Question 12:
Use the symptoms listed on the Qld Health Residential Aged Care End of Life Pathway (Moodle resource) to:
a) List eight (8) symptoms and explain the management and clinical nursing skills required to relieve these for Penny.
) Explain the management and clinical nursing skills used in the wound care of her malignant
east lesion.
Question 13
Not all patients adhere to cultural protocols and traditions.
As the EN, how will you discover whether these protocols and traditions are relevant to your client?
Describe how would you raise these matters with the client or family?
Question 14
A patient you have been caring for and developed a close relationship with has just died. On hearing this news you experience a sense of loss.
Reflect on your feelings and discuss what personal strategies, values and attitudes you could use to help you cope with this situation. Include in your answer, social and community support systems
Question 15
Michelle is at end stage of her terminal illness. In the lead up to her final weeks Michelle has talked extensively with her husband, daughter and medical staff about what is to happen with her in her final hours before dying. As part of her planning she has discussed and signed an Advanced Care Directive (ACD) with her doctor and legal representative. In this she has indicated that she wants no interventions to extend her life. Her husband is her next of kin and appointed attorney. She has agreed to pain and symptom relief if required.
Explain what an Advanced Care Directive is.
Include: Who can use the form? When should it be used? Who has authority over its use?
Question 16:
You have been told at handover that Michelle’s death is imminent and likely to occur in the next few hours. She has become restless and her daughter feels she may be in pain. Her doctor has ordered a small subcutaneous dose of morphine which has just been given. When you enter her room to check on her, you see that her husband and daughter are present, and she is su
ounded by extended family. Her ex-husband and his two young children, and three of Michelle’s friends are huddled in the corner of the room crying. Her ex-husband is demanding that something be done.
As the EN caring for Michelle, describe what would you do in this situation?
Include in your answer two strategies you could use to improve this situation?
Question 17
Members of an elderly client’s family want to know if their mother has indicated how she intends to dispose of her estate.
Describe the EN’s role in relation to this request?
Question 18
Jane is 14 years old and is suffering a terminal illness. She is aware that her condition is deteriorating but still she feels her parents are not telling her the truth about her prognosis. You are assisting her in the shower one day when she says “I’m dying aren’t I?
Describe your response to her question?
Question 19:
Research and
iefly discuss the legal age of consent for medical treatment in Queensland.
Question 20
Nurses in Australia are governed by the International Council of Nurses (ICN) Code of Ethics for Nurses. https:
www.icn.ch/sites/default/files/inline-files/2012_ICN_Codeofethicsfornurses_%20eng.pdf
Identify the purpose of this code and explain how this code can be used to assist the nurse in decision making with regard to palliative care patients.
Consider the values expected of the nurse in your answer.
Question 21
Considering the ICN Code of Ethics for Nurses identify which value statement within the element which fits appropriately in the following situation:
Your patient identifies as a different culture to you and has listed specific requirements for care of his body after his death.
Question 22
Considering the ICN Code of Ethics for Nurses identify which value statement within the element fits appropriately in the following situation:
Your client is in pain and is refusing regular pain relief as he says he does not want to become ‘addicted’.
Question 23
Provide a definition of each type of pain.
1. Nociceptive pain
2. Neuropathic
Question 24
70 year old James has been admitted to your ward for pain control. He has a diagnosis of bowel cancer and treatment has required him to undergo extensive surgery and radiotherapy. He has a couple of good friends who visit him regularly. He lives alone and is no longer able to self-care. James does not engage in conversation and spends most of his time sleeping. He has become dis-interested with life. The Oncologist has explained to him that he is in the end stages of his disease and that all will be done to keep him comfortable and free from pain.
On admission you are the EN assigned to care for him, in collaboration/consultation with the RN address the following questions
Describe how you might provide an appropriate care environment for James, giving consideration to his cu
ent emotional and social situation, and evaluate the effectiveness of his care
Question 25
Your client is an Indigenous Elder and has received many visitors during his stay in hospital. His death is imminent.
As the EN with whom will you discuss final a
angements?
Include any protocols will need to be considered and why?
Question 26
Your patient is a Muslim woman from Syria and has strong religious beliefs. She is at the end stage of her life. Her two
others have recently a
ived from Syria to be with her and to offer support to the family.
