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CI2 > Palliative Care > Flashcards

Palliative Care Flashcards

1
Q

What are the individual factors influencing death & dying?

A
  • Age
  • Past experience
  • Religion
  • Culture
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2
Q

What are some of the common needs & preferences of people with life-limiting illnesses?

A
  • Management of physical symptoms (pain, weakness, fatigue, dyspnoea)
  • Management of psychological symptoms
  • Need for social support
  • Culturally specific needs related to language & info disclosure
  • More info about treatment, diagnosis, prognosis
  • Spiritual/existential concerns
  • Financial/legal concerns
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3
Q

What is palliative care?

A

Specialised are of healthcare developed to respond to the needs of people with life-limiting illnesses

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4
Q

What are the key points in the WHO approach to palliative care?

A
  • Should come early in course of illness
  • Emphasis on promoting holistic care
  • Family & significant others included
  • Emphasis on assessment, early identification of problems & appropriate treatments
  • Disease-modifying treatments may have a role (e.g. chemo)
  • Provided in any setting
  • Emphasis on team approach
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5
Q

What are some examples of life-limiting illnesses?

A
  • Cancer
  • Heart disease
  • COPD
  • Dementia
  • Heart failure
  • Neurodegenerative disease
  • Chronic liver disease
  • Renal disease
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6
Q

What are some of the factors that should be considered when determining a patient’s needs?

A
  • Nature & level of the patient’s health & support needs
  • Individual strengths & resources
  • Individual preferences & choices
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7
Q

What are some of the factors influencing the clinical course of a disease?

A
  • Natural history of the disease itself
  • Presence & nature of co-morbidities
  • Treatment goals & decisions
  • Access to health services
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8
Q

What are the common features of the early stage of imminent death?

A
  • Bed bound
  • Loss of interest &/or ability to eat/drink
  • Cognitive changes (more sleeping, delirium)
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9
Q

What are the common features of the middle stage of imminent death?

A
  • Further decline in mental status to obtundation (only brief periods of wakefulness)
  • Death rattle (loss of swallowing reflex causing pooled oral secretions)
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10
Q

What are the common features of the late stage of imminent death?

A
  • Coma
  • Fever
  • Altered respiratory pattern (cheyne-stokes, apnea, hyperapnea)
  • Mottled extremities
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11
Q

What are some of the most common physical symptoms in palliative care?

A
  • Fatigue
  • Pain
  • Dyspnoea
  • Anorexia
  • Constipation
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12
Q

What are some of the most common psychological symptoms in palliative care?

A
  • Emotional distress
  • Anxiety
  • Depression
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13
Q

What should effective management of symptoms include?

A
  • Integrated approach (e.g. symptom man agent + education)
  • Targeted approach (directed at specific causal mechanisms & factors)
  • Tailored approach (patient’s preferences)
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14
Q

What is existential distress?

A
  • Distress experienced by people when confronted by their own existence
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15
Q

When can people experience existential distress?

A
  • When facing issues of their meaning in life
  • When there is a threat to their sense of personal worth
  • When personal beliefs are challenged
  • When suffering feelings of loss
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16
Q

What are some of the strategies for communication?

A 
PREPARED
P: Prepare for the discussion
R: Relate to the person
E: Elicit patient & caregiver preferences
P: Provide info tailored to their needs
A: Acknowledge emotions & concerns
R: (foster) Realistic hope
E: Encourage questions & further discussions
D: Document
17
Q

What are some of the spiritual care strategies?

A
  • Settings: Identify where they feel safe, ask them what reminds them of that place
  • Stories: Allow them to share their story, ask questions
  • Systems of belief: Ask about their rituals/beliefs, arrange visits from religious practitioners if requested
18
Q

What are some of the physical changes with dying?

A
  • Decreased appetite & thirst
  • Increased sleeping, less alert
  • Temperature
  • Incontinence
  • Secretions
  • Breathing
  • Restlessness

CI2 (17 decks)

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