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Mrs. Govinda is a 75-year-old female with terminal lung cancer. She...

Mrs. Govinda is a 75-year-old female with terminal lung cancer. She has been admitted to the hospital after experiencing an episode of dyspnea. While in the hospital, a healthcare provider discusses palliative care and hospice care with her.

1)     Explain the difference between palliative care and hospice care?

 

2)     Once the healthcare provider informs Mrs. Govinda she has about 4 months to live, which type of care would she most likely receive? 

 

During the next few days in the hospital, Mrs. Govinda refuses to eat and blames the healthcare provider for not detecting the cancer sooner.

3)     According to Kubler-Ross's Stages of Grieving, which stage would you determine Mrs. Govinda to be experiencing?

 

4)     What other Kulber-Ross Stages could Mrs. Govinda experience? Provide an example of the additional stages.

 

 

As Mrs. Govinda's disease progresses, she wishes to be sent home with nursing care. The healthcare provider orders the following medications:

5)     Order: Lorazepam 2mg every 8 hours as needed for anxiety.

Based on the label, how many tablet(s) will be administered? ­­­­­­­__________ tablet(s)


6)     Order: Morphine 30mg orally every 4 hours as needed for pain

Based on the label, how many mL(s) will be administered? _________mL(s)


 

While caring for Mrs. Govinda at home, the hospice nurse notes the following assessment data: sleeping instead of eating her meals, purplish colored and cool feet, and breathing with periods of apnea.

7)     Based on the assessment findings what conclusions would you make about Mrs. Govinda's condition? Are there any preparations needed regarding her care and family?

 

 

 

8)     What other symptoms would the nurse monitor for during the dying process?

 

 

9)     Once Mrs. Govinda passes away, the hospice nurse will need to pronounce death. List the steps in pronouncing death.

 

 

10) Describe how to perform post-mortem care for a client that passed away.

 

 

11) Would Mrs. Govinda need an autopsy? Why or why not?

 

 

12) How might culture influence the type of post-mortem care provided?

 

Please answer the following practice questions related to care of a dying client:

 

13) Fill in the blank: __________________ for family members and other loved ones continues after the patient's death.

 

14) Fill in the blank: If vital organs are to be donated, ___________and_____________ support must be maintained until vital organs can be harvested.

 

15) Fill in the blank: _______________ performing postmortem care, it is important that the nurse determine the patient's infectious status and if the patient needs to be referred to the coroner; biohazard labels should be used if the patient had a notifiable disease (e.g., tuberculosis, Ebola).

 

16) Which actions should the nurse perform during care of a dying client? Select all that apply.

a.      Manage end-of-life symptoms as needed

b.     Respect spiritual and cultural needs

c.      Be proactive in monitoring the client

d.     Take time to discuss the client's care plan

e.      Assess the mental health of loved ones

 

17) Which action during post-mortem care by the assistive personnel (AP) would require intervention by the nurse?

a.      Gently washes the client's body

b.     Organizes the client's personal items

c.      Leaves the client's eyes open

d.     Puts the client's dentures in place

 

18) True or False: The registered nurse (RN) can delegate nursing tasks to the licensed practical nurse (LPN) during end-of-life care.

 

19) True or False: Family, friends, and loved ones should be included in the discussion of the client's care plan.

 

20) True or False: The door to the client's room should remain open during post-mortem care.

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