1. How can you identify the needs of your clients when approaching palliative care planning?
2. In your own words, describe the importance of palliative care for your clients with life limiting illnesses:
3. As an enrolled nurse, describe your role and responsibilities, and those of at least two other team members involved in palliative care:
4. you have a client, Mark, who is in the final stages of lung cancer, which has moved into his spine. He is experiencing pain (self-assessed at 8 out of 10) and asks you for pain relief.
. His doctor has provided an order to deliver morphine for pain relief. Mark also has orders for Dexamethasone and Ondansetron
a) When it is appropriate to / not to use a syringe driver or intima sub-cut line to deliver this pain medication?
b) What complementary care can you provide alongside this medication to help Mark with his pain?
c) What is the likely indication for Mark to have been prescribed Ondansetron?
d) Mark has also been prescribed Dexamethasone, what is this drug used for in palliative care?
5. what resources are available to those requiring grief and bereavement support (including the client, their family, carers and care team – particularly you)?
6. What is typically included in advance care directives (ACD) and how should this directive be followed?
7. Why is it important to consider the needs of the family or carers during the palliative approach to health care, and how can you determine their needs?
8. Describe the process of Advance Care Planning and developing Advance Care Directives (ACD)
9. Kübler-Ross described 5 stages of grief and loss. What are they, and how do they impact
· The palliative client
· Their family and carers
· Their care givers (nursing team)
10. When is an autopsy required as mandatory, and in what other cases may one be ordered?
11. People’s choices at the end of their life will be underpinned by a diverse range of cultural, religious and spiritual factors
a) What are your personal beliefs relating to what your end of life care should be?
b) Perform some research and provide five examples of requirements that end of life requests your clients may have that might conflict with your values?
c) How can you manage a client’s end of life care, when their beliefs and values don’t reflect your own?
12. What does legislation in Victoria require on notification of a death?
13. It is important to continue providing food and fluids to your clients in palliative care as long as they want them and can safely take them (are able to swallow for example). You are caring for Violet, who is starting to struggle with chewing her food and is finding it to be an effort to swallow.
Answer the following three different scenarios based on this information.
a) Violet is keen to continue being independent with her nutrition and hydration. What can you do to help her maintain this independence?
b) Violet is tired and doesn’t have the strength to eat anymore. How can you ensure that Violet is still hydrated and her nutrition requirements are met?
c) Violet has asked as part of her ACD that nobody provide her with artificial nutrition and hydration. She refuses to try eating. Her family are upset and want you to force her to eat. What should you do?
14. A client has not expressed their desires about organ donation in their ACD, and has died while in your care, what should you do?