Caring for Patients at the End of Life in the Intensive Care Unit Managing Pain, Dyspnea, Anxiety, Delirium, and Death Rattle

Author(s): Margaret L. Campbell, RN, PhD, FPCN

Contact Hours 1.00

CERP A 1.00

Pharmacology Hours 1.00

Expires Apr 01, 2018

Topics: Pain Management, Palliative/End-of-life Care, Pharmacology

Population: Lifespan

Role: Staff, APRN

Fees
Member: Free
NonMember: $10.00

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Activity Summary

Critically ill patients receiving palliative care at the end of life are at high risk for experiencing pain, dyspnea, and death rattle. Nearly all these patients are at risk for the development of delirium. Patients who are alert may experience anxiety. Advanced practice nurses and staff nurses are integral to detecting and treating these symptoms. Pain, dyspnea, and anxiety should be routinely assessed by patient self-report when possible. Routine behavioral screening for delirium is recommended. Behavioral observation tools to detect pain and dyspnea and proxy assessments guide symptom identification when the patient cannot provide a self-report. Evidence-based interventions are offered for both prevention and treatment of pain, dyspnea, anxiety, and delirium. Death rattle does not produce patient distress, and current pharmacological treatment lacks an evidence base. Pain management has a robust evidence base compared to management of dyspnea, anxiety, and delirium among this population; well-designed, adequately powered studies are needed.

Objectives

  • Discuss the treatment of dyspnea in palliation.
  • Define death rattle.
  • List 3 symptom assessment tools for dying patients.

Continuing Education Disclosure Statement

Successful Completion

Learners must attend/view/read the entire activity and complete the associated evaluation to be awarded the contact hours or CERP. No partial credit will be awarded.

Disclosure

This activity has been reviewed by the Nurse Planner. It has been determined that the material presented here shows no bias. Approval of a continuing education activity does not imply endorsement by AACN or ANCC of any commercial products displayed or discussed in conjunction with the activity.

Accreditation

The American Association of Critical-Care Nurses (AACN) is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s (ANCC's) Commission on Accreditation, ANCC Provider Number 0012 (60 min contact hour). AACN has been approved as a provider of continuing education in nursing by the California State Board of Nursing, California Provider number CEP01036 for 1.2 contact hours (50 min contact hour).

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