Examen
N450 - Goals of Care and Ethical Issues at the EOL (1).
- Cours
- Établissement
N450 - Goals of Care and Ethical Issues at the EOL (1).
[Montrer plus]
Vendeur
S'abonner
Ace360PRO
Avis reçus
Aperçu du contenu
N450 - Goals of Care and Ethical Issues at the EOLMortality and Ethics - ANS-- Ethics is a formal method for studying moral questions.
- Morality refers to social conventions about acceptable and unacceptable behavior and may
vary by culture.
- Nurse considers many views; apply ethical decision-making principles when conflicts occur
Goals of Care - ANS-- To protect a persons right to make choices
- To provide care that matches older adults' and families' goals and values
- To guide everyday clinical decisions and actions
- To ensure appropriate resource allocation
Patient Self-Determination Act 1991 - ANS-- Purpose of the law: to ensure the rights of
individuals "to accept or refuse medical or surgical treatment"
- Requires health care institutions to inform individuals about their right to participate in
decisions about their health care, including the right to make advance directives
- also right to advanced directive
Advance Directives - ANS-- Written instructions to a health care provider before the need for
medical treatment. Allows informed consent when no longer able to give consent.
- In an AD, you can refuse or consent to future treatment.
- DNR - allow natural death
- Power of attorney - gives someone else the power to make choice for you
- Tissue organ or body donation are considered advanced directives
Types of Advance Directives - ANS-- Living Will: care wanted under certain circumstances (e.g.,
CPR)
- Durable Power of Attorney for HealthCare; designated healthcare proxy (DPOA-HC)
- The Five Wishes: Aging with Dignity advance directive program
- POLST: physician orders that specify treatment decisions
Advance Directives: Imperfect Tools - ANS-- Low rates of completion
- Difficulties in thinking about "what if?" situations
- Lack of communication with and among health care providers
- Uninformed or biased surrogate decision-makers
**They are only in effect if they are in the providers hands - if not then it is not worth anything**
Discussing Values & Treatment Goals- Five Wishes - ANS-- The person I want to make
decisions if I cannot - names a person
- The kind of medical treatment I want or don't want
- How comfortable I want to be
- How I want people to treat me
, - What I want my loved ones to know
Approaches to Decision Making: Outline Scenarios and Treatment Options - ANS-- Health
Conditions - Coma, Dementia, Stroke, Terminal Illness
- Treatment Options (includes discussion of risks/ benefits and probable outcomes of therapy) -
CPR/Mechanical Ventilation, Dialysis, Diagnostic Tests, Hospitalization, ABX, Blood
transfusions, Tube feedings/IV fluids, Pain management, comfort care
Physicians' Orders for Life Sustaining Treatment (POLST) - ANS-- AKA MOLST
- Started in Oregon in 1991, now a national movement
**Not a living will just a doctor's orders**
- is a MD order for tx preferences - medical record and checks off pt. wants
- Can be applied across care settings - transferable
- Studies show that having a POLST form decreases unwanted treatment and enhances
symptom management at EOL
Ideally, the Older Adult who makes the decision is.... - ANS-- Is mentally capable of making
decisions
- Is fully informed about his/her disease, prognosis, and treatment choices
- Decides freely without feeling coerced
- Decides based on his/her values and priorities
- Need to determine if pt is capable or not
Establishing "Capacity" - ANS-- Incapacitated does not equal Incompetent
Incapacity determined by a process:
- Demonstrated inability over time to make decisions that create a significant risk of personal
harm
- Criteria in legal document (e.g., AD)
- Informed Consent - Determination is not based on medical diagnosis, age, poverty,
eccentricity, age, education level or personality
Competency V. Capacity - ANS-- Capacity is the clinical (caregiver or HCP) determination to
make informed decisions
- Competency is determined by the courts - presumption that the person has mental ability to
execute legal tasks - this is all or none
General Approaches to Maximizing Capacity - ANS-- Optimizing nutrition, sleep, bowel function,
managing incontinence
- Identifying and treating depression
- Monitoring & minimizing medication use
- Treating coexisting diseases, e.g., diabetes, COPD
- Correct sensory deficits
- Having a known and trusted person facilitate the discussion
- Conducting the discussion at a time of day when the older adult is likely to be most alert
Les avantages d'acheter des résumés chez Stuvia:
Qualité garantie par les avis des clients
Les clients de Stuvia ont évalués plus de 700 000 résumés. C'est comme ça que vous savez que vous achetez les meilleurs documents.
L’achat facile et rapide
Vous pouvez payer rapidement avec iDeal, carte de crédit ou Stuvia-crédit pour les résumés. Il n'y a pas d'adhésion nécessaire.
Focus sur l’essentiel
Vos camarades écrivent eux-mêmes les notes d’étude, c’est pourquoi les documents sont toujours fiables et à jour. Cela garantit que vous arrivez rapidement au coeur du matériel.
Foire aux questions
Qu'est-ce que j'obtiens en achetant ce document ?
Vous obtenez un PDF, disponible immédiatement après votre achat. Le document acheté est accessible à tout moment, n'importe où et indéfiniment via votre profil.
Garantie de remboursement : comment ça marche ?
Notre garantie de satisfaction garantit que vous trouverez toujours un document d'étude qui vous convient. Vous remplissez un formulaire et notre équipe du service client s'occupe du reste.
Auprès de qui est-ce que j'achète ce résumé ?
Stuvia est une place de marché. Alors, vous n'achetez donc pas ce document chez nous, mais auprès du vendeur Ace360PRO. Stuvia facilite les paiements au vendeur.
Est-ce que j'aurai un abonnement?
Non, vous n'achetez ce résumé que pour €7,61. Vous n'êtes lié à rien après votre achat.
Peut-on faire confiance à Stuvia ?
4.6 étoiles sur Google & Trustpilot (+1000 avis)
70073 résumés ont été vendus ces 30 derniers jours
Fondée en 2010, la référence pour acheter des résumés depuis déjà 15 ans
Récemment vu par vous
Examen ·
C100 - Module 2 with 100% correct answers(latest update)
Examen ·
EMT final | 166 Questions and Answers(A+ Solution guide)
Examen ·
MN 552 QUIZ, MIDTERM EXAM AND FINAL EXAM – PACKAGE 2020
Examen ·
Juridische tekstanalyse blok 1 leer jaar 1 (cijfer 8)
Resume ·
Schematisch overzicht Openbare Financiën (RGBEO00005)
Examen ·
GSM Test Questions with Complete Solutions 2024/2025
Fiches de révision ·
H6 begrippen Biologie 4 HAVO Biologie voor jou
Examen ·
WGU C232: Introduction to Human Resources Assessment
