Symptom management in End of Life Flashcards
symptoms of end of life
Coldness, confusion, restlessness, incontinence, urine decrease, loss of appetite, breathlessness.
Patient factors to consider are?
co-morbidities
pre-existing medications
Routes of administration
Treatment factors to consider in end of life are?
Is the cause of the symptom reversible without medications?
Which medications can specifically be prescribed for symptoms?
Side effects to be considered on administration
what are the causes of agitation and distress in a dying patient
Unmanaged Pain medications such as corticosteroids or opioids nicotine withdrawl urinary retention oxygen deficiency sepsis organ failure cerebral odema
How can you treat agitation and distress without medication
Orientate them to place & Time with a clock Don't dismiss them Ask them to explain their feelings Hold their hand Speak gentley Call family members
How would you manage type 2 diabetes diet controlled or metformin
Stop monitoring BM
How would you manage a type 2 insuline or tablet based?
stop tablets and consider stopping insuline if small dose
Check urinalysis for glucose daily and follow guidance
How would you manage type 1 insuline based patient?
Give 1 dose of morning insuline with reduced dose and monitor at tea time. Reduce or increase dose by 10-20% stages.
Summarise the categories of management in dying patients
Non-medicine symptom management
Medicinal Symptom Management
Anticipatory prescribing
What is different about end of life medications in patients with renal failure
you must check the guidelines for patients with renal failure before prescibing medications
What is the point in ICU
ICU is used for patients to recieve intense treatment if the healthacares deem the patient a suitable candidate for treatment.
Explain some of the frameworks used in end of life care and ICU care.
Advanced care planning document Next of Kin DNACPR Gold Standard Frameworks Lasting Power of Attorney MDT meetings
