End of Life Care Flashcards

1
Q

describe the trajectories seen

A
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2
Q

describe hospice and palliative medicine

A
  • affirms life, regards dying as normal
  • team approach to enhance quality of life and positively influence course of illness
  • offers support system to help patients live as acutely as possible until death
  • relief from pain and distressing symptoms
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3
Q

name the 5 key symptoms to control to optimize quality of life

A
  • 5 key symptoms
    • pain
    • nausea and vomiting
    • agitation
    • dyspnea
    • retained repiratory secretions (RTS)
  • assess and respond to psychological, social and spiritual needs
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4
Q

describe the goals for care of the dying adult

A
  • clinically assisted feeding and hydration
    • give by mouth for as long as possible
    • may relieve distressing signs of dehydration
    • unlikely to prolong life or the dying process
  • review current medication
    • anticipate need to change meds and routes of administration
      • have readily available, note in prescription chart
  • a bad death that was avoidable is a failure
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5
Q

describe the analgesic ladder

A
  • mild pain
    • aspirin, acetominophen, NSAIDS
  • moderate pain
    • aspirin, acetominophen + opioids (codeine, oxycodone, tramadol)
  • severe pain
    • morphine, methadone, fentanyl, + nonopioid analgesics
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6
Q

describe the CDC guideline for prescribing opioids for chronic pain

A
  • before starting and periodically during opioid therapy, discuss with patients known risks, realistic benefits and responsibilties
    • effectiveness and risks of long-term opioid therapy varies
    • nonpharmacologic therapy and nonopioid pharmacologic therapy are preferred
    • before staring opioid therapy for chronic pain, establish realstic treatment for pain and function; consider how to discontinue if benefits do not outweight risks
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7
Q

describe critical thinking skills

A
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8
Q

what questions should be asked to elicit & document patient goals?

A
  • what do you understand about your illness?
  • how much do you want to know about what is likely to happen with your illness?
  • who would you want to make decisions for you if you could not communicate?
  • what are your most important goals now?
  • what are your biggest fears and worries now?
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9
Q

describe how physician should talk with patients during end of life care

A
  • are there situations you would find unacceptable?
  • how does your family feel about your preferences?
  • encourage their questions and be prepared to answer them
    • look up outcome data specific to the patient
    • basis for prognosis and likely outcomes
  • summarize your discussion
    • “so let me see if I understand what you are saying…”
  • make recommendation based on patient goals and medical realities
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10
Q

globally, opiods are ___ and pain is _____

A

globally, opiods are underused and pain is undertreated

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11
Q

explain why opioid use in clinics is low among healthcare practitioners

A
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