8. End of Life Flashcards
Definition of palliative medicine
patients whose disease is not responsive to curative treatment. Management of pain, other symptoms- focus of care is on immediate quality of life
-Focused on comfort, relief and immediate function
What are the 5 Kubhler-Ross Stages
Stages people go through when they find out they are dying
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
T/F The 5 stages of Kubhler-Ross also present in order
F- some steps are even skipped
Why is a sympathetic touch from the doctor significant to patients
leaves people with impression that the visit lasted twice as long
How should you address a patient’s companion
You should always address the patient unless they can’t understand
What oral issue has the greatest prevalence in terminally ill patients? Other oral issues are…
Candidiasis= 1
- Xerostomia
- Denture issues
- Oral soreness
Goals of dental management for terminally ill patients
- Monitor and treat oral disease
- Manage xerostomia
- Evaluate oral hygiene
- Adress oral pain
- Maintain OHI and function
- Maintain overall quality of life
Terminal cancer patients with Head and Neck cancers typically have what oral problems
- Pain
- Feeding issues
- Compromised airway
- Dysphagia
- Xerostomia
- Candida
- Mucositis
- Oral ulcers
- Altered taste
- Poor OH
- Rampant caries
Primary complications from H&N cancer like xerostomia and poor OH (Pain) can lead to what secondary complications
- Dehydration
- Dysguesia (altered taste)
- Source of systemic infection
Radiation of the head and neck can irreversibly injure what tissuses… which can lead to…
- Oral mucosa
- Vasculature
- Muscle
- Bone
Which can lead to… xerostomia, rampant caries, trismus, soft tissue necrosis and osteonecrosis
Acute complications of radiation therapy are
- Oral mucositis
- Infection (bacterial and fungal)
- Salivary gland dysfunction (sialadentis and xerostomia)
- Taste dysfunction
Difference between radiation and chemo
- Radiation damage is site specific
- Chemo travels in blood and affects many sites
The degree of damage by radiation is dependent on
- Type of radiation used
- Total dose administered
- Field/size fractionation
Loss of funciton of salivary glands as a result of radiation is dependent on
- Total dose
- Time
- Gland dependent
Which salivary gland cells are more sensitive to radiation damage (Mucous/serous)
serous
