Ger 14 Palliative Care Flashcards
True or False: pallative care is to improve the quality of life by communicating with patients AND their families.
True
What 2 treatments should you consider if the pt is suffering from anorexia and cachexia?
Megestrol acetate
Dexamethasone
What 2 treatments if the pt exhibits restlessness, agitation, insomnia, hyperventilation, tachycardia, or excessive worrying?
Counseling
Short-acting benzo’s
What 2 things should u question if the pt has constipation?
is the pt taking opioids or has a fecal impaction
What is the treatment process for constipation?
prescribe a stool softener + escalating doses of a stimulant
If escalating doses of a stimulant are ineffective in treating constipation, what drug classes should be added to the treatment?
osmotic laxatives and enemas
If a pt starts to express depression, what treatments are available?
Psychotherapy/cognitive/behavioral therapies
Medications
Which class of antidepressants work within days?
Psychostimulants
Which class of antidepressants take 3-4 weeks to take effect?
SSRI’s
Which class of antidepressants are contraindicated because of their side effects?
Tricyclics
In the delirious patient, in addition to lifestyle changes, what 3 drugs can u prescribe?
Haloperidol
Risperidone
Olanzapine
What is the first line treatment for the dyspnea pt?
Oxygen
Yeah this is weird, but which branch of the trigeminal nerve can u stimulate to provide symptomatic relief for the dyspnea pt?
V2
Which drugs relieve breathlessness without measurable reductions in respiratory rate or oxygen saturation?
Opioids
Where should treatment be directed in the nauseous pt?
the underlying cause
What 2 drugs can u give for the treatment of mild pain?
Acetaminophen or NSAID
What drug do u give for moderate pain?
Titrate short-acting opioids
You should rapidly titrate short-acting opioids if the patient has what kind of pain?
Severe pain
Once pain is controlled with the opidoids in severe pain, what drug is indicated?
Methadone
In rescure doses for pain, what % of of the 24-hour total opioid dose is to be given every hour?
10%
What should be used in addition to opioids during rescue doses?
concomitnant analgesics
What mainly happens during the early stage in the goals of care in pallative medicine?
basically just diagnosis, prognosis, goals, hopes and expectations for treatments
What 2 things must you evaluate the patients understanding of during the middle stage of the goals of care for pallative services?
Understanding of the prognosis and the benefits-to-burden ratio for treatments
In the late stage in the goals of care for pallative services, what is the main thing to help the pt plan for?
Death lol
During the early stage of programmatic support, what 2 things do you advise the pt to sign up for?
Visiting nurse/home services
Case management services
What program do you encourage during the middle stage of programmatic support?
pallative care program
Where do you consider placing a pt in the late stage of programmatic support?
Nursing home
During the early stage of financial planning, you advise financial and insurance support and referral to what person to help with that?
Lawyer
What’s the difference between a catfish and a lawyer?
One is a bottom-dwelling scum-sucker and the other one is just a fish.
The middle stage of financial planning asseses the adequacy of planning for financial, medical, home care, prescription, long-term care, and family support, which all should start considering eligability for what?
Medicaid
What do you inform patients and families about in the early stage of family support?
Support groups
During the late stage of family support, you encourage who to visit because of the likely end for the pt?
Out-of-town family
