36. cancer / chronic dz / grief Flashcards
Obvious prevention advice
stop smoking,
reduce unprotected sexual intercourse, re: prevent human papillomavirus infection
pt who has cancer and is followed by oncology … mdf f/u
remain involved
do not loose pt during cancer care
In a patient diagnosed with cancer, actively inquire, with compassion and empathy, about ….
1) personal and social consequences of the illness (e.g., family issues, loss of job)
2) the patient’s ability to cope with these consequences
inquire about side effects of tx such as
diarrhea, feet paresthesias
Pain management
Nausea/Vomiting (Opioid induced, Gastroparesis, CNS - raised ICP )
Constipation/Diarrhea
Feet paresthesias
Lymphedema
Sedation / Insomnia
Dyspnea
Anorexia / Fatigue
Dry mouth / Dysphagia
pt with atcd de cancer presents with new SOB or neuro sx ddx must include
METS
when you do not know the prognosis, tell the pt
you dont know
pt with a chronic disease frequently R/A…
rx compliance
In patients with chronic disease, actively inquire about (4)
the psychological impact of diagnosis and treatment.
functional impairment.
underlying depression or risk of suicide.
underlying substance abuse.
Oncology Emergencies (6)
Spinal Cord Compression
Superior Vena Cava Obstruction
Hypercalcemia
Pericardial Tamponade
Tumor lysis syndrome
Febrile neutropenia
In all pts and especially if complex grief dépister (5)
depression,
suicidal ideation,
self-medication
alcohol
substance use
In patients with presentations suggestive of grief reactions without obvious triggers look for
triggers that may be unique to each patient
death of a pet,
loss of a job,
reactions to anniversary
acute grief time frame
6-12 mo
Complicated grief definition
bnormally prolonged, intense, and disabling
adaptive responses in grief
physical, emotional, cognitive, behavioral, and spiritual responses
grief different from depression in which ways
depression
Severe persistent symptoms,
persistent decreased function,
suicidal ideation
grief mgmt
Acknowledge the loss and the associated grief
Actively listen to and explore patients’ concerns, reinforce patients’ strengths in coping with their illness
Encourage external sources of support including family, friends, and faith communities, or support groups
Consider psychotherapy if requests or in complicated grief
