End of Life Care - Final Flashcards
All of the following are considered:
• progressive weight loss (especially > 10% over 6 months);
• rapidly declining level on the Palliative Performance Scale (PPS) (refer to Appendix A: Palliative Performance Scale (PPS));
• dyspnea;
• dysphagia; and
• cognitive impairment.
Poor prognostic factors for end of life
The single most important predictive factor in cancer is _______
Performance status and functional ability (BC Guidelines)
True/False
Consider referral to Home Care Nursing when patient’s PPS is transitioning from 70% to 60% or lower
True
Consider an application to BC Palliative Care Drug Plan (Plan P) when patient is in last six months of life and has a
PPS of ____ or less
50% or less
What scale is used to evaluate symptom burden in palliative patients?
ESASr (Edmonton Symptom Assessment System)
Registration can be made to the Palliative Benefits Program when a patient’s life expectancy is estimated to be ____
or less
6 months or less
Recommended visit frequency depends on prognosis. For example, if the illness is stable (PPS ≥70%), ______ visits are
recommended, but if the illness is changing monthly, then visit monthly. More frequent planned visits are warranted in
the face of more rapid decline.
quarterly
List some palliative care emergencies that may require intervention
Spinal cord compression --> MRI SVC compression --> CT chest Pathologic fracture --> x ray/CT ARF --> US Other: Airway obstruction, hemmorhage, seizures
_________ Agreement where you write your instructions and name someone to make your health and personal care decisions if you become incapable.
Representative agreement
____ ______ is instructions for health care that are given to your health care provider, which they must follow directly when it speaks to the care you need at the time if you become incapable.
Advanced Directives
_____ power of attorney is where you appoint someone to make decisions about your financial affairs, business and property
Enduring
Type of pain described as aching, cramping, or sharp. The pain may be referred to undamaged areas
Visceral pain
pain in the skin, muscle, or bone. May be described as throbbing, stabbing, aching or pressure-like
(e.g. bone fracture). Pain is generally experienced in the location of tissue damage.
Somatic pain
What step of the WHO pain scale includes opiods (1-4)
2
List five SE of opioids
Constipation N/V Sedation Resp depression Pruritis Urinary retention Reduced libido Delerium Myoclonus
