palliative care Flashcards

1
Q

Name 3 life-limiting conditions

A

Cancer

Dementia/frailty

Heart/vascular disease

Respiratory disease

Kidney disease - end stage

Liver disease - end stage

Neurological disease - motor neuron disease

Any condition /complications that are not revisable

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2
Q

What is End of Lifecare

A

‘Person and family-centred care provided for a person with an active, progressive, advanced disease, who has little or no prospect of cure and who is expected to die, and for whom the primary treatment goal is to optimise the quality of life.’

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3
Q

What are the five domains of Holistic care?

A

spiritual

cultural

emotional

physical - clinical symptoms: pain, fatigue,

social

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4
Q

What do you need to consider in terms of caring for the pts family?

A

Stressful

Emotionally/psychologically/Spiritually challenging

Need to be

  • Informed
  • Educated
  • Supported
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5
Q

what does the SPICT tool stand for?

A

Supportive & palliative care indicators tool

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6
Q

who are part of the Multidisciplinary team caring for the pt

A

Physicians/Oncologists/Surgeons

Nurses

Palliative Care Team

Nuclear Medicine Specialists

Physio

OT

Social workers

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7
Q

Name the 2 communication frameworks that you can use when communicating with a palliative patient

A

Communication Frameworks:

  • PREPARED
  • SPIKES
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8
Q

what do you need to consider when communicating with a palliative patient

A

Continuous through the patient journey

Involve patient, Family, Loved ones

Needs to be

  • Effective
  • Efficient
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9
Q

What does the prepared framework stand for

A

P- prepare for the discussion
R- relate to the person
E- elicit preferences from patients/carers
P - provide information tailored to the person
A- aknowledge emotions/concerns
R- (foster) realistic hope
E- encourage questions and further discussion
D- documentation

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10
Q

What does the SPIKES framework stand for

A
S- setting up the conversation
P- Assessing the persons pperception
I- obtaining the persons invitation
K- providing knowledge and information to the person
E- recognising emotions 
S- Strategy and summary
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11
Q

When should the goals of care be set?

A

Begin soon after life-limiting illness

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12
Q

Goals of care are a way of beginning _____ planning process

A

advanced care

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13
Q

What elements should a palliative care plan involve (8)

A

Who participated in the plan

Contact details – coordinators of care

Clearly defined Goals & Responsibilities

Ongoing holistic assessment (5 domains)

Multidisciplinary involvement

Sharing/re-evaluation details

Links to the relevant documentation

Planning for expected evens/changes

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14
Q

Symptom Control - Pain Management

A

Stepwise Ladder Approach

Control of breakthrough pain

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15
Q

Symptom Control - Dyspnoea

A

Dyspnoea

Positioning

O2

Suctioning

Anticholinergic drugs – secretions

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16
Q

Symptom Control

A

Pain Management

Dyspnoea

Nausea/dehydration

Neuro deficits
-

17
Q

What are the 6 standards of care for palliative care

A

1) Assessment of needs
2) Develop the care plan
3) Caring for the carers
4) Providing care
5) Transitions within and between services
6) Grief support

18
Q

Caring for the Carers

A

Stressful

  • Carer Support - Assessment
  • Respite Care
  • Spiritual support
19
Q

Caring for the Carers (HCW)

A

End of life care

  • Burnout
  • Moral Distress
  • Compassion fatigue
20
Q

Pharmacological interventions for palliative care patients

A
  • Analgesics
  • Nausea and Vomiting
  • Hydration therapy
  • Anticholergic drugs
21
Q

Anticholinergic drugs

Pharmacodynamics

A
  • Blocks Transmission of acetylcholine throughout the body
  • Relaxation of smooth muscle
  • Drying up of secretions
  • Used in end of life care for secretion management
22
Q

Anticholinergic drugs

Pharmacokinetics

A

Poorly absorbed in the GI tract

Does not cross the blood brain barrier – no effect on CNS

23
Q

Anticholinergic drugs

Indications

Adverse effects

Contraindications

A

Indications – Spasm of GI tract, renal spasm, secretion management in EOL care

Adverse effects – Urinary retention, dizziness, tachycardia

Contraindications – paralytic ileus, urinary retention, glaucoma

24
Q

What is the stepwise ladder approach?

A

starting with no opioid analgesia to control pain before scaling up

eg. panadol - codeine - morphine

25
Q

why are meds given subcut?

A

difficult to gain PVC access

gag reflex absent - cant give oral meds