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Progressive Care Certified Nurse (PCCN)

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End of Life for Progressive Care Certified Nurse (PCCN)

End of Life for Progressive Care Certified Nurse (PCCN)

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Outline

End of Life

Definition/Etiology:

Transition to death
- Multidisciplinary team approach
  - Focus:
    - Improve comfort
    - Improve quality of life
    - Patients with serious illness close to end of life

Pathophysiology:

Who qualifies?
- Patients with serious illness close to end of life (< six months to live)
Treatment
- Symptom management
- Treatment measures stopped (e.g. chemotherapy)
- Management of chronic conditions okay (e.g. hypertension) if helpful

Noticing: Assessment & Recognizing Cues:

Team Members
- Providers
- Nurses
- Home health aids
- Spiritual counselors
- Social workers
- Pharmacists
- Volunteers
- Physical, occupational, and speech therapy
- Bereavement counselors
Support
- Medical
- Emotional
- Spiritual support
- Patient
- Caregiver/family
- Bereavement support to family

Interpreting: Analyzing & Planning:

Stages of Grief
- Denial
- Anger
- Bargaining
- Depression
- Acceptance

Responding: Patient Interventions & Taking Action:

End of life process
Activity decreases
Withdrawn/decreased LOC/Hallucinations
Decrease food/drink
Constipation/incontinence
Pressure wounds
Vital sign changes
- BP, RR, HR, Temp irregular/decreases

Reflecting: Evaluating Patient Outcomes:

Nurse’s Responsibility
- Encourage patient/family to communicate needs
- Advocate for patient’s needs
- Educate on what to expect at end of life
- Try to start conversation early (advance care planning)- team approach may be good. case managers, clergy, etc)

Linchpins (Key Points):

Hospice
- Support-
  - patient and & family
- Stages of grief-
  - denial, anger, bargaining, depression, and acceptance
- Physical Changes-
  - everything declines

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Transcript

References

Mayo Clinic. (2022). Hospice care: Comforting the terminally ill. Healthy lifestyle: End of Life. https://www.mayoclinic.org/healthy-lifestyle/end-of-life/in-depth/hospice-care/art-20048050#:~:text=What%20is%20hospice%20care%3F,psychological%2C%20social%20and%20spiritual%20needs.
National Institute of Health [NIH]. (2021). What are palliative care and hospice care? National Institute on Aging. https://www.nia.nih.gov/health/what-are-palliative-care-and-hospice-care.

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Progressive Care Certified Nurse (PCCN)

Course Lessons

Cardiovascular

Atrial Dysrhythmias for Progressive Care Certified Nurse (PCCN)

Ventricular Dysrhythmias for Progressive Care Certified Nurse (PCCN)

Acute Coronary Syndromes (MI-ST and Non ST, Unstable Angina) for Progressive Care Certified Nurse (PCCN)

Acute Inflammatory Disease (Myocarditis, Endocarditis, Pericarditis) for Progressive Care Certified Nurse (PCCN)

Aneurysm (Dissecting, Repair) for Progressive Care Certified Nurse (PCCN)

Cardiac Surgery (Post-ICU Care) for Progressive Care Certified Nurse (PCCN)

Cardiac Tamponade for Progressive Care Certified Nurse (PCCN)

Cardiac/Vascular Catheterization (Diagnostic, Interventional) for Progressive Care Certified Nurse (PCCN)

Cardiogenic Shock For PCCN for Progressive Care Certified Nurse (PCCN)

Cardiomyopathies (Dilated, Hypertrophic, Restrictive) for Progressive Care Certified Nurse (PCCN)

AV Blocks Dysrhythmias for Progressive Care Certified Nurse (PCCN)

Heart Failure (Acute Exacerbations, Chronic) for Progressive Care Certified Nurse (PCCN)

Hypertension (Uncontrolled) and Hypertensive Crisis for Progressive Care Certified Nurse (PCCN)

Minimally-Invasive Cardiac Surgery (Non-Sternal Approach) for Progressive Care Certified Nurse (PCCN)

Valvular Heart Disease for Progressive Care Certified Nurse (PCCN)

Vascular Disease for Progressive Care Certified Nurse (PCCN)

Pulmonary

Acute Respiratory Distress Syndrome (ARDS) for Progressive Care Certified Nurse (PCCN)

Asthma (Severe) for Progressive Care Certified Nurse (PCCN)

COPD Exacerbation for Progressive Care Certified Nurse (PCCN)

Minimally-Invasive Thoracic Surgery (VATS) for Progressive Care Certified Nurse (PCCN)

Obstructive Sleep Apnea for Progressive Care Certified Nurse (PCCN)

Pleural Space Complications (Pneumothorax, Hemothorax, Pleural Effusion, Empyema, Chylothorax) for Progressive Care Certified Nurse (PCCN)

Pulmonary Embolism for Progressive Care Certified Nurse (PCCN)

Pulmonary Hypertension for Progressive Care Certified Nurse (PCCN)

Respiratory Depression (Medication-Induced, Decreased-LOC-Induced) for Progressive Care Certified Nurse (PCCN)

