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Week 10 Ticket In
Jessica Canez
Carrington College
October 26, 2020
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Week 10 Ticket In
Ticket -In for ATI – Client Comfort & End of life care
You will be required to turn in this completed “Ticket In” the day before your Simulation
in order to participate in the simulation.
Objectives:
After completion of the lesson, the student will be able to:
Analyze nontherapeutic communication techniques
Summarize therapeutic communication techniques
Identify situations in which to use different communication techniques
Discuss techniques to use with clients who have dementia and their families
Using the Fundamentals of Nursing textbook, identify each of the terms below: give a
definition and explain the implications for nursing. You may use other resources if needed.
Provide APA referencing for all sources.
Ethical dilemma- Simply speaking it is knowing the difference between what is right and
wrong and having to make a choice bewteen two difficult decisions.
Hospice- Provides end of life care for patients and family members who have been
diagnosed with about 6 months to live. Hopsice can sometimes work along with pallaiative care
measures to assist with patient needs.
Palliative care- Assists with the long term care of patient and families with life
threatenening illness.
Medications: Type out your med on-classification, action, dosage and route, side effects,
adverse effects, toxicity, pharmacokinetics, interactions, and nursing considerations. (No Copy to
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Paste is accepted, if you cite be sure to acknowledge in APA format). Also include: a brief
explanation as if you were educating the patient regarding the medication.
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Morphine
o Classification: Opioid analgesic, controlled substance schedule II
o Action:Inhibits the pain receptors in the CNS and alters the response and
perception of pain.
o Dosage: varies greatly for acute moderate to severe pain
o Route: PO, IM, IV, SubQ, Rectal, Epidural
o Side Effects: Drowsiness, dizziness, confusion, headache, constpation, dysphoria,
sweating, itching, sedation, flushing, vomiting
o Adverse Effects: hypotention, respiratory depression, increased intracranial
pressure, unusual dreams, seizures, hallucinations
o Toxicity: Use Narcan high risk of overdose and abuse
o Pharmacokineticks: PO: peak 60 min duration 4-5 hr IM: onset 1/2hr, peak 30-60
min IV: peak 20 min. Effects the bowels excreted in urine, breast milk,
metabolized by liver
o Interactions: interacts with alchol, pentazocine, nalbuphine, butorphaol,
naltrexone, St john’s wort, valerian
o Nursing Considerations: Before medication is given, assess patient’s
pain (PQRSTU). Monitor BP and vitals. A low BP and drop in respirations below
12 could indicate too much sedation and respiratory depression. Monitor bowel
sounds due to constipation and I&O and assess pupil changes and reaction.
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o Patient Education: This medication can cause constipation so increase fiber and
water. Report any allergic reations, do not drive or operate any heavy machinery
as this medication will impair mental and physcical functions due to its sedtive
effects. This may also cause withdraw sysptoms of a fever and cramping after
completion of therapy. Also do not not take with alchol.
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Scopolamine
o Classification: Anticholinergic
o Action:
o Dosage/ Route: TD, IM, IV, SUBCUT Adult: IV, IM, SUBCUT 0.32-0.65
mg Child: 0.006 mg/kg max 0.3 mg/dose
o Side Effects: dry mouth, dry skin, sleepiness, dizziness, restlessness, blurred
vision, constipation
o Adverse Effects: painful urination, agitation, delusions, confusion, hallucinations,
paranoia
o Toxicity: Category C
o Pharmacokineticks: Metabolized by liver
o Interactions:
o Nursing Considerations: Monitor vitals, may cause withdrawal symptoms if used
longer than 3 days
caution when operating heavy machinery or tasks which require mental
alertness
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o Patient Education: Do not operate heavy machiery or drive while taking this
medication. Do not drink alchol. Report any allerigic reactions
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Ativan
o Classification: Benzodiazepines
o Action: enhanches GABA in the body to treat anxitey
o Dosage/ Route: PO, IM ADULTS: 4 mg IV 4 mg IV 0.05 to 0.1 mg/kg (Max: 4
mg/dose)
o Side Effects: drowsiness, dizziness, headaches, blurred vision, nausea, sexual
issues
o Adverse Effects: loss of coordination, seizures
o Toxicity: for patients with allergies to Valium
o Pharmacokineticks:
o Interactions: other CNS medications
o Nursing Considerations: Assess fall risk, vitals, and mental status.
o Patient Education: Take medication exactly as directed and not to skip or double
up. Educate on other methods to decrease anxiety, such as exercise, support
groups, yoga, and meditation. Discuss patient to avoid driving and avoid alchol
Scenario overview:
Ms. Audra Longly is hospitalized and dying due to advanced COPD and lung
cancer. Ms. Longly has decided to stop aggressive treatment. The family members are in
disagreement about this decision.
During the clinical day we will complete the following tasks, please do not attempt to
complete these prior to the clinical day:
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Complete the ATI Module: Apply-The Communicator 2.0-Video Interaction-Client
Comfort and End-of-life care
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ATI Module: Apply-The Communicator 2.0-Technique Identifier-Respecting Clients
Cultures
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For your clinical assignment you will complete a concept map based upon your Video
Interaction patient
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References
BS, P.A.P.R.M.P.F.A.G.P.R.E.F.P.S. R. (2017). Fundamentals of Nursing.
https://online.vitalsource.com/#/books/9780323327404/. https://online.vitalsource.com/
Do i have an ethical dilemma? (2010). PubMed Central (PMC).
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003850/
Mosby's 2020 Nursing Drug Reference E-Book. (2019). https://online.vitalsource.com/
What are palliative care and hospice care? | national institute on aging. (2017). National
Institute on Aging. https://www.nia.nih.gov/health/what-are-palliative-care-and-hospicecare