Week 4 Palliative care - overveiw

Question 1

How is palliative care defined?

Answer 1

a person centred and family centred care provided for a person in an acitive progressive advanced disease who has little or no prospect for cure and is expected to die and or whm the primary care goal is optomising quality of life

Question 2

when should palliative care begin?

Answer 2

First begin with the diagnosis of an active, progressive or advanced disease

Question 3

when in the early stages might palliative care be provided?

Answer 3

Clinical triggers for referal to palliative care for chronic conditions - can be provided if there is lots of actue exacerbations and there are many trips to hospital

Question 4

what can paliative care provided managment for?

Answer 4

manamgment of complex pain, and other physical and pshycosocial conditions
- Pain, nausea, SOB
resourcing, cultrual and finacial support

Question 5

where can palliative care be provided?

Answer 5

home, hospital, hospis, residential aged care

depends on support, nature of ilness, palliative care services avaliability

Question 6

what factors influence our veiws on death and dying

Answer 6

Age
social factors 
cultural
spirituality
previous experience with dying and death

Question 7

what cultural considerations impact on death and dying?

Answer 7

communication issues, modes of decison makinf, concepts of death, dying and diseas, customs surrounding death, meaning of pain and other symtoms, attiudes to medication and nutrition

Question 8

what are some aboriginal cultral practices after death?

Answer 8

not using deceased persons name- sorry bussiness- involves family and lasts for days, smoking ceremonies

Question 9

what are some jewish culttural practices after death?

Answer 9

tear in clothing to show grie
body washed and prepared for berrial- deceased person not left alone
burial should happen as soon as possible after death

Question 10

what happens to our breathing as we die?

Answer 10

in terminal phase- slow breathing, rapid and shallow, cheyne stokes respirations and agonal respirations

coughing and swallowing reflexes slow down- siliva and mucus accumulates
pts report suffocating, short of breath, drowning

Question 11

what happens to HR when we die?

Answer 11

extreme tachy or brady or flucuation

Question 12

what does BGL look like when we are dying?

Answer 12

High BGL sue to reduction of insulin and response- can trigger thrist or confusion- sometimes managed with insulin

Question 13

what happens to appetite and thrist as we die?

Answer 13

both decrease- sips of water, moist mouth

Question 14

what happens to sleep and alertness as we die?

Answer 14

may be drowsy and difficult to rouse

Question 15

what happens to a person tempreture as we die?

Answer 15

poor circulation- peripheral circulation shut down- blotchy

between cool or hot

Question 16

what happens to our continece when we are dying?

Answer 16

reduced urin output as kidneys shut down

incontence affects some but not everyone

Question 17

why do we get restless when we die?

Answer 17

poor cerebral cirulation and accumulation of toxins

Question 18

what is the terminal phase?

Answer 18

multiple signs and symptms not reveresed by other cause

peripheral shut down, changes in resp patters, dorwsiness, reduced urinary output, no longer eating, no longer wallowing

Question 19

what is the PANERO neumoic?

Answer 19

Evidence of the terminal phase 
Pain
agitation
nausea
emergencies- vomiting, dyspnea, airway obstruction, SVC obstruction, agitation, seizures, spinal chord compression
resp symptoms
other- related to illness