The document discusses end-of-life care including palliative care, hospice care, the dying process, and goals of end-of-life care. It describes the physical, psychosocial, and spiritual manifestations patients may experience as death approaches. Key aspects of end-of-life care are managing pain, dyspnea, fatigue, and providing emotional and spiritual support for patients and their families. Legal and ethical principles of advance care planning and allowing a peaceful death are also addressed.
The document discusses various aspects of end-of-life care including communicating bad news, managing symptoms, providing comfort, and ensuring a peaceful death. It notes that less than 10% of people die suddenly while 90% experience a prolonged illness. It provides steps for communicating bad news to patients and families, describes approaches to managing common physical and psychological symptoms experienced by dying patients, and emphasizes the nurse's role in coordinating care and advocating for a dignified death without unnecessary suffering.
This document discusses various aspects of end-of-life care including communicating bad news, managing symptoms, types of pain, loss and grief, components of a peaceful death, and postmortem care. It emphasizes the nurse's role in ensuring patients have a good death free from avoidable suffering by properly assessing and treating physical and psychological symptoms, respecting patient wishes, and supporting families through the dying process. The document provides guidance on steps to take when pronouncing death and caring for the deceased's body in a gentle, respectful manner.
This case study describes the end-of-life care of Lorna, a 77-year old woman with metastatic renal cell carcinoma. Lorna originally presented with flank and abdominal pain and was diagnosed with advanced renal cell carcinoma in 2011. In 2014, the cancer recurred and metastasized to her spine, causing cauda equina syndrome with lower limb weakness and urinary/fecal incontinence. She was admitted to palliative care for pain and symptom management, where she received psychological support, medication via syringe pump, and focus on comfort. The document discusses renal cell carcinoma, cauda equina syndrome, medications, nursing interventions and compassionate end-of-life care.
Palliative care aims to improve quality of life for patients facing life-limiting illness and their families through pain and symptom management, psychosocial and spiritual support from diagnosis until end of life. It focuses on preventing and relieving suffering through early identification and treatment of pain, and addresses physical, psychosocial and spiritual problems. Palliative care is applicable alongside curative treatments and aims neither to hasten nor postpone death.
This document discusses end of life care, death, grieving, and related topics. It begins with definitions of key terms like end of life care, death, and grief. It then covers historical perspectives on death. The goals of end of life care and palliative care are to relieve symptoms and enhance quality of life. Hospice care provides support for the dying and their families in a home-like setting. Nursing management at end of life involves comprehensive assessment, addressing psychosocial and physical needs, effective communication, and upholding patient dignity.
The document outlines signs and processes related to death and caring for dying patients. It discusses seven essential features in managing dying patients, including empathy, competence, communication, allowing child visits, family cohesion, humor, and consistency. Physical signs of impending death are described, such as changes to facial appearance, sight, speech, hearing, pulmonary and circulatory functions. Psychological acceptance is also noted. Post-mortem care includes cleaning and positioning the body, closing eyes/mouth, removing appliances, and documenting care.
Mr. TW, an 87-year-old man with multiple medical conditions and early dementia, has become confused, wandering at night, aggressive, and eating little over the past two days. His wife calls for nursing home placement but is distressed. His recent behavior change occurred after his dog died last month. He requires immediate medical evaluation to assess for potential underlying causes like delirium, a reversible acute confusion state often precipitated by illness, medication changes, or environmental stressors in vulnerable older adults like those with dementia.
The document discusses various aspects of end-of-life care including communicating bad news, managing symptoms, providing comfort, and ensuring a peaceful death. It notes that less than 10% of people die suddenly while 90% experience a prolonged illness. It provides steps for communicating bad news to patients and families, describes approaches to managing common physical and psychological symptoms experienced by dying patients, and emphasizes the nurse's role in coordinating care and advocating for a dignified death without unnecessary suffering.
This document discusses various aspects of end-of-life care including communicating bad news, managing symptoms, types of pain, loss and grief, components of a peaceful death, and postmortem care. It emphasizes the nurse's role in ensuring patients have a good death free from avoidable suffering by properly assessing and treating physical and psychological symptoms, respecting patient wishes, and supporting families through the dying process. The document provides guidance on steps to take when pronouncing death and caring for the deceased's body in a gentle, respectful manner.
This case study describes the end-of-life care of Lorna, a 77-year old woman with metastatic renal cell carcinoma. Lorna originally presented with flank and abdominal pain and was diagnosed with advanced renal cell carcinoma in 2011. In 2014, the cancer recurred and metastasized to her spine, causing cauda equina syndrome with lower limb weakness and urinary/fecal incontinence. She was admitted to palliative care for pain and symptom management, where she received psychological support, medication via syringe pump, and focus on comfort. The document discusses renal cell carcinoma, cauda equina syndrome, medications, nursing interventions and compassionate end-of-life care.
Palliative care aims to improve quality of life for patients facing life-limiting illness and their families through pain and symptom management, psychosocial and spiritual support from diagnosis until end of life. It focuses on preventing and relieving suffering through early identification and treatment of pain, and addresses physical, psychosocial and spiritual problems. Palliative care is applicable alongside curative treatments and aims neither to hasten nor postpone death.
This document discusses end of life care, death, grieving, and related topics. It begins with definitions of key terms like end of life care, death, and grief. It then covers historical perspectives on death. The goals of end of life care and palliative care are to relieve symptoms and enhance quality of life. Hospice care provides support for the dying and their families in a home-like setting. Nursing management at end of life involves comprehensive assessment, addressing psychosocial and physical needs, effective communication, and upholding patient dignity.
The document outlines signs and processes related to death and caring for dying patients. It discusses seven essential features in managing dying patients, including empathy, competence, communication, allowing child visits, family cohesion, humor, and consistency. Physical signs of impending death are described, such as changes to facial appearance, sight, speech, hearing, pulmonary and circulatory functions. Psychological acceptance is also noted. Post-mortem care includes cleaning and positioning the body, closing eyes/mouth, removing appliances, and documenting care.
Mr. TW, an 87-year-old man with multiple medical conditions and early dementia, has become confused, wandering at night, aggressive, and eating little over the past two days. His wife calls for nursing home placement but is distressed. His recent behavior change occurred after his dog died last month. He requires immediate medical evaluation to assess for potential underlying causes like delirium, a reversible acute confusion state often precipitated by illness, medication changes, or environmental stressors in vulnerable older adults like those with dementia.
This document discusses pain assessment and management for people with advanced dementia. It notes that pain is underreported and undertreated in cognitively impaired older adults due to challenges in assessment. It recommends using behavioral observation scales to assess pain in people with dementia, and provides examples of assessment tools like the Doloplus-2 scale and Abbey Pain Scale. It also provides guidance on managing chronic pain in older adults with dementia, including starting low-dose regular analgesics and considering transdermal patches to provide steady doses.
