NRS 311 Study Guide - Final Guide: Sick Role, Hypoesthesia, Palliative Care
27 May 2018
School
Department
Course
Professor
Providing Support during a Life-Threatening Illness
• Support- Impact of Illness on Communication Climate
o Physical stages of illness: Onset, course, prognosis
o Psychosocial stages: Damage to self-esteem and feelings of worthlessness associated
with loss
▪ Transition to illness
▪ Acceptance
▪ Convalescence
o Patient responses to dependency and the sick role are unique, based on bio-psycho-
social-cultural-spiritual makeup of the patient/family
• Advance Directives
o Page 188 Box 15-1
• Koenig’s guidelines
o Do take a spiritual history
o Do support the patient’s eliefs
o Do say a short prayer if requested by the patient (check your comfort level)
o Do refer spiritual needs to chaplains
o Do alter the healthcare environment to accommodate religions rituals and practices
• Don’ts – 188-191 Box 15-2
o Don’t presrie religion to non-religious patients
o Don’t ontinue a spiritual history if the patient is not religious
o Don’t pray ith a patient if they don’t ask
o Don’t proide spiritual ounsel or adise unless you hae had speialized training
o Don't argue with patients about their religious beliefs even when those beliefs conflict
with medical or nursing care
• Palliative care
o focuses on quality of life by providing adequate symptoms control and promoting
comfort, can begin at any time. Often initiated when the disease progresses and causes
problematic symptoms. Goals of palliative care
o CMO – Comfort Measures Only
o AND – Allow Natural Death
o Hospice is generally focused on the last 6 months of life
• Stages of Grief
o Denial
o Anger
o Bargaining
o Depression
o Acceptance
o Loss of pet—20 hrs crying
o Spouse, parent, friend, child—200 to 300 hrs crying
o Talk through tears; review good and bad memories
o Restructure and rebuild lives without the loved one
• Takes about 1-3 years
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