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Starts at $9.98 per contact hour
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8 hours $7.98
12 hours $6.98
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End-of-Life Issues: Physiologic Changes at the End of Life

3.5 Contact Hours / 0.35 AOTA CEUs
Target Audience: Nurses, healthcare professionals, and interested individuals
Purpose/Goal: The outcome of this course is for the learner to describe the physiologic changes in body systems associated with the end of life and guidelines for the care of specific physical symptoms at the end of life.
$34.93
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For healthcare professionals to provide compassionate, quality care to patients at the end of life, they must understand the many changes the patient undergoes. Holistic end-of-life care provides relief, comfort, and support whenever possible. It involves a comprehensive approach to the physical, emotional, psychological, and spiritual aspects of the individual during this unique time in their lives.

Upon completion of the course, you will be able to do the following:

  • Describe major physiologic changes at the end of life related to the cardiovascular system.
  • Describe major physiologic changes at the end of life related to the gastrointestinal system.
  • Describe major physiologic changes at the end of life related to the nervous system.
  • Describe end-of-life changes in the respiratory system.
  • Describe end-of-life changes in the renal system.
  • Describe end-of-life changes associated with malignancies.
  • Explain the end-of-life changes that occur with HIV/AIDS.
  • Describe clinical care guidelines for specific conditions at the end of life, including ascites, cachexia, and anorexia.
  • Describe clinical care guidelines for the end-of-life conditions of constipation and diarrhea.
  • Describe clinical care guidelines for the end-of-life conditions of cough and fatigue.
  • Describe clinical care guidelines for the end-of-life conditions of nausea and vomiting.
  • Discuss the symptoms present in the final days and hours of life.

As an individual nears the end of his or her life, decisions about health care become more complex. Not only does physical care become important, but the patient’s emotional, social, spiritual, and psychological needs must also be addressed. Family and caregivers must be included in the overall management of the disease (Comfort, 2001). Communication is extremely important. For example, the intent of decisions made by the individual, family, and health care providers may be misunderstood and the consequences less certain (Kuebler, Berry, & Heidrich, 2002; National Institutes of Health [NIH], 2013a; Strada, 2013).

The physical changes experienced at the end of life become more challenging and the results of their assessment and treatment can “ripple” through the patient, family, and friends.

Most life-threatening illnesses have a familiar and documented natural clinical course, which provides patients and their families with a framework in which to make important quality-of-life decisions about care at the end of life. The trajectory of the disease provides the health care professional with valuable information about what patients have undergone, their emotional states (as well as the emotional state of the family), and their goals for care (Kuebler et al., 2002; McCarthy, Phillips, Zhong, Drews, & Lynn, 2000; NIH, 2013a).

However, preferences of the caregivers may not be the same as the patient’s preferences at the end of life. Some disagreed about controlling the time and place of death but patients and caregivers usually agreed about symptom and pain management (Comfort, 2001; NIH, 2013a).

Physiological changes at the end of life can vary widely, since individuals may be of any age, or they may be individuals who are dying from “natural causes” related to the normal process of aging.

Complete the course post exam (CE Test) with a score of 80% or greater. Complete all fields of the course evaluation form. Certificate of Completion is provided once the course post exam is passed per criteria above.