Describe the Interpreter services that may be required for this family
Question 27
Using your cultural research skills:
a) Explain with whom you would be discussing the final a
angements with?
) Define the protocols relating to diet and grieving that would need to be observed for this client pre and post death.
Question 28:
All hospitals and nursing homes have policy and procedures relating to palliative care.
Use Queensland Health’s document Clinical Guidance for the Dying Patient (Moodle resource) to answer the following questions.
a) List who must be notified when your client dies, apart from the family members
) Explain two (2) pieces of information that can be provided to the person’s family or next of kin in order the help them move forward, both practically and emotionally.
Question 29
Explain the processes that may occur in accordance with organisation policy and procedures as a part of after death care.
Your response should address:
(a) Who determines the person is deceased?
(b) Who can request an autopsy?
Question 30
Research and
iefly explain the process of Organ and Tissue Donation.
· Study Note 1: RECOGNISE THE SPECIAL NEEDS OF A PERSON REQUIRING A PALLIATIVE APPROACH TO CARE
https:
moodle-vet.cqu.edu.au/pluginfile.php/694534/mod_resource/content/4/HLTENN010%20Element%201%20Study%20Guide%20Final%20%283%29.pdf
International Council of Nurses(ICN) Code of
https:
www.icn.ch/sites/default/files/inline-files/2012_ICN_Codeofethicsfornurses_%20eng.pdf
Palliative Care Standards
https:
palliativecare.org.au/wp-content/uploads/dlm_uploads/2018/11/PalliativeCare-National-Standards-2018_Nov-web.pdf
Residential Aged Care Palliative Approach Toolkit
https:
www.caresearch.com.au/CareSearch/tabid/3579/Default.aspx
Palliative Care - Symptom Assessment GuideFile
https:
moodle-vet.cqu.edu.au/pluginfile.php/694542/mod_resource/content/1/VPCNPC%20Symptom%20Assessment%20Guide%202011.pdf
· Study Note 2 : SUPPORT PERSON, FAMILY OR CARERS USING THE PALLIATIVE APPROACH
https:
moodle-vet.cqu.edu.au/pluginfile.php/694550/mod_resource/content/2/HLTENN010%20Element%202%20Study%20Guide%20%20%281%29.pdf
Residential Aged Care End of LIfe PathwayTop of FormBottom of Form
Queensland Health Residential Aged Care End of Life Pathway. Use this tool for symptom identification in the 'end of life' care and clinical management of them
https:
moodle-vet.cqu.edu.au/pluginfile.php/694539/mod_resource/content/2/Residential%20Aged%20Care%20End%20of%20Life%20Pathway.pdf
study note 3: IDENTIFY AND RESPOND TO SIGNS OF DETERIORATION AND THE STAGES OF DYING
A Guide to Understanding End-Of-Life Signs & Symptoms
Top of Form
Bottom of Form
This resource will assist you to answer your assessment questions around 'End of Life Signs and Symptoms' https:
www.crossroadshospice.com/hospice-caregiver-support/end-of-life-signs/
https:
www.caresearch.com.au/caresearch/tabid/1511/Default.aspx
Advanced Heath Directive
https:
www.qld.gov.au/law/legal-mediation-and-justice-of-the-peace/power-of-attorney-and-making-decisions-for-others/advance-health-directive
End-of- life care: Guidelines for decision-making about
withholding and withdrawing life-sustaining measures from adult patients
https:
www.health.qld.gov.au/__data/assets/pdf_file/0033/688263/acp-guidance.pdf
study note 4: CARE FOR THE PERSON'S BODY AFTER DEATH AND PROVIDE SUPPORT FOR THE FAMILY AND OTHERS.
What to do after someone dies.
Top of Form
Bottom of Form
Reviewing this material will assist you with your assessment in regards to care of a patient after death https:
www.qld.gov.au/health/support/end-of-life/after-death
Sad new So
y business: Guidelines for caring for Aboriginal and To
es Strait Islander people https:
www.health.qld.gov.au/__data/assets/pdf_file/0023/151736/so
y_business.pdf
Caring for Muslim Patients
https:
www.icv.org.au/caring-for-muslim-patients
stage note 5 PROVIDE FOR OWN SELF-CARE IN PALLIATIVE CARE ROLE.