Lecture 21: Psychological issues at the end of life Dr.Reem AlSabahAHS_student
This document discusses psychological issues at the end of life from a holistic perspective. It addresses the physical, emotional, social, psychological, and spiritual needs and concerns of dying individuals. Regarding physical needs, it discusses pain management, body image, and finding meaning in illness. Emotionally, it explores common fears, loss/grief, and positive emotions. Socially, it addresses concerns for loved ones and communication patterns. Psychologically, it focuses on maintaining control and contributing to others. Spiritually, it examines religion/spirituality, meaning of life/death, and hope. The document also introduces palliative care and its role in improving quality of life compared to hospice care. Finally, it provides an overview
1) Physical therapy can help manage common cancer symptoms like breathlessness, fatigue, and pain through various interventions including breathing retraining, graded exercise, positioning, modalities, and therapeutic exercises.
2) Assessment of symptoms is important for physical therapy, using tools like VAS, Borg scale, and evaluating factors like respiratory function, impairment, and impact on daily activities.
3) Management of symptoms involves a multifaceted approach including medical treatment, non-pharmacological interventions, education, relaxation, energy conservation techniques, and addressing psychosocial factors. The goals are to prevent impairments, maintain function, and improve quality of life.
This document provides an overview of key concepts in medical and surgical nursing related to death and dying, pathophysiology, and spirituality. It discusses frameworks for understanding grief and the stages of death, including Kubler-Ross' five stages of grief. It also covers nursing implications around end-of-life care, including providing comfort, addressing needs, and exploring choices. Palliative care aims to relieve suffering and improve quality of life. The document also discusses assessing and supporting patient spirituality through listening, conveying care, and suggesting practices like prayer.
This document discusses holistic approaches to managing cancer pain beyond just opioids. It outlines how pain affects the endocrine, metabolic, cardiovascular, pulmonary, gastrointestinal and musculoskeletal systems as well as psychological factors. A holistic assessment considers physical, social, psychological and spiritual needs of the patient. Non-drug approaches to pain discussed include cutaneous stimulation, distraction, relaxation, art therapy, acupuncture, therapeutic touch, TENS, and humor. While medications should be the primary therapy, non-drug methods can help manage pain by improving mood and reducing distress.
END OF LIFE CARE- all ages deserve quality end of life careSandhya C
End of life care involves supporting patients who are in the last months or years of life. It focuses on comfort rather than cure and can be provided by a team including physicians, nurses, social workers, counselors and others. The goals are to enhance quality of life, maintain function, relieve suffering and allow a natural death with dignity. Nurses play a key role in providing physical, psychosocial and spiritual support to dying patients and their families.
Section 6 assisting with end-of-life care (1)baxtermom
This document discusses end-of-life care, including the physical and emotional needs of dying persons, their families, and care of the body after death. It outlines the stages of dying according to Kübler-Ross, common comfort needs, signs that death is near, and post-mortem care procedures. Legal issues like advance directives determining treatment wishes are also addressed. The overall focus is on providing compassionate care and support for the dying individual and their loved ones.
The document discusses various topics related to aging and end of life, including:
1) Physical, psychological, and social changes that occur with aging, such as hearing loss, arthritis, menopause, and changing social roles.
2) Options for end of life care like hospice, palliative care, and advance directives to outline one's wishes for medical treatment.
3) The importance of coping with aging, illness, grief, and one's own mortality in order to fully embrace life.
This document provides an overview of end of life care, including defining end of life care and palliative care, identifying the target population, and differentiating between palliative care and hospice care. It discusses factors that influence attitudes towards death, decision making at end of life, barriers to good end of life care, and nursing skills needed to provide palliative care. The goal is to help students understand end of life care and how to support older adults and their families during this process.
Chronic illness health psychologist Alison Wearden talks about how stress effects our health and our recovery from illness, and specialist physiotherapist Phil Langridge talks about breathlessness and what we can do to control it.
Graham Atherton discusses gardening for those with allergies, the signs of heart disorder to be aware of if you are taking itraconazole and advice on travel.
The document discusses the physiological and psychological components of pain. It defines pain and outlines its pathway through the body, including its transmission through the nervous system and the factors that can influence pain perception. The document also examines different types of pain like acute, chronic, and neuropathic pain. It reviews various treatments for pain, including medications, holistic approaches, and physical activity. The consequences of ignoring pain are also mentioned.
The document discusses mood disorders including depressive disorders such as major depressive disorder and dysthymic disorder, as well as bipolar disorders. It covers the epidemiology, etiology, types, symptoms, nursing assessments, diagnoses, and treatment options for mood disorders. The treatment section addresses psychotherapy, pharmacotherapy, electroconvulsive therapy, and suicide assessment and intervention.
Out-patient Primary and Specialty Palliative CareMike Aref
Presentation on primary and specialty palliative care, covering what is palliative care, basics of primary palliative care including pain and symptom management, and referral criteria for out-patient specialty palliative care.
This document provides an introduction to medical-surgical nursing concepts. It discusses homeostasis and how the body maintains equilibrium during disease or stress. Stress is defined as having a stressor and a stress response from the body. Common stressors can be physiological, psychological, sociocultural, or environmental in nature. The body's stress response occurs in three stages: alarm, resistance, and exhaustion. Nurses aim to support patients' normal adaptive processes through supportive care methods like health education, explanations, and comfort measures. Rest, sleep, and biological cycles are also discussed in relation to stress and homeostasis.
Geriatric Population. Pain and Palliative Care for the Older (Geriatric) AdultMichelle Peck
Michelle Peck | Legal Nurse | Nurse Practitioner | Health Care | Geriatric | Consultant | Speaker | Educator | Researcher
During your journey through this slide deck of Geriatric Populations, Pain and Palliative Care for the Older (Geriatric) Adult, you will experience: the assessment of pain; pain management strategies; and learn more about Palliative Care services.
As a health care consumer it is important to recognize and be aware of the quality of life benefits of good pain and symptom control. This begins with a good assessment of the factors contributing to the pain. Pain is a multifaceted experience. There are many barriers to achieving effective pain control in the elderly (geriatric population). Health care providers need to be aware of personal biases surrounding pain for proper pain management. There are also many health care provider misconceptions regarding Palliative Care especially in the geriatric population.
To enrich your geriatric understanding, at the end of this slide deck we discuss Palliative Care: the relief you need when you are experiencing serious medical illness.
Learn it-Live it-Love it-Your path for a more informed life!
Michelle Peck | Legal Nurse | Nurse Practitioner | Health Care | Geriatric | Consultant | Speaker | Educator | Researcher
Motor Neurone Disease (MND) is an incurable neurological disorder that leads to progressive paralysis and death within a few years. Palliative care is involved from the time of diagnosis to help patients live as fully as possible by managing symptoms, providing support, and encouraging advance care planning. While there are limited treatment options to slow the disease, palliative care aims to enable patients and their families through a team approach that addresses physical, psychological, and spiritual needs during all stages of the disease.
