End of Life Peace Without Pain

End of Life Peace without Pain Jacqueline R. Reviel Loyola University New siege of Orleans End of Life Peace without Pain Pain management during end of life c atomic number 18 is authoritative to the sympathizer and peace of the diligent and their family. With better perturb control, dying patients live longer and better. Pain shortens life. Relief of painful sensation extends life (Zerwekh et al. , 2006, p. 317). The think of must educate about (a) disease pathology, (b) signs & symptoms, (c) interventions, (d) medications, (e) alternative therapies, and (f) substantiative care, colligate to end of life care.Pain management involves understanding the pharmacological issues, and management issues surrounding opioid drugs make use ofd for pain control. The identification of (a) nursing diagnosis, (b) implementation, and (c) fosterage are inherent in keeping the patient and family comfy and at peace. Pathology, Signs and Symptoms End of life presents with specific pathology which ignore cause extreme pain and discomfort. The bodys organs begin to shut down as death approaches hypoventilation causes hypoxemia and hypercapnia in turn increasing the workload of the heart as it tries to oxygenate the vital organs.The kidneys and coloured begin to fail and toxins begin to build up. The heart fails as it cant keep up with the demand. Zerwekh (2006) lists specific signs and symptoms associated with death (a) reduced level of consciousness, (b) pickings no fluids or only sips, (c) decreased urine output, (d) progressing coldness and mottling in legs and arms, (e) irregular labored breathing periods of no breathing, and (f) the death rattle. Diagnosis & InterventionsDiagnoses colligate to end of life care are (a) Ineffective weave perfusion, (b) Alteration in comfort, (c) Activity intolerance, (d) Impaired gas exchange (e) Ineffective breathing patterns, and (f) diminish cardiac output. Interventions are attached to each diagnosis and a plan of care is es tablished for the patient. Interventions for alternation in comfort include (a) spiritual, (b) pharmacological, and (c) alternative methods. Ineffective tissue perfusion involves (a) positioning, (b) O2, and (c) fluid management.Activity intolerance is managed by pacing periods of activity with rest. Impaired gas exchange is managed by decreasing fluid shifts with medication. Ineffective airway clearance is helped by (a) positioning and (b) suctioning to clear the airway. Disturbed thought processes interventions are (a) reorient the patient, (b) supporting family, and (c) visitors at times when the patient is most alert. Interventions are tailored peculiarly to the patients needs and their disease process. Pain management Dying does not need to be painful (Moynihan et al. , 2003 p. 401). Holistic pain management is crucial during end of life care. Terminally ill patients can have (a) physical, (b) spiritual and (c) emotional pain. Providing comfort is important in decreasing suf fering. Emotional pain can be addressed by (a) laughter, (b) memories, and (c) intuitive feeling. Spiritual pain can be helped with (a) prayer, (b) meditation, (c) talking, (d) listening, (e) pastoral care, and (f) providing the last rights. Physical pain is managed pharmacologically and with alternative comfort measures. Opioids are given to treat severe pain at the end of life.Parlow (2005) used nitrous oxide to control incident pain in terminally ill patients with verificatory results. Pharmacological issue related to pain management Pharmacological issues surrounding pain management are (a) issues of addiction under medication, (b) legal repercussions, (c) respiratory effects, and (d) typeface effects. Zerwekh (2006) sums up the fallacy of addiction by stating persons with addiction take their opioids to escape life, whereas persons with pain take their opioids to live life more fully. These issues and lack of knowledge ofttimes cause Physicians to under medicate during end o f life care.The fellate needs to have full understanding of how opioids work and how to ad however the medications to control severe pain and break though pain without entering into (a) legal issues, (b) respiratory depression and (c) side effects. Complementary and alternative therapies Along with the pharmacological methods to keep the patient comfortable there are many alternative method the nurse can use and teach the family to assist with braggy the family the gift of caring for their loved single and feeling like they are helping.The patient also benefits from the touch and interaction from his or her loved ones. Therapies such as (a) massage, (b) therapeutic touch, (c) guided imagery, (d) aromatherapy, (e) hypnosis and (f) relaxation, are just a few alternative therapies used. Supportive nursing care Often when a family member is dying their loved ones do not know what to ordinate or do and often feel helpless. While providing care for the patient the nurse engages the fa mily in the care and breaks down the fear that they cant touch the dying patient. The nurse encourages the family to (a) gather, (b) share, and (c) grieve.The family and patient are educated to end of life care so they know what to expect and can recognize it. By giving the family