4.3.4: FRAME 4- Generate Solutions
- Page ID
- 90024
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The hospice nurse returns to Rhys’ house the next morning and recognizes Rhys is transitioning. The nurse talks with the family about comfort care measures for Rhys during this time.
QUESTION: Drop-Down Cloze
Scoring Rule: 0/1
The nurse identifies changes in Rhys condition. Complete the sentence below by selecting word choices from the box provided.
| Word Choices |
|---|
| Terminal restlessness |
| Moaning sounds |
| Urinary output |
| Pain |
| Anxiety |
| Comfort care measures |
| Respiratory rate |
Putting It All Together
DEBRIEF
The nurse should discuss comfort care methods with the family. The family may choose to assist in providing care for Rhys. Comfort care actions are dependent on the symptoms Rhys is experiencing. For example, if he is febrile, comfort care includes removing blankets, applying cold compresses, or using a fan to decrease his core body temperature.
If Rhys is demonstrating signs of pain or difficulty breathing, positioning from side to side can help to drain oral secretions and provide comfort. Hyoscyamine may be administered to decrease saliva production. The nurse should reposition the client on their side. Elevating the head of the bed can help keep the client comfortable and aid in performing mouth care. Assess pain management before changing position and observe for nonverbal signs of pain when positioning and providing care. The nurse should encourage the family to communicate if they sense Rhys may need medication to help alleviate pain or anxiety.
Generally, it is important to talk to the client while providing cares. Hearing is widely thought to be the last sense to go during the process of active death. Many people become unresponsive during the final hours of life; however, EEG data revealed that the dying brain responds to sounds throughout the final moments of life (University of British Columbia, 2020).
RECOGNIZING SOCIAL DETERMINANTS OF HEALTH (SDOH)
Addressing SDOH encompasses a holistic assessment of the client and their family. The AACN Essentials (2011) recognize the nurses’ role beyond the acute care setting. This case study addresses hospice/palliative/supportive care. This sphere of care includes end-of-life care and palliative and supportive care for individuals requiring extended care, those with complex, chronic disease states, or those requiring rehabilitative care. This holistic approach incorporates the domain of person-centered care, which focuses on the individual within multiple complicated contexts, including family and/or important others. Person-centered care is holistic, individualized, just, respectful, compassionate, coordinated, evidence-based, and developmentally appropriate. Person-centered care builds on a scientific body of knowledge that guides nursing practice regardless of specialty or functional area. Care provisions focusing on person-centered care can improve health outcomes by recognizing the SDOH that adversely affects health outcomes.
What Do You Think About?
- What is terminal restlessness?
- What are five comfort care measures that can be employed for Rhys during his end-of-life transition?
- In addition to comfort care measures for Rhys, what are other considerations should the nurse be cognizant of during the end-of-life transition?