The document discusses several topics related to stress and health, including:
1) Stress can cause physical illness, especially when stress is prolonged or combined with unhealthy behaviors, which may increase risks of diseases like heart disease.
2) Fields like health psychology study how stress, emotions, and behaviors influence disease risk and promote health and well-being.
3) Prolonged or chronic stress can have maladaptive effects on health, while moderate short-term stress can sometimes have positive effects.
An acute subdural hematoma is a brain injury involving the accumulation of blood between the dura and arachnoid layers covering the brain. It can occur suddenly after head trauma and progresses rapidly. Symptoms include headache, neurological deficits, pupillary abnormalities, and decreasing consciousness. Diagnosis is made using CT or MRI scans. Treatment focuses on controlling increased intracranial pressure through medications, oxygenation, head elevation, and fluid management. Nursing care prioritizes impaired gas exchange and risk for cerebral hypoperfusion, while also addressing ineffective coping related to the trauma. A strict regimen of medications like Phenytoin, Lorazepam, Propofol, and Furosemide is needed as supportive
Palliative Care ~ Physiological Changes in DyingGerinorth
This document summarizes a tele-continuing nurse education session on physiological changes in dying. It discusses changes in several body systems as death approaches, including the circulatory, integumentary, neurological, respiratory, urinary and gastrointestinal systems. Key signs covered include decreased blood pressure and perfusion, mottled skin, decreased consciousness, irregular breathing patterns, and decreased appetite and urine output. The presentation emphasizes the importance of symptom relief, comfort, assurance and pacing care appropriately during this time.
This document discusses communication in palliative care. It defines communication and outlines types of verbal and non-verbal communication. It discusses skills for effective communication like listening, checking understanding, asking questions and answering questions. It also covers qualities needed for effective communication, barriers to communication, and considerations for communication with children and those with HIV/AIDS. Effective communication is important for providing quality palliative care.
Pericarditis is inflammation of the pericardium, the sac surrounding the heart. It causes sharp chest pain that worsens with certain movements or positions. While usually mild and self-limiting, pericarditis can be caused by infection, autoimmune diseases, injury, or other cardiac issues. Symptoms include chest pain and other signs like cough, fatigue, or palpitations. Treatment focuses on resolving the underlying cause, and complications may include fluid buildup around the heart or thickening/scarring of the pericardium if not addressed.
This document discusses pain assessment and management for people with advanced dementia. It notes that pain is underreported and undertreated in cognitively impaired older adults due to challenges in assessment. It recommends using behavioral observation scales to assess pain in people with dementia, and provides examples of assessment tools like the Doloplus-2 scale and Abbey Pain Scale. It also provides guidance on managing chronic pain in older adults with dementia, including starting low-dose regular analgesics and considering transdermal patches to provide steady doses.
Lecture 21: Psychological issues at the end of life Dr.Reem AlSabahAHS_student
This document discusses psychological issues at the end of life from a holistic perspective. It addresses the physical, emotional, social, psychological, and spiritual needs and concerns of dying individuals. Regarding physical needs, it discusses pain management, body image, and finding meaning in illness. Emotionally, it explores common fears, loss/grief, and positive emotions. Socially, it addresses concerns for loved ones and communication patterns. Psychologically, it focuses on maintaining control and contributing to others. Spiritually, it examines religion/spirituality, meaning of life/death, and hope. The document also introduces palliative care and its role in improving quality of life compared to hospice care. Finally, it provides an overview
1) Physical therapy can help manage common cancer symptoms like breathlessness, fatigue, and pain through various interventions including breathing retraining, graded exercise, positioning, modalities, and therapeutic exercises.
2) Assessment of symptoms is important for physical therapy, using tools like VAS, Borg scale, and evaluating factors like respiratory function, impairment, and impact on daily activities.
3) Management of symptoms involves a multifaceted approach including medical treatment, non-pharmacological interventions, education, relaxation, energy conservation techniques, and addressing psychosocial factors. The goals are to prevent impairments, maintain function, and improve quality of life.
This document provides an overview of key concepts in medical and surgical nursing related to death and dying, pathophysiology, and spirituality. It discusses frameworks for understanding grief and the stages of death, including Kubler-Ross' five stages of grief. It also covers nursing implications around end-of-life care, including providing comfort, addressing needs, and exploring choices. Palliative care aims to relieve suffering and improve quality of life. The document also discusses assessing and supporting patient spirituality through listening, conveying care, and suggesting practices like prayer.
This document discusses holistic approaches to managing cancer pain beyond just opioids. It outlines how pain affects the endocrine, metabolic, cardiovascular, pulmonary, gastrointestinal and musculoskeletal systems as well as psychological factors. A holistic assessment considers physical, social, psychological and spiritual needs of the patient. Non-drug approaches to pain discussed include cutaneous stimulation, distraction, relaxation, art therapy, acupuncture, therapeutic touch, TENS, and humor. While medications should be the primary therapy, non-drug methods can help manage pain by improving mood and reducing distress.
END OF LIFE CARE- all ages deserve quality end of life careSandhya C
End of life care involves supporting patients who are in the last months or years of life. It focuses on comfort rather than cure and can be provided by a team including physicians, nurses, social workers, counselors and others. The goals are to enhance quality of life, maintain function, relieve suffering and allow a natural death with dignity. Nurses play a key role in providing physical, psychosocial and spiritual support to dying patients and their families.
Section 6 assisting with end-of-life care (1)baxtermom
This document discusses end-of-life care, including the physical and emotional needs of dying persons, their families, and care of the body after death. It outlines the stages of dying according to Kübler-Ross, common comfort needs, signs that death is near, and post-mortem care procedures. Legal issues like advance directives determining treatment wishes are also addressed. The overall focus is on providing compassionate care and support for the dying individual and their loved ones.
The document discusses various topics related to aging and end of life, including:
1) Physical, psychological, and social changes that occur with aging, such as hearing loss, arthritis, menopause, and changing social roles.
2) Options for end of life care like hospice, palliative care, and advance directives to outline one's wishes for medical treatment.
3) The importance of coping with aging, illness, grief, and one's own mortality in order to fully embrace life.
This document provides an overview of end of life care, including defining end of life care and palliative care, identifying the target population, and differentiating between palliative care and hospice care. It discusses factors that influence attitudes towards death, decision making at end of life, barriers to good end of life care, and nursing skills needed to provide palliative care. The goal is to help students understand end of life care and how to support older adults and their families during this process.
Chronic illness health psychologist Alison Wearden talks about how stress effects our health and our recovery from illness, and specialist physiotherapist Phil Langridge talks about breathlessness and what we can do to control it.
Graham Atherton discusses gardening for those with allergies, the signs of heart disorder to be aware of if you are taking itraconazole and advice on travel.
The document discusses the physiological and psychological components of pain. It defines pain and outlines its pathway through the body, including its transmission through the nervous system and the factors that can influence pain perception. The document also examines different types of pain like acute, chronic, and neuropathic pain. It reviews various treatments for pain, including medications, holistic approaches, and physical activity. The consequences of ignoring pain are also mentioned.
