Deck 7: Palliative Care and Chronic Disease Management

Question 1

Discuss themes and goals related to of palliative care.

Answer 1

Palliative care is both a philosophy and a structure for the delivery of care. There are many definitions of palliative care; common themes through most definitions include (1) the addressing of symptoms to relieve and prevent suffering and improve one's quality of life in the face of serious illness; (2) the inclusion of the patient and family caregivers; (3) facilitation of autonomy; and (4) access to information and choice with a team approach to the delivery of care. The themes of care do not preclude treatment of the underlying condition or illness. The overall goal of palliative care is to provide symptoms management, prevent and treat suffering, and maintain or improve one's quality of life for the patient and the family members

Question 2

Articulate the importance of implementing a goal-oriented process in palliative care.

Answer 2

Goal-setting discussions with patients and their caregivers is a critical part of the palliative care process. Use of a goal-oriented process facilitates communication and decision making. In addition, a goal-oriented process reduces patient uncertainty and promotes the patient's identification of desired health outcomes. Discussing goals serves to encourage patients and families to identify facilitators that will help patients reach their goals and barriers that may prevent goal attainment.

Question 3

Explain the concept of care transitions, including the role of the advanced practice nurse during transition times.

Answer 3

Care transitions represent changes in treatment approaches and philosophy due to progression or remission of a disease. Care transitions also are reflective of changes in the complexity level of healthcare services delivered to patients and their caregivers. For most patients, care transitions are associated with uncertainty, worry, and related physical, functional, and social adjustments. Advanced practice nurses play a central role in supporting patients and their caregivers through care transitions to reduce uncertainty, increase knowledge, and promote their self-management. For advanced practice nurses, transition times serve as opportunities for reassessing the goals of care, promoting key palliative care objectives of symptom management, advocating for patients and their family members, and facilitating consultation among members of the palliative care interdisciplinary team.

Question 4

The nurse practitioner (NP) is using the Quality of Life (QOL) model to conceptualize a patient's care. Which topic will the nurse practitioner include when addressing a primary domain of the QOL model?

A) Spiritual
B) Financial
C) Ethical
D) Moral

Question 5

Summarize the importance of collaboration to address the multidimensional nature of palliative care.

Question 6

When providing care to the patient diagnosed with anorexia and cachexia, which principle guides the nurse practitioner's approach to care?

A) Cachexia is most commonly associated with acute illnesses.
B) Research does not support the use of appetite stimulants.
C) Treatment of anorexia emphasizes addressing symptoms.
D) Mealtimes are often associated with cultural meaning.

Question 7

The nurse practitioner (NP) provides care to a patient diagnosed with lung cancer. When assessing the patient for dyspnea, which data is most important for the NP to consider?

A) The patient's respiratory rate is 24 breaths per minute.
B) The patient pauses to take a breath in between sentences.
C) The patient's oxygen saturation is 89% on room air.
D) The patient reports feeling short of breath.

Question 8

The nurse practitioner (NP) assesses an adult male patient who was recently diagnosed with metastatic brain cancer. Which patient assessment data is most reflective of fatigue?

A) The patient's hematocrit is 30%.
B) The patient reports a decrease in functional status.
C) The patient's hemoglobin level is 11 g/dL.
D) The patient reports taking several naps each day.

Question 9

The nurse practitioner (NP) assesses a patient for physical and psychosocial health alterations. Which patient assessment data is most consistent with a diagnosis of clinical depression?

A) Hopelessness one week after experiencing home foreclosure
B) Difficulty sleeping three weeks after discovering a breast lump
C) Helplessness five days after learning of the presence of a lung mass
D) Social isolation immediately after the loss of a pet

Question 10

Discuss the relationship between palliative care and hospice care.

Question 11

What are some common definitions of palliative care?

Question 12

Why is a goal -setting discussion important to have with a client requiring palliative care?

Question 13

What is the role of the nurse practitioner with care transitions?

Question 14

Which palliative care organizations are available for nurse practitioners to help with client care needs?