Palliative Care Flashcards

1
Q

What is palliative care?

A

Improving the quality of life of patients with life threatening illnesses by preventing and relieving suffering, treating pain and other physical, psychosocial and spiritual problems

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2
Q

What is included in this?

A
Pain control
Emotional help
Practical help
Financial help
Advanced care planning 
Bereavement care
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3
Q

What kind of symptoms do people in palliative care have?

A
Pain
Fatigue/weakness
Poor mobility 
SOB
Poor appetite
Sore/dry mouth
N+V
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4
Q

List the steps of pain management.

A
  1. Paracetamol (1g 4x daily) or NSAID (500mg 2x daily)
  2. Codeine 30-60mg 4x daily or Co-codomol
  3. Strong opiate e.g morphine
  4. Add paracetamol/NSAID to morphine
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5
Q

Hallucinations, drowsiness and myoclonus are symptoms of what?

A

Opioid toxicity

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6
Q

What happens to patients once they are started on morphine?

A

They become dependant and cannot be suddenly withdrawn i.e opioid tolerant

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7
Q

What drug can reverse the effects of morphine instantly?

A

Naloxone

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8
Q

What is a severe side effect of morphine?

A

Respiratory distress

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9
Q

What 2 types of morphine should be given?

A

Background/modified release - given 2x daily

Breakthrough/immediate release - given PRN

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10
Q

How do you get dose of breakthrough morphine?

A

Divide background by 6

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11
Q

Name some types of non-drug pain relief.

A

Radiotherapy
Chemo
Surgery
Orthotics

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12
Q

What does the KIS include?

A

Resus wishes, place of death, ‘just in case’ drugs, power of attorney

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13
Q

How do you recognise a dying patient?

A

Becoming weaker, not eating or drinking, sleep more, can’t take oral medicines

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14
Q

What must you always make sure?

A

That there is no reversible features

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15
Q

What does a syringe driver do?

A

Smoothest delivery of drugs via SC route
Max 3 drugs
Can also add anti-emetic

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16
Q

How often is a syringe driver changed?

A

Daily

17
Q

How do you work out SC dose of morphine?

A

Divide PO dose by 2

18
Q

Pain/SOB

A

Morphine 2mg SC hourly

19
Q

Distress

A

Midazolam 2mg SC hourly

20
Q

Nausea

A

Levomepromazine 2.5mg every 8 hours

21
Q

Secretions

A

Buscopan 20mg hourly

22
Q

Benefits of giving fluids?

A

Reduce dry mouth, constipation, delirium

23
Q

Burdens of giving fluids?

A

Fluid overload, oedema, worsening secretions

24
Q

How is death verified?

A
Reaction to voice or pain
Resp efforts 
Check eyes
Feel pulses for 1 minute 
Auscultate heart and lungs for 1 minute
Record date and time