Palliative Care Flashcards

1
Q

Seriously ill, hospitalized patients report that what things are worse than death?

A
  • Incontinence
  • Requiring a ventilator
  • Persistent mental confusion
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2
Q

Doctors are more likely to opt for dying at ____________.

A

home

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3
Q

What proportion of medicare beneficiaries have the following in the last month of life?
•ED visit
• ICU admission
• Inpatient surgery

A
  • ED: 1 in 2
  • ICU: 1 in 3
  • Inpatient surgery: 1 in 5
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4
Q

What is the GAPS mnemonic?

A
  • Goals at the end of life
  • Advanced directive
  • Psycho-spiritual support
  • Symptom control
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5
Q

What is necessary for hospice care?

A

A prognosis of six months or less

Note: palliative care does not require this. PC is primarily a symptom-management team for people with serious illness.

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6
Q

Over the last thirty years, more people are dying in _____________ and fewer are dying in ____________.

A

their homes or in nursing homes; as inpatients

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7
Q

List six things that dying people often want.

A
  • A dedicated decision maker
  • Financial life in order
  • Knowing prognosis
  • Knowing what physical changes to expect
  • Pain control
  • Maintain dignity
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8
Q

How adept are doctors at recognizing the dying process?

A
  • 49% can diagnose it in the last 24 hours

* 21% can diagnose it in the last 72 hours

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9
Q

The cardiac system often goes from _________ to ___________ during the dying process.

A

tachycardic; bradycardic

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10
Q

_____________ often need to be discontinued when dying people start struggling to breath.

A

IV fluids (which can worsen pulmonary edema)

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11
Q

_____________ are often given to treat dyspnea. There is no evidence that this hastens death.

A

Opioids

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12
Q

Three systems need to be checked to determine death: ________________.

A
  • Neurologic: no cranial reflexes; nonresponsive
  • Cardiac: no pulse
  • Pulmonary: no respirations
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