Respiratory Failure (Acute, Chronic, Failure to Wean) for Progressive Care Certified Nurse (PCCN)

Respiratory Infections (Pneumonia) for Progressive Care Certified Nurse (PCCN)

Thoracic Surgery (Lobectomy, Pneumonectomy) for Progressive Care Certified Nurse (PCCN)

Endocrine/Hematology/Neurology/Gastrointestinal/Renal

Diabetes Mellitus for Progressive Care Certified Nurse (PCCN)

Diabetic Ketoacidosis for Progressive Care Certified Nurse (PCCN)

Hyperglycemia for Progressive Care Certified Nurse (PCCN)

Hypoglycemia for Progressive Care Certified Nurse (PCCN)

Anemia for Progressive Care Certified Nurse (PCCN)

Coagulopathies, Medication-Induced (Coumadin, Platelet Inhibitors, Heparin, HIT) for Progressive Care Certified Nurse (PCCN)

Encephalopathy (Hypoxic-ischemic, Metabolic, Infectious, Hepatic) for Progressive Care Certified Nurse (PCCN)

Seizure Disorder for Progressive Care Certified Nurse (PCCN)

Stroke for Progressive Care Certified Nurse (PCCN)

Functional GI Disorders (Obstruction, Ileus, Diabetic Gastroparesis, Gastroesophageal Reflux, Irritable Bowel Syndrome) for Progressive Care Certified Nurse (PCCN)

GI Bleed (Upper, Lower) for Progressive Care Certified Nurse (PCCN)

GI Infections (C. difficile) for Progressive Care Certified Nurse (PCCN)

GI Surgeries (Resections, Esophagogastrectomy, Bariatric) for Progressive Care Certified Nurse (PCCN)

Hepatic Disorders (Cirrhosis, Hepatitis, Portal Hypertension) for Progressive Care Certified Nurse (PCCN)

Ischemic Bowel for Progressive Care Certified Nurse (PCCN)

Malnutrition (Failure to Thrive, Malabsorption Disorders) for Progressive Care Certified Nurse (PCCN)

Pancreatitis For PCCN for Progressive Care Certified Nurse (PCCN)

Renal Failure- Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD) for Progressive Care Certified Nurse (PCCN)

Electrolyte Imbalances for Progressive Care Certified Nurse (PCCN)

End-Stage Renal Disease (ESRD) for Progressive Care Certified Nurse (PCCN)

Musculoskeletal/Multisystem/Psychosocial

Functional Issues (Immobility, Falls, Gait Disorders) for Progressive Care Certified Nurse (PCCN)

End of Life for Progressive Care Certified Nurse (PCCN)

Healthcare-Acquired Infections: Catheter-Associated Bloodstream Infections (CAUTI) for Progressive Care Certified Nurse (PCCN)

Healthcare-Acquired Infections: Central-Line-Associated Infections (CLABSI) for Progressive Care Certified Nurse (PCCN)

Healthcare-Acquired Infections: Surgical Site Infections (SSI) for Progressive Care Certified Nurse (PCCN)

Infectious Diseases: Influenza for Progressive Care Certified Nurse (PCCN)

Infectious Diseases: Multidrug-Resistant Organisms (MRSA, VRE, CRE, ESBL) for Progressive Care Certified Nurse (PCCN)

Pain (Acute, Chronic) for Progressive Care Certified Nurse (PCCN)

Palliative Care for Progressive Care Certified Nurse (PCCN)

Pressure Injuries (Ulcers) for Progressive Care Certified Nurse (PCCN)

Rhabdomyolysis for Progressive Care Certified Nurse (PCCN)

Sepsis for Progressive Care Certified Nurse (PCCN)

Shock States (Anaphylactic, Hypovolemic) For PCCN for Progressive Care Certified Nurse (PCCN)

Toxic Ingestion, Inhalation, Overdose for Progressive Care Certified Nurse (PCCN)

Wounds (Infectious, Surgical, Trauma) for Progressive Care Certified Nurse (PCCN)

Altered Mental Status- Delirium and Dementia for Progressive Care Certified Nurse (PCCN)

Disruptive Behaviors, Aggression, Violence for Progressive Care Certified Nurse (PCCN)

Psychological Disorders (Anxiety, Depression) for Progressive Care Certified Nurse (PCCN)

Substance Abuse (Alcohol, Drug Withdrawal) for Progressive Care Certified Nurse (PCCN)

Substance Abuse (Chronic Alcohol Abuse, Chronic Drug Abuse) for Progressive Care Certified Nurse (PCCN)

Substance Abuse (Drug-Seeking Behavior) for Progressive Care Certified Nurse (PCCN)

Professional Caring and Ethical Practice

Advocacy & Moral Judgement for Progressive Care Certified Nurse (PCCN)

Caring Practices for Progressive Care Certified Nurse (PCCN)

Response to Diversity for Progressive Care Certified Nurse (PCCN)

Facilitation of Learning for Progressive Care Certified Nurse (PCCN)

Collaboration for Progressive Care Certified Nurse (PCCN)

Systems Thinking for Progressive Care Certified Nurse (PCCN)

Clinical Inquiry for Progressive Care Certified Nurse (PCCN)