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NURS 217 Health Assessment

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1.What historical developments have been most influential in shaping attitudes and beliefs about death and dying in western societies in the 20th century? Consider factors such as:
a) Scientific advances
b) Information technology
c) Health care developments
d) Demographic changes
e) Consumers
2. Think about how you and your immediate family react and respond to death and dying. What cultural or personal factors influenced the way you or your family reacted when someone close to you died?
If you haven't experienced the death of someone close to you, consider how you think it would make you feel?
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3. Describe the key elements of cultural safety.
4. What are some of the common concerns people facing life-limiting illnesses might have? Satisfactory Not Yet Satisfactory
5. What are some of the physical, psychological and social changes that could make a person with a lifelimiting illness feel a loss of control?
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6. What are the reasons that people often fear pain and other symptoms even when effective symptom management may be available? Satisfactory Not Yet Satisfactory
7. How do you define quality of life?
8. Why is it important for health care professionals to understand a person's perception of quality of life
and how it changes over time?
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9. The World Health Organization's (WHO) definition of palliative care states that palliative care 'is applicable early in the course of illness, in conjunction with other therapies that are intended to prolong life, such as chemotherapy or radiation therapy, and includes those investigations needed to better understand and manage distressing clinical complications'.
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10. Discuss what is meant by 'early in the course of a life-limiting illness'.
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11. How would you respond in a situation where a caregiver has asked you not to inform the patient about
their illness?
12. How do you respond to a patient who tells you that they have ‘had enough’ and no
longer want treatment?
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13. Review Palliative Care Australia's publication “Standards for providing quality palliative care for all
Australians” and identify the key points distinguishing the following definitions:
palliative approach
palliative care provider.
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14. What are the main issues for children when a parent has a life-limiting illness?
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15. How would you respond to a parent who is concerned about the effect of their illness on their children?
16. What are the potential barriers that may hinder discussions between health professionals and patients
about their distress?
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17. What strategies might a health care professional use to introduce sensitive issues, such as spirituality,
intimacy or sexuality?
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18. What might be some of the issues experienced by families and carers in the following
End-of-life care settings:
a) hospital
b) home
c) Hospice?
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19. Review the following terms and provide a definition for each:
a) life-limiting illness
b) illness trajectory
c) prognostic factors
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20. Choose one type of cancer (for example, lung cancer) and one non-cancer life-limiting illness (for
example, chronic heart failure). Research the literature and answer the following questions:
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21. Identify current epidemiological data relating to incidence and survival rates
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22. Identify classifications, staging, grading and/or prognostic factors
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23. What types of health problems or needs might arise throughout the course of the illness trajectory for
these conditions?
24. How are these trajectories similar or different to that of a frail older person who is dying?
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25. List the key principles for undertaking a multidimensional assessment of the symptoms for people with
advanced life-limiting disease?
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26. How would you describe the primary goals of palliative care?
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27. How can you assess a person’s preference for their care?
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28. What are some of the reasons that individuals with life-limiting illnesses may continue to have the goal
of cure?
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29. Visit the Respecting Patient Choices (RPC) website. Review the relevant legislation in conjunction
with the RPC Guide to Advance Care Planning.
Answer the following questions:
a) What are the steps that an individual would follow in order to participate in advance care
b) What are the implications of the legislation for you as a health professional?
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30. Select the most appropriate answer. Pain is often misunderstood and misjudged because it is:
a) objective and can only be measured through diagnostic data
b) subjective and cannot be objectively measured
c) self-reporting and objective in nature
d) the nurse is the best judge of the client’s pain
31. Select the most appropriate answer. What purpose does pain serve for individuals?
a) To provide gate control
b) To act as a protective mechanism
c) To minimise noxious stimuli
d) To limit movement
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32. Select the most appropriate answer. When objective and subjective data about a client’s pain are in
conflict, which report should the nurse consider to be the primary source?
a) Objective data
b) Subjective data
c) Combination of objective and subjective
d) Objective data and reports of family members
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33. Select the most appropriate answer. During the assessment process, the nurse must remain aware of
their own:
a) Pain levels and tolerance
b) Cultural values
c) Values and expectations of pain behaviours
d) Understanding of types of pain
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34. Select the most appropriate multiple-choice answer. Which theory of pain proposes that pain can be
relieved by blocking the transmission of pain impulses to the brain by physical modalities and altering
the individual has thought processes, emotions or other behaviours?
a) Gate control theory
b) Kussmaul’s theory
c) Perception modulation
d) Transduction
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35. Read the following multiple answer question and select the most appropriate answer. Which type of drug has an addictive effect to analgesics?
a) Adjuvants
b) Anaesthesia
c) Narcotics
d) Opiates
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36. Read the following multiple answer question and select the most appropriate response. For the client
with cancer pain, what is the preferred route of providing pain medication?
a) Intramuscular
b) Intravenous
c) Oral
d) Transdermal
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37. Select the most appropriate answer. Which method of non-invasive pain relief focuses the client’s
attention on something other than the pain?
a) Cutaneous stimulation
b) Distraction
c) Guided imagery
d) Relaxation
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38. Select the most appropriate answer. Which of the following may occur as a side effect when
administering opiates?
a) Anxiety
b) Diarrhoea
c) Palpitations
d) Respiratory depression
39. Select the most appropriate answer. Which route of pain medication administration provides the
MOST rapid onset of pain relief?
a) Intramuscular
b) Intravenous
c) Oral
d) Transdermal
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40. List three (3) major functions of a multidisciplinary palliative care team.
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41. Describe how you could provide a warm, caring environment for a dying resident in an aged care
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42. What is an advance care plan and how will this assist a palliative care person as their condition
43. List five (5) physical symptoms associated with incurable illness.
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44. What nursing actions could help an emaciated individual whose pain is controlled but who cannot get
physically comfortable in bed?
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45. Describe five (5) ways you can promote a sense of wellbeing in the partner of a person who is dying in
the acute care hospital setting.
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46. Undertake research on one (1) of the following complementary/alternative therapies listed below.
You are required to identify for this therapy what it is, how this style of therapy could be used as part of a therapeutic regime for a client’s comfort and relaxation. Outline the benefits and contraindications if any. For this suggested complementary therapy what stage of life would benefit from it the most?
The therapies to choose from are -
a) Relaxation
b) Imagery
c) Tai Chi
d) Therapeutic touch
e) Reflexology
f) Aromatherapy
g) Animal assisted therapy
h) Music therapy
i) Play therapy
j) Meditation
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