Outline the pathophysiology changes that are associated with a…

QuestionAnswered step-by-stepOutline the pathophysiology changes that are associated with a…   Outline the pathophysiology changes that are associated with a life-limiting illness and the needs of the dying person  in regards to 2 common issues – Dyspnoea and Cachexia Anorexia Syndrome. Note: Pathophysiology is not signs and symptoms. Pathophysiology explains the processes within the body that result in the signs and symptoms of a disease. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  DyspnoeaPathophysiology……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. Management ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  Cachexia Anorexia SyndromePathophysiology ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  Management  ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..   Discuss the impact that loss and grief can have on the patient  family including psychosocial impact………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  Discuss the impact that loss and grief can have on staff members………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  Identify signs and symptoms of respiratory difficulties. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  Identify signs and symptoms of swallowing difficulties. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  outline 4 strategies that can assist in the management for end of life care in regards to respiratory and swallowing issues………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..   Research the specific state you live in, (QLD) discuss the specific components of their advanced care planning and the process for notification of death.State                        Specific documents         http://palliativecare.org.au/support-and-services/advance-care-planning/  Notification of death. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  Advance Care Directives – what are they and why are they used, including legal and ethical implications ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..   Discuss 3 reasons a patient or family may wish to continue or not continue with nutrition and hydration at the end-of-life. ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………  Outline your own role and responsibilities as the Enrolled Nurse and those of other team members involved when assisting in patient-centered palliative care planning.Own role…………………………………………………………………………………………………………………………. ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… Roles of other possible team members. ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… …………………………………………………………………………………………………………………………  Ms Lee a 62-year-old lady with progressive late stage breast cancer, is admitted to your ward for palliative care assessment, plus pain and wound management due to a tumour of the right breast which has developed into a fungating wound with infection, unpleasant odour, discharge and bleeding. Ms Lee identifies herself as an indigenous Australian (a person of Aboriginal or Torres Strait Islander descent).  She was born in Arnhem Land but moved firstly to a rural township in the Northern Territory before settling into her current home in a metropolitan city to be nearer to her only daughter and family. Her daughter is also unwell at the present and although she would like to look after her mother at home she is unable to. Miss Lee has been in respite care on and off but now finds it too hard to manage at home as her condition has deteriorated due to progression of her cancer and wound.  Discuss 4 management strategies that can be implemented for Ms Lee for the management of her non-healing malignant wound………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… ………………………………………………………………………………………………………………………… Ms Lee has now been on the Palliative Care ward for a week.  Her condition has deteriorated in the past few days and is she is now bed bound and the care team have commenced a syringe driver for continuous pain relief. She has difficulty breathing and swallowing and is therefore refusing nutrition as she has decided she wishes to die. Her daughter has been able to be by her side intermittently over the past 2 days as Ms Lee’s death is imminent. She is not there at the time of her death however.Ms Lee has had an advanced care directive where she states she is not to be resuscitated, ventilated, artificially hydration, have artificial nutrition, antibiotics or provided with any treatment to prolong her life. She has also stated that she doesn’t wish to be an organ donor or receive any lifesaving blood transfusions. She also wishes for her daughter (if she is not present at the time) to be contacted regarding her death by an aboriginal liaison officer.The care team have created a care plan around these wishes and are planning to provide comfort and pain relief for Ms Lee.  Outline the indications and contraindications for use of syringe drivers for continuous infusion in administration of pain medication. Indications. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  Contraindications. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  Outline the indications for the use of intima / butterfly sub cut lines for intermittent / PRN pain relief, anti-nausea and or steroid injections………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  Various medications may be administered to a palliative patient for their end-of-life-care. These may be via a syringe driver as a continuous infusion or intermittent via a subcutaneous line depending on doctor orders and advanced care plan. These medications can include ones for pain, anti-nausea or be steroid based. Outline the reasons for use at the end-of-life care for the 5 medications listed in the table.Medication  Reasons for use in end-of-life care Midazolam    Dexamethasone    Maxolon    Morphine    hyoscine    Discuss 3 common non-pharmaceutical and complementary care that many contribute towards the holistic care of the patient alongside analgesia……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..   Outline 3 strategies you may like to implement that would show how you can support the dignity of Ms Lee when undertaking all care activities in her end-of-life stages as well as after her death………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  In accordance with Ms Lee’s Advanced Care Directive she is to be kept comfortable and provided with adequate pain relief. Identify the signs of a person’s deterioration or imminent death and how would you report these signs………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  Outline your roles and responsibilities when caring for a person in general, after death. Include what standard precautions are needed and why and who is to be notify when a person dies within a care facility………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  Outline the appropriate cultural and spiritual care of the death of an Aboriginal person………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  Outline 4 ways for each of the 2 areas below, as to how you can provide the person, family or carer with opportunities to discuss spiritual and cultural issues in an open and non-judgmental manner. Spiritual……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. Cultural ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..   Due to diversity in culture, spiritual or religious factors that underpin a person choices in an advanced care directive at end-of-life, conflicts can arise especially around issues such as organ donation and autopsy’s. Discuss 3 ways an advanced health Directive can reduce conflicts that may occur in regards to the above………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ………………………………………………………………………………………………………………..  Diversity in culture, spiritual or religious factors underpin a person’s choices at end-of-life. Discuss how advanced care directives may affect their decisions, including issues such as organ donation and request for autopsy………………………………………………………………………………………………………………… ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. ……………………………………………………………………………………………………………….. Health ScienceScienceNursingHLT ENN003Share Question

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