The document discusses mood disorders including depressive disorders such as major depressive disorder and dysthymic disorder, as well as bipolar disorders. It covers the epidemiology, etiology, types, symptoms, nursing assessments, diagnoses, and treatment options for mood disorders. The treatment section addresses psychotherapy, pharmacotherapy, electroconvulsive therapy, and suicide assessment and intervention.
Out-patient Primary and Specialty Palliative CareMike Aref
Presentation on primary and specialty palliative care, covering what is palliative care, basics of primary palliative care including pain and symptom management, and referral criteria for out-patient specialty palliative care.
This document provides an introduction to medical-surgical nursing concepts. It discusses homeostasis and how the body maintains equilibrium during disease or stress. Stress is defined as having a stressor and a stress response from the body. Common stressors can be physiological, psychological, sociocultural, or environmental in nature. The body's stress response occurs in three stages: alarm, resistance, and exhaustion. Nurses aim to support patients' normal adaptive processes through supportive care methods like health education, explanations, and comfort measures. Rest, sleep, and biological cycles are also discussed in relation to stress and homeostasis.
Geriatric Population. Pain and Palliative Care for the Older (Geriatric) AdultMichelle Peck
Michelle Peck | Legal Nurse | Nurse Practitioner | Health Care | Geriatric | Consultant | Speaker | Educator | Researcher
During your journey through this slide deck of Geriatric Populations, Pain and Palliative Care for the Older (Geriatric) Adult, you will experience: the assessment of pain; pain management strategies; and learn more about Palliative Care services.
As a health care consumer it is important to recognize and be aware of the quality of life benefits of good pain and symptom control. This begins with a good assessment of the factors contributing to the pain. Pain is a multifaceted experience. There are many barriers to achieving effective pain control in the elderly (geriatric population). Health care providers need to be aware of personal biases surrounding pain for proper pain management. There are also many health care provider misconceptions regarding Palliative Care especially in the geriatric population.
To enrich your geriatric understanding, at the end of this slide deck we discuss Palliative Care: the relief you need when you are experiencing serious medical illness.
Learn it-Live it-Love it-Your path for a more informed life!
Michelle Peck | Legal Nurse | Nurse Practitioner | Health Care | Geriatric | Consultant | Speaker | Educator | Researcher
Motor Neurone Disease (MND) is an incurable neurological disorder that leads to progressive paralysis and death within a few years. Palliative care is involved from the time of diagnosis to help patients live as fully as possible by managing symptoms, providing support, and encouraging advance care planning. While there are limited treatment options to slow the disease, palliative care aims to enable patients and their families through a team approach that addresses physical, psychological, and spiritual needs during all stages of the disease.
The document discusses several topics related to stress and health, including:
1) Stress can cause physical illness, especially when stress is prolonged or combined with unhealthy behaviors, which may increase risks of diseases like heart disease.
2) Fields like health psychology study how stress, emotions, and behaviors influence disease risk and promote health and well-being.
3) Prolonged or chronic stress can have maladaptive effects on health, while moderate short-term stress can sometimes have positive effects.
An acute subdural hematoma is a brain injury involving the accumulation of blood between the dura and arachnoid layers covering the brain. It can occur suddenly after head trauma and progresses rapidly. Symptoms include headache, neurological deficits, pupillary abnormalities, and decreasing consciousness. Diagnosis is made using CT or MRI scans. Treatment focuses on controlling increased intracranial pressure through medications, oxygenation, head elevation, and fluid management. Nursing care prioritizes impaired gas exchange and risk for cerebral hypoperfusion, while also addressing ineffective coping related to the trauma. A strict regimen of medications like Phenytoin, Lorazepam, Propofol, and Furosemide is needed as supportive
Palliative Care ~ Physiological Changes in DyingGerinorth
This document summarizes a tele-continuing nurse education session on physiological changes in dying. It discusses changes in several body systems as death approaches, including the circulatory, integumentary, neurological, respiratory, urinary and gastrointestinal systems. Key signs covered include decreased blood pressure and perfusion, mottled skin, decreased consciousness, irregular breathing patterns, and decreased appetite and urine output. The presentation emphasizes the importance of symptom relief, comfort, assurance and pacing care appropriately during this time.
This document discusses communication in palliative care. It defines communication and outlines types of verbal and non-verbal communication. It discusses skills for effective communication like listening, checking understanding, asking questions and answering questions. It also covers qualities needed for effective communication, barriers to communication, and considerations for communication with children and those with HIV/AIDS. Effective communication is important for providing quality palliative care.
Pericarditis is inflammation of the pericardium, the sac surrounding the heart. It causes sharp chest pain that worsens with certain movements or positions. While usually mild and self-limiting, pericarditis can be caused by infection, autoimmune diseases, injury, or other cardiac issues. Symptoms include chest pain and other signs like cough, fatigue, or palpitations. Treatment focuses on resolving the underlying cause, and complications may include fluid buildup around the heart or thickening/scarring of the pericardium if not addressed.
Pneumonia is an inflammation of the lungs that is common but occurs more frequently in childhood. It can be caused by viruses, bacteria, fungi, or aspiration. Signs and symptoms include cough, fever, difficulty breathing, and chest pain. Treatment involves antibiotics, oxygen, fever medication, and careful monitoring by nurses. Complications can include respiratory distress, lung abscesses, or respiratory failure. Prevention involves vaccination, good nutrition, hygiene, and avoiding smoking.
The document summarizes Uganda's national health policies and plans over several decades. It outlines definitions of key terms like national health policy. It describes Uganda's transition from a project-based system damaged by conflict to developing long-term national health policies and plans beginning in the 1990s to guide health sector development. The National Health Policy II from 2011 aimed to improve access and quality of care. The Uganda National Minimum Health Care Package defines essential services. Subsequent health sector plans like HSSP and HSDP built on these policies and aimed to further reduce mortality and morbidity while increasing financial protection and progress toward universal health coverage.
The document outlines 20 principles for effective public health workers. Key principles include working as part of a team with other health workers, being responsible to health authorities, maintaining professional relationships, providing services to all people irrespective of attributes, being non-political and non-sectarian, never accepting gifts or bribes, basing services on need, providing reliable services and facilities, focusing work on families and communities, providing training, conducting evaluations, keeping records and reports, being qualified, providing training opportunities, maintaining job satisfaction, supervising nursing services, and developing professional interests while knowing the community served.
The document provides an overview of research, including definitions, characteristics, types, purposes and processes. It defines research as a systematic investigation to discover new information or reach a new understanding. The document outlines different types of research methods, including quantitative, qualitative, applied and fundamental research. It also discusses topics like health research, research proposals, and the roles of researchers and supervisors.
