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20 Cards in this Set
- Front
- Back
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pallative care
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delivering treatment and care where cure is no longer possible
<6 months to live |
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patients receiving pallative care
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usually terminal cancer patients
also AIDS, CF, MS, CV disease |
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pallative care has change of focus
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from curative to controlling & alleviating symptoms
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objective of pallative care
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decrease or prevent pain
physical emotional spiritual social needs |
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multidiciplinary approach to pallative care
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many professionals
including social workers, therapists provide bereavement counseling |
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symptoms found in palliative care
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pain, fatigue, GIT, respiratory
all of body systems use multiple medications to treat symptoms |
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cause of symptom in palliative care
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could be due to disease, treatment, medication, concurrent illness.
patient thinks terminal phase?, relapse? |
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symptoms which may need to be relieved
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fatigue (dexamphetamine)
GIT (dry mouth -> artificial saliva) nausea and vomiting (many causes -> use metoclopramide or olanzapine) constipation (laxatives) |
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emergencies
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spinal cord compression
superior vena cava obstruction acute airway obstruction sudden severe haemorrhage |
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terminal care
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last days of life
issues : communication (change in way pain is assessed because patient cant tell you) site of care : home or hospital? |
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resuscitation
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discussed early
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nutrition/ food
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decreased intake = anxiety
mouth care/ice chips rehydration necessary |
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adequate analgesia
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fear that meds may be accelerating death
pain relief DOESNT speed up death decreases suffering |
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chronic illness
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polypharmacy (long term medications, review regularly)
distinction (symptom benefit, long term prevention) |
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cordotomy
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e.g. lung cancer (pain on one side of body)
needle in neck where cross over of nerve pathways, find area, put electrical stimulation to ablate nerve (stop pain stimulation on that side of body) require less opioids/ analgesics |
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ventriculostomy
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administer drugs directly into CNS to reduce opioid consumption
insert port under skin and feed canular into brain |
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implantable pumps
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opioid (morphine/hydromorphone most common)/ local anaesthetic
pump in lower abdomen feed right into CNS |
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spinal cord stimulation
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battery device -> electrical stimulation -> stimulates descending inhibitory pathways
messes up message to brain to decrease pain -> tingling often chronic non-cancer |
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syringe drivers
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simple pump programed to give standard rate of liquid over 24 hour period
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CADD pumps
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resouvoir on bottom
program baseline delivery rate and breakthrough pain dose |
