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Palliative Care > Lesson 4 > Flashcards

Lesson 4 Flashcards

1
Q

ALS feeding tube placement

A

should be placed before vital capacity drops below 50% predicted

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2
Q

Hypercalcemia rx

A

first step: IV hydration
then, diuretics and bisphosphonates

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3
Q

most common type of delirium for hospitalized elderly

A

mixed delirium

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4
Q

TCA with less anti-cholinergic effects

A

desipramine
nortriptyline

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5
Q

neonate pain rating scale

A

CRIES

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6
Q

FLACC pain scale rating

A

2 months to 7 years old

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7
Q

methadone maintenance therapy

A

dose methadone q6 to q8
opioid prn

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8
Q

hard stool in rectal vault rx

A

enema

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9
Q

most closely correlated to driving performance

A

Clock Drawing Test

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10
Q

opiate

A

any drug that is natural product of opium poppy plant

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11
Q

list of opiates

A

morphine
codeine
thebaine

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12
Q

synethic opioid

A

fentanyl

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13
Q

Buddhist beliefs re: meds

A

meds that contain animal byproducts may be resitrictdd

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14
Q

Buddhist beliefs re: death

A

believe patient is not completely dead until several hours after pronounced, so don’t want body to be moved quickly

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15
Q

depression meds with increased risk of seizures

A

bupropion
maprotiline

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16
Q

depression rx

A

SSRI
then try another SSRI
then try another med

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17
Q

first-line rx for neuropathic pain

A

SNRIs
TCAs
gabapentinoids

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18
Q

NSAIDs

A

COX inhibitors
prolong bleeding time

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19
Q

methadone mechanism of action

A

NMDA antagonist
full mu receptor agonist
MAO inhibitor

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20
Q

methadone oral bioavailability

A

80%

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21
Q

methadone metabolites

A

no active metabolites

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22
Q

adjust methadone dose at what CrCl?`

A

<10%

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23
Q

atheist/agnostic physicians more likely to

A

make decisions to hasten death

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24
Q

more religious physicians less likely to

A

discuss end of life decisions with patients

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25
Q

fatigue steroid treatment

A

dexamethasone most studied

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26
Q

fatigue med

A

megestrol

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27
Q

stimulants for fatigue studied in what patient population?

A

cancer patients

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28
Q

SVC syndrome management for patient on hospice

A

elevated head
supplemental O2
consider steroids, diuresis
consider outpatient radiation

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29
Q

WHO pain ladder

A

non-opioids
weak opioids
strong opioids

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30
Q

weak opioid examples

A

codeine
tramadol

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31
Q

hip fracture in hospice patients, traction

A

does not reduce pain
not recommended

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32
Q

hip fracture in patient >75 with hgb<12

A

transfuse

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33
Q

majority of hospice patients with hip fracture who go to hospital

A

get surgery

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34
Q

pancreatic cancer pain management

A

celiac plexus block

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35
Q

celiac fibers

A

antero-crural

36
Q

splanchnic fibers

A

retro-crural

37
Q

headache due to increased ICP

A

NSAIDs
corticosteroids

38
Q

clarithromycin effect on cyt p450

A

suppression

39
Q

fentanyl patch onset of pain relief

A

12 hours
may take 24 to 48 for full pain relief

40
Q

dosing interval for fentanyl patch

A

q72 hours

41
Q

skin care

A

avoid hot water
powder applied first, then cream

42
Q

cultural preference scale

A

ABCD

43
Q

neuroma-related pain from amputated limb

A

ultrasound guided radio frequency ablation

44
Q

non-specific nausea first line treatment

A

metoclopramide

45
Q

NSAIDs available in IV form

A

meloxicam
diclofenac
ibuprofen
ketorolac

46
Q

FICA

A

results have been shown to closely correlate with QOL tools assessing spirituality

47
Q

FICA stands for

A

Faith and belief
Its importance
Community (religious/spirituality)
Addressing how patient would want you to incorporate this

48
Q

Naproxen

A

propionic acid derivative (same class as ibuprofen)

49
Q

Citalopram side effect

A

QTc prolongation
check EKG before and after starting med
dose not to exceed 40 mg

50
Q

Tramadol should not be

A

stopped abruptly

51
Q

Tramadol method of action

A

mu-opioid agonist

52
Q

most validated instrument to assess functional level in palliative care patients

A

Palliative Performance Scale

53
Q

ECOG used for

A

performance status in cancer patients

54
Q

Lansky score

A

functional status for children

55
Q

methylnaltrexone used for

A

constipation, itching

56
Q

prevalence of elder abuse/neglect in last year

A

10%

57
Q

steroid which causes hiccups

A

dexamethasone

58
Q

first line rx for hiccups

A

chlorpromazine

59
Q

relational risk for addiction

A

having a friend with addiction

60
Q

NSAID with highest CV risk

A

diclofenac

61
Q

opioid effect on respiratory system

A

morphine decreases minute ventilation by decreasing RR

62
Q

sodium phosphate enema side effects

A

dehydration
hyperphosphatemia, hypocalcemia, hypokalemia
avoid in those with CHF, renal dysfunction, cirrhosis

63
Q

anterior cord syndrome

A

can be side effect of celiac plexus block
loss of motor, pain, light touch, temp sensation

64
Q

CCB side effect

A

constipation

65
Q

dextromethorphan can cause

A

serotonin syndrome

66
Q

post-mastectomy pain syndrome associated with

A

younger age
prior history of headaches
more extensive disease
immediate post-op pain

67
Q

weak opioids

A

codeine
tramadol
hydrocodone/acetaminophen

68
Q

pain assessment Likert scale

A

any change is considered clinically significant

69
Q

change of 2 points on numeric pain rating scale

A

considered clinically significant

70
Q

antidepressant discontinuation syndrome

A

flu-like sx
electric zaps/shock sensation in head

71
Q

pill esophagitis causes

A

tetracyclines
potassium
iron
NSAIDs
bisphosphonates

72
Q

reiki

A

hands/touch transfer “universal energy” from practitioner’s palms to encourage healing

73
Q

context-sensitive half-life

A

time taken for blood plasma concentration of drug to decline by one half following infusion at steady state

74
Q

highest rate of suicide

A

non-hispanic Native American youth have highest rate

75
Q

bereaved suicide rate (males vs. females)

A

higher in males

76
Q

use of antipsychotics in individuals with dementia associated with

A

increased mortality
increased risk of stroke

77
Q

constipation as side effect of opioids occurs in what percent of patients?

A

40-95%

78
Q

melanoma poor prognostic findings

A

elevated LDH
elevated serum calcium

79
Q

NSAID with highest CV risk

A

diclofenac

80
Q

POLST

A

more details than advance directives

81
Q

GBM poor prognostic lab findings

A

thrombocytosis
anemia

82
Q

MELD components

A

INR
bilirubin
creatinine
etiology of cirrhosis
sodium

83
Q

Child Pugh components

A

INR
albumin
bilirubin
ascites
encephalopathy

84
Q

minimum life expectancy for placement of intrathecal pain pump

A

three months

85
Q
A

Palliative Care (4 decks)

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