The document outlines Uganda's immunization schedule, including the target diseases, vaccines, dosages, and administration details. It provides recommendations for vaccinating against 14 diseases from birth through childhood and into adolescence/adulthood. Vaccines are administered on a routine schedule starting at birth or 6 weeks of age and include BCG, polio, diphtheria, pertussis, tetanus, hepatitis B, Hib, pneumococcal disease, rotavirus, measles, rubella, yellow fever, HPV and tetanus toxoid for women. The schedule aims to fully protect individuals from vaccine-preventable diseases through multiple doses of recommended vaccines.
Lymphadenitis is an inflammation of the lymph nodes that causes swelling and tenderness. It can be caused by bacterial, viral, fungal or parasitic infections spreading to the lymph nodes from another part of the body. Common infectious causes include Staphylococcus, Streptococcus, tuberculosis, HIV and Epstein-Barr virus. Non-infectious causes include lymphoma. Symptoms include hard, swollen or tender lymph nodes, itchy skin, redness, warmth or swelling in the affected area. Diagnosis involves physical examination, blood tests, scans and lymph node biopsy. Treatment depends on the cause but may include antibiotics, anti-inflammatories, surgery or chemotherapy and radiation for cancer cases.
Parkinson's disease is a neurodegenerative disorder caused by low dopamine and high acetylcholine levels in the basal ganglia. Symptoms include tremors, rigidity, bradykinesia, and gait abnormalities. Treatment aims to increase dopamine or block acetylcholine. Levodopa combined with carbidopa replaces dopamine but causes fluctuations. Dopamine agonists, MAO-B inhibitors like selegiline and rasagiline, and COMT inhibitors provide alternative treatment options with varying mechanisms of action and side effect profiles.
Marburg virus disease (MVD) is a severe and often fatal illness that causes viral hemorrhagic fever in humans. Symptoms include fever, severe headaches, vomiting, diarrhea, chest pain and cough. The virus is transmitted through direct contact with infected bodily fluids or contaminated surfaces, and health care workers are at risk without proper infection control. There is no approved vaccine and treatment is supportive, but community engagement is important to control outbreaks. The average fatality rate is around 50% but has varied between outbreaks.
Use of misoprostol for induction of labour mpdrs.pptxMaukiRichard2
This document provides guidelines on the use of misoprostol for induction of labour. It defines induction of labour and lists common indications for it such as preeclampsia, PROM, post-term pregnancy, and others. Contraindications include contracted pelvis, major placenta praevia, and previous C-section. Pre-requisites for safe induction are established, including gestational age confirmation, tests, and ensuring capacity for emergency care. Methods of induction discussed include mechanical and drug options, with misoprostol highlighted for its availability, stability, low cost, and ability to ripen the cervix and induce contractions when administered orally or vaginally. Guidelines are provided for the oral mis
5-hydroxytryptamine or 5-HT or Serotonin is a neurotransmitter that serves a range of roles in the human body. It is sometimes referred to as the happy chemical since it promotes overall well-being and happiness.
It is mostly found in the brain, intestines, and blood platelets.
5-HT is utilised to transport messages between nerve cells, is known to be involved in smooth muscle contraction, and adds to overall well-being and pleasure, among other benefits. 5-HT regulates the body's sleep-wake cycles and internal clock by acting as a precursor to melatonin.
It is hypothesised to regulate hunger, emotions, motor, cognitive, and autonomic processes.
Nano-gold for Cancer Therapy chemistry investigatory projectSIVAVINAYAKPK
chemistry investigatory project
The development of nanogold-based cancer therapy could revolutionize oncology by providing a more targeted, less invasive treatment option. This project contributes to the growing body of research aimed at harnessing nanotechnology for medical applications, paving the way for future clinical trials and potential commercial applications.
Cancer remains one of the leading causes of death worldwide, prompting the need for innovative treatment methods. Nanotechnology offers promising new approaches, including the use of gold nanoparticles (nanogold) for targeted cancer therapy. Nanogold particles possess unique physical and chemical properties that make them suitable for drug delivery, imaging, and photothermal therapy.
Computer in pharmaceutical research and development-Mpharm(Pharmaceutics)MuskanShingari
Statistics- Statistics is the science of collecting, organizing, presenting, analyzing and interpreting numerical data to assist in making more effective decisions.
A statistics is a measure which is used to estimate the population parameter
Parameters-It is used to describe the properties of an entire population.
Examples-Measures of central tendency Dispersion, Variance, Standard Deviation (SD), Absolute Error, Mean Absolute Error (MAE), Eigen Value
The biomechanics of running involves the study of the mechanical principles underlying running movements. It includes the analysis of the running gait cycle, which consists of the stance phase (foot contact to push-off) and the swing phase (foot lift-off to next contact). Key aspects include kinematics (joint angles and movements, stride length and frequency) and kinetics (forces involved in running, including ground reaction and muscle forces). Understanding these factors helps in improving running performance, optimizing technique, and preventing injuries.
Pictorial and detailed description of patellar instability with sign and symptoms and how to diagnose , what investigations you should go with and how to approach with treatment options . I have presented this slide in my 2nd year junior residency in orthopedics at LLRM medical college Meerut and got good reviews for it
After getting it read you will definitely understand the topic.
These lecture slides, by Dr Sidra Arshad, offer a simplified look into the mechanisms involved in the regulation of respiration:
Learning objectives:
1. Describe the organisation of respiratory center
2. Describe the nervous control of inspiration and respiratory rhythm
3. Describe the functions of the dorsal and respiratory groups of neurons
4. Describe the influences of the Pneumotaxic and Apneustic centers
5. Explain the role of Hering-Breur inflation reflex in regulation of inspiration
6. Explain the role of central chemoreceptors in regulation of respiration
7. Explain the role of peripheral chemoreceptors in regulation of respiration
8. Explain the regulation of respiration during exercise
9. Integrate the respiratory regulatory mechanisms
10. Describe the Cheyne-Stokes breathing
Study Resources:
1. Chapter 42, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 36, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 13, Human Physiology by Lauralee Sherwood, 9th edition
Breast cancer: Post menopausal endocrine therapyDr. Sumit KUMAR
Breast cancer in postmenopausal women with hormone receptor-positive (HR+) status is a common and complex condition that necessitates a multifaceted approach to management. HR+ breast cancer means that the cancer cells grow in response to hormones such as estrogen and progesterone. This subtype is prevalent among postmenopausal women and typically exhibits a more indolent course compared to other forms of breast cancer, which allows for a variety of treatment options.
Diagnosis and Staging
The diagnosis of HR+ breast cancer begins with clinical evaluation, imaging, and biopsy. Imaging modalities such as mammography, ultrasound, and MRI help in assessing the extent of the disease. Histopathological examination and immunohistochemical staining of the biopsy sample confirm the diagnosis and hormone receptor status by identifying the presence of estrogen receptors (ER) and progesterone receptors (PR) on the tumor cells.
Staging involves determining the size of the tumor (T), the involvement of regional lymph nodes (N), and the presence of distant metastasis (M). The American Joint Committee on Cancer (AJCC) staging system is commonly used. Accurate staging is critical as it guides treatment decisions.
