1. Review

2. * Sense of physical, environmental, and social well-being or ease * Not just freedom from pain!

3. * Physical * Psychospiritual * Social * Environmental

4. * Basic Care and Comfort - providing comfort and assistance in the performance of activities of daily living * Related content includes but is not limited to: * Assistive Devices „ * Nutrition and Oral Hydration * Elimination * Personal Hygiene * Mobility/Immobility * Rest and Sleep * Non-Pharmacological Comfort Interventions

5. * Assess the client’s need for alternative and/or complementary therapy * Assess the client’s need for palliative care * Assess client need for pain management * Recognize differences in client perception and response to pain * „Apply knowledge of pathophysiology to non-pharmacological comfort/palliative care interventions * Incorporate alternative/complementary therapies into client plan of care (e.g., music therapy, relaxation therapy) * „Counsel client regarding palliative care * „Respect client palliative care choices * „Assist client in receiving appropriate end of life physical symptom management * Plan measures to provide comfort interventions to clients with anticipated or actual impaired comfort * „Provide non-pharmacological comfort measures * „Evaluate the client’s response to non- pharmacological interventions (e.g., pain rating scale, verbal reports) * „Evaluate the outcomes of alternative and/or complementary therapy practices * „Evaluate outcome of palliative care interventions

6. * Assist client to compensate for a physical or sensory impairment (e.g., assistive devices, positioning, compensatory techniques) * „Assess and manage client with an alteration in elimination (e.g., bowel, urinary) * „Perform irrigations (e.g., of bladder, ear, eye) * „Perform skin assessment and implement measures to maintain skin integrity and prevent skin breakdown (e.g., turning, repositioning, pressure-relieving support surfaces) * „Apply, maintain or remove orthopedic devices (e.g., traction, splints, braces, casts) * „Apply and maintain devices used to promote venous return (e.g., anti-embolic stockings, sequential compression devices) * „Implement measures to promote circulation (e.g., active or passive range of motion, positioning and mobilization) * „Assess client need for pain management * „Provide non-pharmacological comfort measures * „Manage the client’s nutritional intake (e.g., adjust diet, monitor height and weight) * „Provide client nutrition through continuous or intermittent tube feedings * „Evaluate client intake and output and intervene as needed * „Assess and intervene in client performance of activities of daily living * „Perform post-mortem care * „Assess client need for sleep/rest and intervene as needed

7. 1. The nurse is caring for a child in pain, and the parents are distraught and arguing about the child’s condition. Which of the following interventions are appropriate for the nurse to take to help the parents cope? Select all that apply. a) Permitting the parents to help plan the care for the day b) Negotiating with the parents how long they can leave the child alone c) Allowing the parents to watch the child from a distance when not in the room d) Informing the parents of the daily plan of care developed by the nurse e) Providing an opportunity for the parents to discuss their concerns

8. 2. A client has malignant pleural effusions. The nurse should conduct a focused assessment to determine if the client has which of the following? Select all that apply. a) Hiccups. b) Weight gain. c) Peripheral edema. d) Chest pain. e) Dyspnea. f) Cough.

9. 3. A nurse is caring for an unconscious child with Reye’s syndrome. Which nursing actions will prevent complications associated with this syndrome? Select all that apply. a) Place the child on a supportive mattress overlay b) Perform oral care once a shift c) Place the child in a supine position d) Encourage the family to talk to and stimulate the child e) Elevate the head of the bed 15°

10. 4. A client is scheduled for the first electroconvulsive therapy (ECT) treatment in the morning. The client has been unable to sleep, but at 10 PM refused to take temazepam as the nurse suggested. The client is still unable to sleep at 11:15 PM. In what order should the nurse do the following? a) Sit quietly with the client. b) Discuss specific concerns. c) Offer use of MP3 player with relaxing music. d) Encourage the use of temazepam.

11. 5. The nurse is caring for a client who is receiving nasal oxygen. Identify the area where the nurse should inspect the client for signs of pressure from the tubing.