loss of gag reflex)
Priority Decision: A terminally ill patient is unresponsive and has cold,
clammy skin with mottling on the extremities. The patient's husband and
two grown children are arguing at the bedside about where the patient's
funeral should be held. What should the nurse do first?
a. Ask the family members to leave the room if they are going to argue.
b. Take the family members aside and explain that the patient may be able
to hear them.
c. Tell the family members that this decision is premature because the
patient has not yet died.
d. Remind the family that this should be the patient's decision and to ask
her if she regains consciousness. - answer b. Hearing is often the last
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