NCLEX-PN

distention. Management may include addressing hypotension, oxygen, fluids, and sometimes pericardiocentesis. ●​ Septic Shock : Immunocompromised clients near the end of life are susceptible to septic shock. Indications comprise high temperature, confusion, and pulmonary edema. Treatments encompass fluid replacement, antibiotics, oxygen, mechanical ventilation, dialysis, and blood pressure-enhancing medications. ●​ Hypovolemic shock : This condition results from severe dehydration or significant fluid loss and requires treatment through intravenous fluid replacement, blood components, plasma expanders, and positioning the client in the Trendelenburg position. ●​ Hypercalcemia Management : Elevated blood calcium, known as hypercalcemia, is frequently observed near the end of life, particularly in clients with bone cancer. Symptoms may include anorexia, nausea, weakness, and pain. Managing hypercalcemia typically includes intravenous fluids, pain relief, diuretics, and other medications tailored to individual preferences and needs. ●​ Tumor Lysis Syndrome : This syndrome is prevalent in clients with aggressive tumors and involves the release of substances into the bloodstream. Symptoms may include lethargy, pain, and renal failure. Management often necessitates treatments such as dialysis, fluids, and medications. ●​ Increased Intracranial Pressure : Various causes, including head injuries and tumors, can elevate intracranial pressure. Symptoms comprise altered respiration, pulse pressure changes, and Cushing's signs. Management includes diuretics, anticonvulsants, corticosteroids, and addressing hypertension. ●​ Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) : Clients with certain cancers are prone to SIADH, causing fluid retention. Symptoms encompass irritability, altered mental status, and hyponatremia. Management involves fluid intake, hypertonic fluids, and specific medications. These interventions should be approached in line with the client's preferences and consent, aiming to enhance their comfort during the end-of-life phase. Assessing Client Response to Nonpharmacological Interventions The assessment of client response to both nonpharmacological and pharmacological comfort measures is conducted with the same methodology. The evaluation centers around the predetermined expected outcomes that were established to gauge the client's comfort level and their alleviation of pain and discomfort. Several anticipated outcomes are assessed to determine their achievement, including: ●​ Verbal Expression of Relief : Monitoring whether the client communicates a sense of pain relief following the implementation of progressive relaxation techniques

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