Palliation

Every question here, with the answer

1. At shift handoff, a patient receiving palliative care for cancer pain reports that medication provides relief for four hours, although doses are prescribed every six hours. You have notified the provider and requested a review; no new order has been received. Which entry best documents the situation?

   1. Patient reports pain relief lasting four hours with the prescribed six-hour regimen. Provider notified; medication-order review requested, with no new order received.
   2. Current six-hour pain regimen continued; comfort needs reviewed with the provider.
   3. Pain relief lasts four hours; medication interval changed to every four hours based on the patient's response.
   4. Pain medication ineffective; provider notified that a stronger medication is required.

   Answer: Patient reports pain relief lasting four hours with the prescribed six-hour regimen. Provider notified; medication-order review requested, with no new order received.

   The correct entry records the patient's response and accurately distinguishes a request from a new order. Changing the interval would imply an order not yet received, while the general comfort note omits the limited duration of relief. Calling the medication ineffective and requiring a stronger medication overstates the findings.

2. During today's shift, you observe that a patient receiving palliative care has more pain in one position than another. The patient also has difficulty participating in physical therapy when pain medication is not administered thirty minutes to an hour beforehand. Which documentation and communication actions should you include in the handoff process? Select all that apply.

   1. Document which positions increase pain and communicate this information to nurses, nursing assistants, and the physical therapy team.
   2. Document the observed relationship between pain-medication timing and the patient's ability to participate in therapy.
   3. Communicate the need for pain medication before therapy to opposite-shift nurses and the physical therapy team.
   4. Record the pretherapy medication timing in the nursing note and rely on the physical therapy team to find it during routine chart review.
   5. Include the positioning concerns in verbal handoff only, since they do not require a medication-order change.

   Answer: Document which positions increase pain and communicate this information to nurses, nursing assistants, and the physical therapy team., Document the observed relationship between pain-medication timing and the patient's ability to participate in therapy., Communicate the need for pain medication before therapy to opposite-shift nurses and the physical therapy team.

   The section requires both documentation of these observations and communication to the team members involved in care. Charting alone does not replace communication with physical therapy, and verbal handoff alone leaves the positioning concerns undocumented.

3. Before discharge home, you review bathing and dressing assistance with a patient's wife, who will participate in the patient's palliative care. She says she understands. Which next step best supports a note describing her ability to provide the care?

   1. Ask her to describe the care verbally, then document that she can perform it without observing a demonstration.
   2. Ask her to re-demonstrate the care while explaining each step, then document what she demonstrates and explains.
   3. Review the instructions again, then document that she attended the complete teaching session.
   4. Ask whether she has questions, then document understanding if she has none.

   Answer: Ask her to re-demonstrate the care while explaining each step, then document what she demonstrates and explains.

   The section specifically calls for family caregivers to re-demonstrate care with a verbal walkthrough. Agreement, absence of questions, and attendance document participation rather than demonstrated ability. A verbal explanation alone omits the re-demonstration required by the source.