  • American Board of Managed Care Nursing
    The American Board of Managed Care Nursing recognizes all of ALLEGRA Learning Solutions' ANCC accredited courses for continuing education credit for Certified Managed Care Nurses (CMCNs).
  • ANCC - American Nurses Credentialing Center
    ALLEGRA Learning Solutions, LLC is accredited with distinction as a provider of nursing continuing professional development by the American Nurses Credentialing Center’s Commission on Accreditation.
  • AOTA - American Occupational Therapy Association
    ALLEGRA Learning Solutions, LLC, is an approved provider of continuing education for occupational therapists by the American Occupational Therapy Association. Approved Provider # 3166
  • ASWB - Association of Social Work Boards
    This course is approved by the Association of Social Work Boards (ASWB) Approved Continuing Education (ACE) program to be offered by ALLEGRA Learning Solutions, LLC as an individual course. Individual courses, not providers, are approved at the course level. State and provincial regulatory boards have the final authority to determine whether an individual course may be accepted for continuing education credit. ACE course approval period: 04/22/2021-04/22/2024. Social workers completing this course receive the specified distance learning continuing education credits.
  • California Board of Behavioral Sciences
    California Board of Behavioral Sciences Provider Number PCE 1564. Course meets the qualifications for the stated hours of continuing education credit for MFTs and/or LCSWs as required by the California Board of Behavioral Sciences.
  • California Board of Registered Nursing
    ALLEGRA Learning Solutions is approved by the California Board of Registered Nursing, Provider # CEP 14693 for the number of hours stated.
  • California Department of Health, Aid, and Technician Certification Section
    The California Department of Health, Aid, and Technician Certification Section accepts continuing education offered by CA-BRN approved providers.
  • District of Columbia Board of Nursing
    ALLEGRA Learning Solutions (CE Provider # 50-12076) submits all continuing education records to CE BROKER after successful completion.
  • Florida Board of Nursing
    ALLEGRA Learning Solutions, LLC is accredited as a provider of continuing education by the Florida Board of nursing (CE Provider # 50-12076). Courses are automatically submitted to CE Broker.
  • Florida Board of Nursing - Certified Nursing Assistants
    ALLEGRA Learning Solutions (CE Broker Provider # 50-12076) submits all continuing education records to CE Broker after successful completion.
  • Florida Board of Respiratory Care
    ALLEGRA Learning Solutions, LLC is accredited as a provider of continuing education by the Florida Board of Respiratory Care
  • Florida Council of Dietetics and Nutrition
    ALLEGRA Learning Solutions, LLC is accredited as a provider of continuing education by the Florida Council of Dietetitics and Nutrition
  • Florida Council of Licensed Midwifery
    ALLEGRA Learning Solutions, LLC is accredited as a provider of continuing education by the Florida Council of Licensed Midwifery
  • NAADAC - The National Association of Alcohol and Drug Abuse Counselors
    This course has been approved by ALLEGRA Learning Solutions, LLC, as a NAADAC Approved Education Provider, for educational credits. NAADAC Provider #813, ALLEGRA Learning Solutions, LLC is responsible for all aspects of their programming.
  • NCBTMB -National Certification Board for Therapeutic Massage & Bodywork
    ALLEGRA Learning Solutions, LLC is approved by the National Certification Board for Therapeutic Massage & Bodywork (NCBTMB) as a continuing education Approved Provider. Provider Number 451562-11.
  • Florida Board of Massage Therapists
    ALLEGRA Learning Solutions, LLC is accredited as a provider of continuing education by the Florida Board of Massage Therapists
AOTA CEUs:

0.35

Practice Level:

Intermediate

Content Focus:

Professional Issues

Course Expires:

May 30, 2025

Instructor(s):
  • Cyndie Koopsen, RN, BSN, MBA, HNB-BC, RN-BC, HWNC-BC
  • Caroline Young, MPH
Jurisdictional Requirements:

Continuing education (CE) licensing requirements vary by jurisdiction, are not well defined, and may change. These CE requirements may vary in terms of the number of hours required to the types of courses that must be taken. ALLEGRA Learning Solutions, LLC recommends you contact your licensing board or accrediting organization for the latest continuing education requirements of your state or territory. Compliance with CE requirements is the responsibility of the individual health care provider. Health care providers must understand the CE requirements in their jurisdictions, and be sure they are up-to-date on any rule changes that affect their license. For further information, please see our Accreditation Information.

Accommodations for Disabilities:

Every effort will be made to accommodate your special needs. To request accommodations, please contact us.

Conflicts of Interest and Relevant Financial Relationships:

The authors/planning committee members have no conflicts of interests or relevant financial relationships to declare relevant to this activity.

Commercial Support:

No commercial support has been received for this activity.

Non-endorsement of products:

Accreditation refers to recognition of continuing nursing education only and does not imply ALLEGRA Learning Solutions, LLC approval or endorsement of any commercial product.

Off-label Use of Products:

None of the authors intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.

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