Palliative Care_Unrein

Question 1

Hospice eligibility

Answer 1

<6mo to live (clinical judgement)

qualifying dx ( CA, HIV, CVD, Pulmonary, renal, liver….)

Question 2

competence

Answer 2

legal term determined by judge

Question 3

capacity

Answer 3

medical term
is someone capable understanding and making decision
otherwise need surrogate or MOST

Question 4

opioids

Answer 4

work on receptors in the CNS and PNS inhibit Ca binding and alerts NT release

also modulate sensation of SOB

Question 5

mild-moderate

Answer 5

Codeine
Hydrocodone (Schedule II)

Question 6

Moderate-severe pain

Answer 6

Morphine 
hydromorphone 
oxycodon 
fentanyl 
methadone

Question 7

s/e of opioids

Answer 7

CONSTIPATION
Nausea
Somnolence
Myoclonus and neurotoxicity

Question 8

methylnaltrexone

Answer 8

opiate antagonist that cant cross the BBB

good for constipation

Question 9

Does hospice require DNR

Answer 9

NOPE

Question 10

POLST/MOST

Answer 10

legal document that declares what someone wants in terms of Abx, CPR, Enteric feeding

Question 11

The Law of Double Effect

Answer 11

FIRST DO NO HARM
used explain the permissibility of an action that causes a serious harm, such as the death of a human being, as a side effect of promoting some good end.

OK to give morphine if INTENT is to relieve pain