Palliation Flashcards
What is an advanced directive?
A legal document that allows individuals to choose their preferred treatment plan while they are able to ensure that their wishes will be carried out even when they are unable to make decisions for themselves.
What makes an advanced directive legal?
They should all be in writing, signed by the patient, witnessed, and notarized.
How do infants typically respond to pain?
- exhibits body rigidity or thrashing
- exhibits a facial expression of pain
- cries inconsolably
- hypersensitivity or irritability
- poor oral intake
- unable to sleep
What are some interventions for pain for an infant?
- offer a pacifier
- swaddle the infant
- rock infant
- allow the parent to hold the infant
- offer distractions such as music or a small toy
- breastfeed the infant
How do toddlers and preschoolers typically respond to pain?
- May describe pain through basic words or gestures
- may be verbally aggressive
- may cray intensely
- exhibits physical resistance by pushing away painful stimulus
- guards painful area of the body
- may request emotional support from parent
What are some interventions for pain for a toddler or a preschooler?
- offer distractions like toys, books, or treats
- Allow the parent to hold the child
- teach the child what to expect when encountering a painful procedure
- paly games (blow bubbles, pinwheel, peek-a-boo)
- Encourage the parent to be calm, as children can sense a parent’s anxiety
How do school-aged children typically respond to pain?
- should be able to accurately describe their pain
- may exhibit stalling behaviors
- exhibits muscle rigidity and other behaviors in anticipation of pain
- may revert to an earlier developmental stage with persistent or severe pain
What are some interventions for a school-aged child in pain?
- simulate/act out the procedure beforehand
- encourage a parent to be present to provide support
- videos
- guided imagery
- give the child a book to reach or an activity to do
- encourage cultural practices such as prayer
Define palliative care
An approach that improved the quality of life of patients and their families facing the problem associated with a life-threatening illness, through the prevention and relief of suffering by means of early identification and impeccable assessment and treatment of pain and other problems, physical, psychosocial, and spiritual
Define hospice care
A type of palliative care that focuses on the last 6 months of life.
When should palliative care for a child be started?
At the beginning of the diagnosis of a chronic condition.
How much time should parents be allowed to see their child on palliative care?
They should be allowed to spend as much time as possible with their child, and nursing staff should provide privacy for the family as needed.
What are some barriers to palliative care for a child?
- lack of formal pediatric palliative care education, uncertainty about a prognosis, and concern regarding the timing of palliative care
- Patient and family-related barriers such as misperceptions between the child’s parents’ beliefs about palliative care and the providers’ beliefs about palliative care, and concern over the ability of community PCC to be provided at the level of satisfaction of hospital care
- resource-related barriers such as lack of community palliative service for children, lack of referrals to a PCC team, financial barriers, and cultural barriers
What are the stages of grief?
- denial
- Anger
- Bargaining
- depression
- acceptance
What are the goals of palliative care?
relieve pain and other distressing symptoms, affirming life, viewing death as a normal process, integrating psychologic and spiritual aspects of care, offering a support system for both patients and their families, and using a team to address the needs of patients and families