Treatment Options
Endocrine Therapy
Endocrine therapy is the cornerstone of treatment for HR+ breast cancer in postmenopausal women. The primary goal is to reduce the levels of estrogen or block its effects on cancer cells. Commonly used agents include:
Selective Estrogen Receptor Modulators (SERMs): Tamoxifen is a SERM that binds to estrogen receptors, blocking estrogen from stimulating breast cancer cells. It is effective but may have side effects such as increased risk of endometrial cancer and thromboembolic events.
Aromatase Inhibitors (AIs): These drugs, including anastrozole, letrozole, and exemestane, lower estrogen levels by inhibiting the aromatase enzyme, which converts androgens to estrogen in peripheral tissues. AIs are generally preferred in postmenopausal women due to their efficacy and safety profile compared to tamoxifen.
Selective Estrogen Receptor Downregulators (SERDs): Fulvestrant is a SERD that degrades estrogen receptors and is used in cases where resistance to other endocrine therapies develops.
Combination Therapies
Combining endocrine therapy with other treatments enhances efficacy. Examples include:
Endocrine Therapy with CDK4/6 Inhibitors: Palbociclib, ribociclib, and abemaciclib are CDK4/6 inhibitors that, when combined with endocrine therapy, significantly improve progression-free survival in advanced HR+ breast cancer.
Endocrine Therapy with mTOR Inhibitors: Everolimus, an mTOR inhibitor, can be added to endocrine therapy for patients who have developed resistance to aromatase inhibitors.
Chemotherapy
Chemotherapy is generally reserved for patients with high-risk features, such as large tumor size, high-grade histology, or extensive lymph node involvement. Regimens often include anthracyclines and taxanes.
“Psychiatry and the Humanities”: An Innovative Course at the University of Mo...Université de Montréal
“Psychiatry and the Humanities”: An Innovative Course at the University of Montreal Expanding the medical model to embrace the humanities. Link: https://www.psychiatrictimes.com/view/-psychiatry-and-the-humanities-an-innovative-course-at-the-university-of-montreal
Know the difference between Endodontics and Orthodontics.Gokuldas Hospital
Your smile is beautiful.
Let’s be honest. Maintaining that beautiful smile is not an easy task. It is more than brushing and flossing. Sometimes, you might encounter dental issues that need special dental care. These issues can range anywhere from misalignment of the jaw to pain in the root of teeth.
Summer is a time for fun in the sun, but the heat and humidity can also wreak havoc on your skin. From itchy rashes to unwanted pigmentation, several skin conditions become more prevalent during these warmer months.
Travel vaccination in Manchester offers comprehensive immunization services for individuals planning international trips. Expert healthcare providers administer vaccines tailored to your destination, ensuring you stay protected against various diseases. Conveniently located clinics and flexible appointment options make it easy to get the necessary shots before your journey. Stay healthy and travel with confidence by getting vaccinated in Manchester. Visit us: www.nxhealthcare.co.uk
1. Carla Hunt, RN, BSN
“To live in hearts we leave behind is not to die”
Thomas Campbell
2. Realities of Care
Rapidly aging U.S. population
Medical care has limitations and inappropriate use
of advanced technology to prolong life when death
is inevitable (Peaceful Death: Recommended Competencies and Curricular
Guidelines for End-of-Life Care, 1997).
Exorbitant expense is associated with futile care
2.5 million U.S. deaths have been negotiated
annually while life-extending/sustaining
measures were provided (Tilden & Thompson, 2009).
3. Palliative Care
Intends to improve the quality of life for patients and
families faced with life-limiting illness (World Health Organization,
2012).
Provides support in chronic illness: cardiac (CHF),
pulmonary (COPD), renal disease, cancer, immune
suppression, HIV/AIDS , dementia, traumatic injury
(McLean-Heitkemper, 2011).
Care or treatment that reduces or controls symptoms
instead of seeking cure or efforts to delay death.
4. Palliative Care
Begins after the patient receives the diagnosis
of life-limiting illness.
Goals:
Prevent and relieve patient suffering
Improve quality of life
Timeframe includes hospice, end-of-life, and
bereavement.
Generally precedes hospice.
Hospice philosophies are the foundation of
palliative care.
McLean-Heitkemper, 2011
5. Hospice
Holistic, compassionate care for the dying and their family
during terminal illness.
Hospice Medicare eligibility requires a prognosis of less
than six months life expectancy.
Provides supportive care for patients in the last phase of
incurable disease. Palliative focus instead of curative.
Preserves dignity and quality of life throughout the dying
process.
Focuses on symptom management, advanced care
planning, spiritual care, family support, and bereavement.
McLean-Heitkemper 2011
6. Hospice
Addresses physical, emotional, social, and spiritual
needs of patients and families.
Collaborative and coordinated care via
interdisciplinary team members.
Care team includes: physicians, pharmacist, nurses,
nursing assistants, chaplain, volunteers, social worker,
and bereavement coordinator.
Services offered in the home, hospital, residential
care center, and nursing home.
McLean-Heitkemper 2011
7. End-of-Life
Generally refers to care in the final phase of illness
when the patient is near death or actively dying.
EOL care may be a few hours, weeks, or months .
The timeframe from diagnosis to death varies by
diagnosis and disease extensiveness.
Institute of Medicine considers EOL as the time of
coping with terminal illness or advanced age even
if death is not clearly imminent.
McLean-Heitkemper, 2011
8. Goals of EOL Care
Comfort and supportive care for the patient
and family during the dying process.
Improved quality of life for the life that
remains.
Dignified and peaceful death.
Emotional support for both patient and family.
McLean-Heitkemper, 2011
9. Consider for a moment…..
How would your life change if you learned
you would die in the next 12 months, six
months, or one month? (Sherman, Matzo, Panke, Grant, Rhome ,
2003)
What would you want to do if you were
diagnosed with a terminal condition?
How would you need to do to prepare?
Never loose sight of how very personal this
is for the patient and family!
10. When will death occur?
Prognosis is influenced by disease, desire to
live, and sometimes anticipation of special
events (Sherman, Matzo, Pitorak, Ferrlll, Malloy, 2005).
Not all patients experience the same
symptoms as there is no specific sequence
(McLean-Heitkemper , 2011).
Death results when all vital organ function
stops (cardiac, respiratory, and brain).
11. Brain Death
No brain or brainstem function.
Cerebral cortex no longer functions or is
irreversibly damaged.
Clinical brain death in the ICU—heart continues
to beat (intubation with mechanical ventilation).
Legal definition—brain function must cease for
brain death to be pronounced and life support
removed.
McLean-Heitkemper 2011
12. Death Draws Near:
Physical Manifestations
Slowed metabolism and impaired organ function
that leads to multi-system failure and organ shut-
down.
Respirations are usually the first to stop.
Heart usually stops within a few minutes of
respirations.
