All About Nursing · Hospice & Palliative Care

Determining Prognosis: Patients with End-Stage Cardiac Disease (Reading & Sharing)

The principles for determining when patients with end-stage cardiac disease require end-of-life care, are actually similar to those for determining prognosis of patients with advanced pulmonary disease.

Disabling Dyspnea or Chest Pain

  • Dyspnea or chest pain with rest or minimal exertion and can therefore classified as New York Heart Association class IV (NYHA class IV)
  • Ejection fraction less or equal 20%, if available
  • Persistent symptoms despite optimal medical management with vasodilators and dialectics, or
  • Inability to tolerate optimal medical management due to hypotension and/or renal failure
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All About Nursing · Blog Reading & Sharing · Hospice & Palliative Care

Hospice – Eligibility (Reading & Sharing)

Hospice is an all-encompassing service available for patients with a prognosis under 6 months. Under the Medicare hospice benefit, patients eligible for hospice are greater than 65 years or receiving Medicare disability payments. At the start of care, two physicians must sign a statement certifying that the patient’s life expectancy is six months or less based on their best estimate of the patient’s medical prognosis. While hospice benefit was originally designed for Medicare recipients, most insurance providers cover hospice care for patients not eligible for Medicare. But, hospice eligibility depends on more than only a physician determining a prognosis of six months o less until death.

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All About Nursing · Hospice & Palliative Care · Nursing Continue Education

Euthanasia- Good Death vs Killing on Request (Reading & Sharing)

The word euthanasia is combination of the Greek eu= good, and thanatos = death. Literally and etymologically it therefore means “good death”. Historically and scholarly, euthanasia in the strict- and in the Dutch context the only proper- sense refers to the situation in which a doctor kills a person who is suffering “unbearably” and “hopelessly” at the latter’s explicit request (usually by administering a lethal injection)… and euthanasia is in the Netherlands reserved for killing on request. In concrete terms, euthanasia invovles injecting the patient with two types of eubstances: barbiturates to induce coma, followed by neuromuscular blockers which cause respiratory muscle paralysis. The consequent anoxia and cardiac arrest bring on immediate death.

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Hospice & Palliative Care

End Stage Disease Progression and Complications – Oncologic Disorders (Learning Hospice)

  • Breast cancer is the most frequently diagnosed and is the leading cause of death from cancer in women worldwide.
  • Lung cancer is the most frequently diagnosed and the leading cause of death from cancer in men worldwide.
  • Cancer is the second most common cause of death in the United States following heart disease.

Cancer is characterized by uncontrolled growth and spread of abnormal of mutated cells that can be caused by external and internal factors. Mutated cells have certain characteristics as follows:

  • can avoid apoptosis (cell death)
  • resist normal aging process
  • can replicate outside normal controlling mechanisms
  • produce chemicals that dissolve surrounding tissue
  • invade other parts of the body
  • overcome the immune system
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