5.3.4: FRAME 4- Generate Solutions
- Page ID
- 90255
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Question Type: Drop-down Cloze
Scoring: 0/1
NCSBN Item Type and Scoring: https://www.ncsbn.org/public-files/p...main_stage.pdf
The nurse identifies changes in Rhys condition. Complete the sentence below by selecting word choices from the box provided.
Rhys is exhibiting signs of 
.
The nurse should assess 
, 
, , and 
.
RATIONALE
The nurse plays a significant role in end-of-life care. The nurse’s interactions and leadership can influence the perception of death and how the family deals with death of their loved one. The American Nurses Association position statement on the nurses’ roles and responsibilities in providing care and support at the end-of-life states,
Nurses are obliged to provide comprehensive and compassionate end-of-life care. This includes recognizing when death is near and conveying that information to families. Nurses should collaborate with other members of the health care team to ensure optimal symptom management and to provide support for the client and family. Nurses and other health care providers have a responsibility to establish decision-making processes that reflect physiologic realities, client preferences, and the recognition of what, clinically, may or may not be accomplished. Establishing goals of care for this client at this time may provide a framework for discussion about what care should be provided. This process often involves collaboration with experts in decision making, such as ethics committees or palliative care teams (ANA, 2016).
FOCUSED GUIDE
In advanced illness, confusion and terminal restlessness or agitation are common. It is estimated that between 25 and 85 percent of individuals who are dying, experience symptoms associated with restlessness before death. Terminal agitation or restlessness can be defined as agitated delirium with cognitive impairment. It tends to occur frequently at the end stage of cancer. The main symptoms are agitation, myoclonic jerks or twitching, irritability, and impaired consciousness. Other symptoms include hallucinations, paranoia, confusion, and disorientation.
The American Nurses Association (ANA) position statement on the Nurses’ Roles and Responsibilities in Providing Care and Support at the End-of-life addresses the background, practice, education, research, and administrative roles in end-of-lifecare. Have students review and apply the concepts to the case study. The ANA position statement can be found at https://www.nursingworld.org/~4af078...nstatement.pdf
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 as well as 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 that focus on person-centered care can improve health outcomes by recognizing the SDOH that adversely affect health outcomes.