Managing Self Care
Top of Form
Bottom of Form
Self care after caring for a dying person and their family is very important.
The following resources will assist in your assessment and implementing of self-carehttps:
www.caresearch.com.au/caresearch/tabid/2173/Default.aspx
Self Care and Staff Support
https:
www.palliaged.com.au/tabid/4316/Default.aspx Bottom of Formcar9n
· Study Note 1: RECOGNISE THE SPECIAL NEEDS OF A PERSON REQUIRING A PALLIATIVE APPROACH TO CARE
https:
moodle-vet.cqu.edu.au/pluginfile.php/694534/mod_resource/content/4/HLTENN010%20Element%201%20Study%20Guide%20Final%20%283%29.pdf
International Council of Nurses(ICN) Code of
https:
www.icn.ch/sites/default/files/inline-files/2012_ICN_Codeofethicsfornurses_%20eng.pdf
Palliative Care Standards
https:
palliativecare.org.au/wp-content/uploads/dlm_uploads/2018/11/PalliativeCare-National-Standards-2018_Nov-web.pdf
Residential Aged Care Palliative Approach Toolkit
https:
www.caresearch.com.au/CareSearch/tabid/3579/Default.aspx
Palliative Care - Symptom Assessment GuideFile
https:
moodle-vet.cqu.edu.au/pluginfile.php/694542/mod_resource/content/1/VPCNPC%20Symptom%20Assessment%20Guide%202011.pdf
· Study Note 2 : SUPPORT PERSON, FAMILY OR CARERS USING THE PALLIATIVE APPROACH
https:
moodle-vet.cqu.edu.au/pluginfile.php/694550/mod_resource/content/2/HLTENN010%20Element%202%20Study%20Guide%20%20%281%29.pdf
Residential Aged Care End of LIfe PathwayTop of FormBottom of Form
Queensland Health Residential Aged Care End of Life Pathway. Use this tool for symptom identification in the 'end of life' care and clinical management of them
https:
moodle-vet.cqu.edu.au/pluginfile.php/694539/mod_resource/content/2/Residential%20Aged%20Care%20End%20of%20Life%20Pathway.pdf
study note 3: IDENTIFY AND RESPOND TO SIGNS OF DETERIORATION AND THE STAGES OF DYING
A Guide to Understanding End-Of-Life Signs & Symptoms
Top of Form
Bottom of Form
This resource will assist you to answer your assessment questions around 'End of Life Signs and Symptoms' https:
www.crossroadshospice.com/hospice-caregiver-support/end-of-life-signs/
https:
www.caresearch.com.au/caresearch/tabid/1511/Default.aspx
Advanced Heath Directive
https:
www.qld.gov.au/law/legal-mediation-and-justice-of-the-peace/power-of-attorney-and-making-decisions-for-others/advance-health-directive
End-of- life care: Guidelines for decision-making about
withholding and withdrawing life-sustaining measures from adult patients
https:
www.health.qld.gov.au/__data/assets/pdf_file/0033/688263/acp-guidance.pdf
study note 4: CARE FOR THE PERSON'S BODY AFTER DEATH AND PROVIDE SUPPORT FOR THE FAMILY AND OTHERS.
What to do after someone dies.
Top of Form
Bottom of Form
Reviewing this material will assist you with your assessment in regards to care of a patient after death https:
www.qld.gov.au/health/support/end-of-life/after-death
Sad new So
y business: Guidelines for caring for Aboriginal and To
es Strait Islander people https:
www.health.qld.gov.au/__data/assets/pdf_file/0023/151736/so
y_business.pdf
Caring for Muslim Patients
https:
www.icv.org.au/caring-for-muslim-patients
stage note 5 PROVIDE FOR OWN SELF-CARE IN PALLIATIVE CARE ROLE.
Managing Self Care
Top of Form
Bottom of Form
Self care after caring for a dying person and their family is very important.
The following resources will assist in your assessment and implementing of self-carehttps:
www.caresearch.com.au/caresearch/tabid/2173/Default.aspx
Self Care and Staff Support
https:
www.palliaged.com.au/tabid/4316/Default.aspx Bottom of Formcar9n