McLean-Heitkemper 2011
13. Death Draws Near:
Physical Manifestations cont.
Sensory:
Decreased sensation
Decreased ability to perceive pain and touch
Poor sense of taste and smell
Eyes: blurred vision, absent blink reflex,
sunken, glazed over, blank stare, slit eye lids
Loss of hearing (last sense to loose)
Inability to respond
McLean-Heitkemper, 2011
14. Death Draws Near:
Physical Manifestations cont.
Respiratory: (distress and air hunger common)
Rapid, slow, shallow, irregular breathing
Cheyne-Stokes respirations (alternating apnea
and deep, rapid respirations)
Slowed respirations “terminal gasps” or “guppy
breaths”
Unable to cough and clear secretions
Noisy, gurgling secretions audible without a
stethoscope, “death rattle”
McLean-Heitkemper, 2011
15. Death Draws Near:
Physical Manifestations
Cardiovascular:
Increased heart rate that begins to slow
Weak or absent pulses
Progressive decrease in blood pressure
Delayed absorption of injected medications
Irregular rhythm
McLean-Heitkemper 2011
16. Death Draws Near:
Physical Manifestations cont.
Urinary:
Decreasing output
Incontinent
Inability to void
Gastrointestinal:
Decreased motility and peristalsis
Abdominal distention, nausea, and constipation
Loss of sphincter control makes incontinence common
as death occurs.
McLean-Heitkemper 2011
17. Death Draws Near:
Physical Manifestations cont.
Musculoskeletal:
Severe weakness and inability to move
Relaxed facial tone—jaw drop, difficulty/inability
to speak and/or swallow
Poor body posturing and alignment
Impaired gag reflex
Myoclonus (involuntary jerking commonly seen
with high-dose opioids)
McLean-Heitkemper 2011
18. Death Draws Near:
Physical Manifestations cont.
Integumentary:
Cold, clammy, diaphoretic, fever
Cyanosis of nose, nail beds, ears
Mottling of hands, feet, toes, arms, legs, and
knees
Skin may have wax-like appearance
McLean-Heitkemper 2011
19. Death Draws Near:
Psychosocial Manifestations cont.
Conflicting decisions
Anxiety regarding things left undone
Feelings of meaningless life contributions
Fear of pain or shortness of breath
Loneliness
Helplessness
Depression
McLean-Heitkemper 2011
20. Death Draws Near:
Psychosocial Manifestations cont.
Anticipatory grieving
Difficulty saying goodbye
Reminiscent of life’s events
Fear of loss of independence and functional
decline
Recognized condition deterioration that patient
correlates with approaching death
Restlessness
Inability to understand communication
McLean-Heitkemper 2011
21. Confusion-Disorientation-Delirium
Management
Determine etiology—Disease progression, fever,
nearing death awareness, opioid effects, full
bladder , hypoxia, metabolic imbalances, toxin
accumulation due to liver or renal failure.
Management—Assess cause and treat, safety
precautions, administer sedatives, speak truthfully
regarding condition, provide spiritual and
emotional support, assess for caregiver fatigue.
McLean-Heitkemper 2011; Sherman et al., 2005
22. Dyspnea Management
Pharmacologic Nonpharmacologic
Opioids (morphine)
Bronchodilators (albuterol)
Diuretics (furosemide)
Benzodiazpines (lorazepam;
alprazolam)
Anxiolytics (buspirone)
Steriods (dexametasone, Solu-
Medrol)
Antibiotics
Oxygen if hypoxic
Fan for air circulation, cool
room temperature
Positioning, elevate head
of bead
Suctioning
Sherman et al., 2004
24. Fatigue-Weakness Management
Increased weakness
Interventions include:
Assist with ADL’s
Bedrest—ROM, turning, positioning, and skin
assessment.
Alter medication routes—least invasive and
most effective
Aspiration precautions
Suction
McLean-Heitkemper 2011; Sherman et al., 2004; Sherman et al., 2005
25. Pain Management
Patients fear that they will die in pain
Scheduled analgesia for pain control (long/short
acting)
Inability to swallow—consider alternate
administration routes
Interventions—massage, reposition,
bracing/splinting
Alternative/ complimentary therapies
Use standardized tools for pain assessment
McLean-Heitkemper 2011; Sherman et al., 2004
26. Comfort Care:
Actively Dying
Simple patient directions
Oral care—sips of fluid, mouth care, lip
moisturizer
Preventive skin care—manage incontinence, skin
barriers.
Medications to alleviate respiratory congestion,
agitation, pain, and dyspnea.
Antiemetics for discomfort associated with
nausea and vomiting.
Sherman et al., 2005
27. Care of the Spirit
May or may not mean religion
Spiritual support provides strength and
decreases despair at EOL
Pray with patient and family
Involve pastoral services
Recognize spiritual diversity and ritualistic
EOL practices
McLean-Heitkemper 2011
28. Emotional Support
Provide hope, comfort, and peacefulness (Matzo, Sherman, Sheehan,
Ferrell, & Penn, 2003).
Reassure the patient you will not abandon them
Ask yourself, “What would I do if this were my
family member?”
Provide realistic and honest information
Prepare for emotional decline and cognitive changes
Empathetic and compassionate care (McLean-Heitkemper, 2011)
Encourage sharing of life stories, memories, and life
contributions
Live your life until you die (Cramer, 2010).
29. Communication
Communication is 7% verbal, 38% tone, and 55% body
language (Cramer, 2010)
Be present, use eye contact and touch, sit at the bedside,
listen more than you talk.
Communicate with open acceptance (McLean-Heitkemper, 2011)
Create an environment that feels safe to share feelings and
express emotion. Silence is ok.
Nearing death awareness:
Patient may see or talk with a loved ones that have
died
Patient may provide instructions for those left
behind
30. Response to Loss
Grief is normal, healthy process of reacting to loss and adapting
to change.
Bereavement is the time after death when grief and mourning
occur
Factors that influence grief:
Personal characteristics
Relationship with the deceased
Life stressors
Coping resources
Support systems
Often begins prior to death
Powerful, affects all aspects of one’s life
Nurse may be the recipient of anger. Do not react or take it personal.
McLean-Heitkemper 2011; Sherman et al., 2003
31. Grief/Bereavement:
Response to loss
Poor concentration, persistent sadness, constant
thoughts of the one who died
Guilt, anger, abnormal behavior
Weight loss, poor appetite
Difficulty sleeping, palpitations
Anxiety, fear, loneliness, hopelessness,
powerlessness
McLean-Heitkemper 2011
32. Legal and Ethical Principles in
Complex EOL Care
Care determined by the patient’s wishes (McLean-Heitkemper ,2011)
Organ and tissue donations
Advance directives
Medical power of attorney or living wills
Resuscitation
The nurse must recognize how her/his personal beliefs,
values, and expectations influence EOL care (Matzo et al., 2003).
Fear of death, lack of experience , not knowing what to say,
unresolved grief, and disagreement with patient wishes
A nurse has an ethical responsibility to ensure everything
possible is done to provide a peaceful death.
