1.     Describe relevant terminology.

Hospice, Palliative care, Integrated hospice palliative care approach, End-of-life (EOL) care, Continuous palliative sedation.

2.     Contrast the approach of palliative care with disease modification therapy.

Illness trajectory, Goals, Focus of care, Presentation/Diagnosis.

3.     Recognize physical manifestations of the end of life and determine patient priority nursing problems (diagnoses).

Sensory, Cardiovascular, Respiratory, Genitourinary, Gastrointestinal,Musculoskeletal, Integumentary.

4.     Recognize psychosocial manifestations of the end of life and determine patient priority nursing problems (diagnoses).

Withdrawal, Communication, Vision-like experiences, Anxiety/Depression, Anger, Hopelessness, Powerlessness, and All types of fear.

5.     Outline the nurse’s responsibilities for assessment in the person at end of life.

Determining priorities in assessment.

Physical, Symptom (OPQRST), Social, Spiritual, Cultural.

6.     Implement appropriate nursing interventions and pharmacological treatment based on patient’s needs at end of life.

Psychosocial support of patient, family and caregivers.

Physical care: Pain, delirium, dysphagia, weakness, fatigue, dehydration, dyspnea, myoclonus, skin breakdown, bowel and urinary changes, anorexia, nausea and vomiting, candidiasis.

Analgesia, antiemetics, anticholinergic (glycopyrrolate), bronchodilators, oxygen, anxiolytics, antidepressants, topical treatments.

7.     Describe steps in post-mortem care. 

Pronouncement of death, Certification of death, Preparing the body.

8.     Identify special needs of nurses who provide end of life care.

Rewarding.

Challenging: Feelings of loss and grief manifested in physical and emotional ways. Must utilize interventions for coping to maintain well-being.