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NUR 257 ( LATEST 2024 / 2025 ) MIDTERM 4 | QUESTIONS & ANSWERS (SOLVED)
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NUR 257 ( LATEST 2024 / 2025 ) MIDTERM 4 | QUESTIONS & ANSWERS (SOLVED)
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NUR 257 MIDTERM 41. Living will
Answer
A legal document in which an individual gives written instructions expressing his or her wishes
regarding health care in the event that person can no longer make those decisions.
2. advanced directives
Answer
3 types
living will
-health proxies
-power of attorney
limited to hospital + Long term care facilities
3. POLST
Answer
a form that a physician fills out that determines if life saving resuscitation is desired or not in
order for EMS to know what to do for a patient who is considered to be at risk for a life
threatening event
including if the patient wants/does not want
,-intubation
-hydration
-antibiotics
-artificial nutrition
4. impaired secretion in near death stage
Answer
buildup of saliva due to the loss of swallow ability
death rattle
xerostomia (Dry mouth)
-exacerbated by oxygen + reliance on open mouth breathing use anticholinergic to decrease
secretions
oral care with swabs + moistened cloths
5. Dyspnea in near death stage
Answer
changes in respiratory patterns (Shallow + peri- ods of apnea)
increased respiratory effort
-retractions
-accessory muscle use
-paradoxical abdominal breathing treatment
,-bronchodilators
-steroids
-lorazepam for anxiety which can make dyspnea worse
-O2 for comfort or hypoxemia
-opiods to reduce air hunger discomfort
6. dehydration in the near death stage
Answer
it is believed this can help with the release of endorphins which can provide a sense of well-
being to a dying patient
not as many secretions, decreased risk of pulmonary congestion less urine output so there is no
need for bed pan or urinal
7. cachexia + anorexia
Answer
cachexia - lean muscle loss anorexia - inadequate nutritional intake
caused by disturbance in carbohydrate, protein, and fat metabolism, endocrine dysfunction and
anemia
results in severe asthenia - loss of energy appetite stimulants are not effective
not usually reversible
Parenteral/enteral nutrition useful ONLY for pt with appetite who cannot swallow. ORAL
CARE.
8. impaired skin integrity
Answer
dusky , gray , cold , clammy , mottling which takes place days before death
, do not massage non-blanch able redness/actual breakdown keep skin clean + moist
incontinence - prevent further breakdown , changing the patient regularly.
9. terminal + irreversible delirium
Answer
confusion , restlessness , agitation hallucinations (Auditory + visual) , sleep disturbances ,
common in patients with brain + liver metastases
use benzodiazepines + neuroleptics lorazepam + halloo
this is a different approach than traditional approach to treating delirium
10. Neurotransmitter for parkinson
Answer
dopamine
11. Nausea + Vomiting
Answer
identify cause + remove it
treatment
Answer
-anticholinergic
-steroid
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