33. Organ and Tissue Donation
Any part of the entire body may be
donated
Decision may be made prior to death but
family must consent at time of donation
Usually retrieved within a few hours after
death
Designated requestors at every hospital
McLean-Heitkemper 2011
34. Legal Documents:
Protect the Patient’s Wishes
Advance directives
Written statements of medical care wishes
Sometimes called a living will
Directive to physicians
Patient’s desire to accept or deny treatment
Durable power of attorney for health care
Lists the person to make health care decisions should a
patient become unable to make informed decisions for
self
McLean-Heitkemper 2011
35. Common Legal Documents
Do not resuscitate (DNR)
Orders instructing health care providers not to
perform CPR
Often requested by family
Must be signed by a physician to be valid
Purple bracelet placed on client
Push to change the term to allow natural death
(AND) to more clearly describe what occurs
McLean-Heitkemper 2011
36. Ethical Issues
Beneficence—To do good without causing harm.
Give effective amounts of timely pain medication.
Failure to give effective pain medication and adequate dosing
neglects the principles of beneficence.
Nonmaleficence—To “do no harm”. To refrain from causing
harm.
Effective pain control that alleviates suffering in the
terminally ill.
Under treatment of pain may be more harmful than the
presumed harmful side effects.
Secondary effects that may hasten death are ethically
justified.
Bernhofer, 2011
37. Postmortem Care
After patient is pronounced dead the nurse prepares or
delegates preparation of the body
If death is in a semi-private room—move the other patient
out
Considerations when preparing body:
Cultural and ritualistic practices
Adherence to policies and procedures
Close the patient’s eyes
Replace dentures
Wash the body as needed
Remove tubes and dressings
Straighten the body
Leave a pillow in place to support the head
McLean-Heitkemper 2011
38. Postmortem Care
Immediate family viewing and saying final
goodbye
Family should be allowed privacy and as much
time as needed with the deceased loved one
Body may stay on the unit 2 hours
McLean-Heitkemper 2011
39. Special Needs of the Nurse
Recognize what can and cannot be
controlled
It is appropriate to cry with the patient and
family during the grieving process
Care for the dying is emotionally
challenging for everyone involved
It is common for nurse to feel helpless and
powerless
Feelings of sorrow, guilt, and frustration
need to be expressed
McLean-Heitkemper 2011
40. Nursing Management
Nursing Diagnoses: Psychosocial
Acute/ chronic confusion
Compromised family coping
Death anxiety
Disturbed thought processes
Spiritual distress
Ineffective denial
Interrupted family processes
Insomnia
41. Nursing Management
Nursing Diagnoses: Psychosocial
Fear
Grieving
Hopelessness
Impaired religiosity
Impaired social interaction
Impaired verbal communication
Ineffective coping
Readiness for enhanced spiritual
well-being
Risk for loneliness
Social isolation
43. Nursing Management
Nursing Diagnoses: Physical
Fatigue
Imbalanced nutrition: less than body requirements
Impaired bed mobility
Impaired comfort
Impaired gas exchange
Impaired oral mucous membrane
Impaired skin integrity
Impaired swallowing
44. Nursing Management
Nursing Diagnoses: Physical
Ineffective breathing pattern
Ineffective thermoregulation
Ineffective tissue perfusion
Nausea
Risk for aspiration
Risk for infection
Risk for injury
Self-care deficit
Total urinary incontinence
45. Resources
American Cancer Society (http:/www.cancer.org)
National Hospice and Palliative Care Organization
(http://www.nhpco.org)
Hospice and Palliative Nurses Association
(http://www.hpna.org)
Oncology nursing Society (http://ons.org)
Journal of Supportive oncology: Quality of Life/Symptom
Management/Palliative care
(http://www.supportiveoncology.net)
End of Life Nursing Education Consortium From the
American Association of College of Nursing
(http://www.aacn.nche.edu/elnec/curriculum.htm)
46. References
Ackley, B.J. & Ladwig, G.B. (9th ed). Nursing diagnosis handbook: An evidence-
based guide to planning care. Mosby.
American Association of Colleges of Nursing. (2004). Peaceful death:
Recommended competencies and curricular guidelines for end-of-life nursing
care. Retrieved from
http://www.aacn.nche.edu/Publications/deathfin.htm
Bernhofer, E. (2011). Ethics: Ethics and pain management in hospitalized patients.
The Online Journal of Issues in Nursing, 17(1). doi:
10.3912/OJN.Vol17No01EthCol01
Cramer, C. F. (2010). To live until you die: Quality of life at the end of life. Clinical
Journal of Oncology Nursing, 14(1), 53-56. doi: 10.1188/10.CJON.53-56
Matzo, M. L., Sherman, D. W., Lo, K., Egan, K. A., Grant, M., & Rhome, A. (2003).
Strategies for teaching loss, grief, and bereavement. Nurse Educator, 28(2), 71-
76. doi: 10.1097/00006223-200303000-00009
Matzo, M. L., Sherman, D. W., Nelson-Marten, P., Rhome, A., & Grant, M. (2004).
Ethical and legal issues in end-of-life care: content of the End-of-life Nursing
Education Consortium Curriculum and teaching strategies. Journal for Nurse
in Staff Development, 20(2), 59-66. doi: 10.1097/00124645-20040300-00001
47. References
McLean-Heitkemper, M. (2011). Palliative care at the end-of-life. In S. L. Lewis, S. Ruff-
Dirksen, M. McLean-Heitkemper, L. Bucher, & I. M. Camera (Eds.), Medical-
surgical nursing: Assessment and management of clinical problems (pp. 153-166). St.
Louis, MO: Mosby.
Sherman, D. W., Matzo, M. L., Coyne, P., Ferrell, B. R., & Penn, B. K. (2004). Teaching
symptom management in end-of-life care: The didactic content and teaching
strategies based on the End-of-Life Nursing Education Curriculum. Journal for
Nurses in Staff Development, 20(3), 103-115. doi: 10.1097/00124645-200405000-00001
Sherman, D. W., Matzo, M. L., Panke, J., Grant, M., & Rhome, A. (2003). End-of-Life
Nursing Education Consortium Curriculum: An introduction to palliative care.
Nurse Educator, 28(3), 111-120. doi: 10.1097/00006223-200305000-00004
Sherman, D. W., Matzo, M. L., Pitorak, E., Ferrell, B. R., & Malloy, P. (2005).
Preparation and care at the time of death: Content of the ELNEC Curriculum and
teaching strategies. Journal for Nurses in Staff Development, 21(3), 93-100. doi:
10.1097/00124645-200505000-00003
Tilden, V. P., & Thompson, S. (2009). Policy issues in end-of-life care. Journal of Professional
Nursing, 25(6), 363-368. doi: 10.1016/j.profnurs.2009.08.005
World Health Organization. (2012). http://www.who.int/cancer/palliative/en/