these skills it is a gift so the family has time to say goodbye and to spend the last days in peace not in fear and chaos. The nurse manages symptoms so the patient and the family can concentrate on each other. OBrien (2011) stated one of the best ways of providing spiritual support in this office staff is to allow the patient and family to verbalize their feelings for the dying person one of the greatest spiritual gifts a nurse can give is to listen (Burns, 1991, p. 1). Patient & Family didactics Education gives the patient and the family great power and strength to face the path ahead and not be fearful of the process. Discussion around key tuition such as (a) the patients wishes, (b) spiritual care, (c) visitation, (d) pain control, (e) disease process, (f) multi organ failure, (g) specific signs and symptoms, (h) interventions that can be provided, (i) interventions the patient may not want, (j) comfort care, and (k) funeral arrangements, must take place with the patient and their family.Patients may believe that pain is to be expected and education informing them that comfort willing bring them musical note time to spend with their loved ones and to not suffer in silences is vital. Encouraging the family to (a) hold their love ones hand, (b) stroke hair, (c) massage, and (d) talk to them until they take their last breath, is all education the nurse encourages. The nurses role is to (a) support, (b) pray and (c) answer question that might arise. Conclusion Caring for patients as they die involves (a) a great deal of knowledge, (b) compassion, and (c) caring, on the nurses part.Effective pain management decreases suffering in the terminally ill patient and can make all the di fference in how the patient arrives at the end of life. The nurse must be versed and comfortable with the many issues surrounding end of life care so she or he can advocate for the needs of the patient and their family. The nurses role in (a) educating, (b) providing spiritual care, and (c) physiological care, to the patient and their family during this very important and stressful time plays a huge part in the comfort and peace that they experience as they journey down the path of loss and grieving.References Moynihan, T. J. (2003). usage of opioids in the preaching os severe pain in terminally ill patients-Dying should not be painful. Mayo Clin Proc. , 1397-1401. OBrien, M. E. (2011). Spirituality in nursing Standing on blessed ground. Sudbury, MA Jones Barlett Learning. Parlow, J. L. (2005). Self-administered nitrous oxide for the management of incident pain in the terminally ill patient A blind case series. Palliative Medicine, 19 3-8. Zerwekh, J. V. (2006). treat care at t he end of life Palliative care for patients and families.Philadelphia, PA F. A. Davis Company. LOYOLA UNIVERSITY NEW siege of Orleans NURS 384 End-of-Life Issues Paper Student _Jackie Reviel__________________________Semester_Fall__Year_2011__ Directions The purpose of this paper is to examine end-of-life issues. salve a 4-5 page paper on one of the topics that are suggested in your syllabus. Focus the paper on the care of the terminally-ill patient education of patient and family, and supportive nursing care. Use ast least 4 references (current text and articles) for this assignment and format paper in APA style.Criteria End-of-Life Issues Paper Max. Points Score 1. secerns terminal Illness. Include pathology and signs and symptoms 15 2. determine palliative care/interventions associated with illness 15 3. Address pharmacological issues related to terminal illness 10 4. Address complementary and alternative therapies 15 5. Describe supportive nursing care related to terminal Illness. 15 6. Discuss at least 5 nursing diagnosis taken from those listed in the northeastern American Diagnosis Association. 15 7. Provide key information to be discussed with patients families on terminal illness. 15 Total Comments Faculty Signature _______________________________Date_______________________ LOYOLA UNIVERSITY NEW ORLEANS Evaluation of Communication Skills Student ________________________________Semester ____Year _____Skill in communication is defined as the ability to (a) effectively express ideas through a variety of media, (b) use communication technology to enhance personal and professional functioning, and (c) use the group process for the purpose of achieving common goals. Note Your grade on Communication Skills will comprise 10% of your final course grade. You will be rated using a scale of 0-10, where 0 indicates no reference and 10 indicates maximum credit for the item indicated. Writing Criteria Nursing Research Critique Paper Score 1. Use ap propriate language and erminology. 2. Use correct sentence structure and paragraphing. 3. Use correct grammar, spelling, and punctuation. 4. Demonstrate knowledge of relevant content areas. 5. Express ideas clearly and convincingly. 6. Organize ideas logically. 7. Use APA format correctly. 8. Overall effectiveness of the written work in meeting identified goals. Communication Skills Pts earned (_____)/ 80 pts = _____% Letter Grade____ Percent of Final Course Grade Pts earned (____)/ 80 pts =___% X 10 = ____% Comments Faculty Signature____________________________________Date______________