Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

N4400 > Week 4 - Palliative - Part 2 > Flashcards

Week 4 - Palliative - Part 2 Flashcards

1
Q

What are the 5 domains of quality EOL care?

A
  1. Receiving adequate pain and symptom management
  2. Avoiding inappropriate prolonging of dying
  3. Achieving a sense of control
  4. Relieving burden (to others)
  5. Strengthening of relationships with loved ones
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the 5 most prevalent symptoms in palliative care?

A

Dyspnea, constipation, fatigue, pain, delirium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

unpleasant sensory awareness of breathing; subjective experience of difficulty or uncomfortable breathing

A

Dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What pharmacologic agents are used in the management of dyspnea?

A

Aerosol corticosteroids and bronchodilators
in the palliative patient, opioids (e.g. morphine/hydromorphone) can help steady breathing and take away air hunger

Anxiolytics - Haldol or BDZs

disease specific:
COPD - nebulizer
CHF lung congestion - Lasix, glycopyrolate (not too early)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Why don’t we want to give glycopyrolate too early in CHF patients?

A

Might dry up secretions and create a mucus plug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is another word for haldol?

A

vitamin H

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why is Haldol given for dyspnea in the palliative patient?

A

Anxiety is usually the largest factor that causes dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are some non-drug interventions for dyspnea?

A

DB&C, meditation, music therapy, raising HOB, chest physio
push ribcage as patient is breathing to push out mucus
humidified nasal prongs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How does one screen for constipation?

A

Auscultate for bowel sounds
check for abdominal distension
ask about last BM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Describe the prevention of constipation.

A

Get them up and moving
Preventing it by using laxatives (oral first, then PR)
fibre and fluids (metamucil, prune juice)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are pharmacologic agents to treat constipation?

A

Laxatives, lactulose, senna, peglyte, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When will a suppository not work?

A

When the stool is not right there when you put it in

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are some non-drug ways to manage constipation?

A

Ambulation, prune juice, digitally removing stool (if a doctor’s order is present and their condition warrants it)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are ways to screen for fatigue?

A

Asking about their energy levels and sleep schedules

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are ways to manage fatigue pharmacologically?

A

Haldol for deeper sleep
lowering haldol dose when they want to be awakre
(caffeine - but careful about constipation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are non-pharmacological ways to manage fatigue?

A

Encouraging sleep

Talk to them, get them up to a window, etc.

17
Q

What is one of the most feared and incapacitating symptoms among patients facing the end of life?

A

pain

18
Q

Pain is what….

A

the patient says it is

19
Q

What is the OPQRST acronym?

A

Onset, palliation/provocation, quality, radiation, severity, time

20
Q

For palliative patients, is it detrimental to give pain meds when you see them furrowing their brow or when they say they are in pain?

A

No - never think that if you give the next dose of hydrophone you will kill them
(focus on QOL and pain management - if q2 but only 1hr and a half passed - call physician for pain meds)

21
Q

What are some non-pharmacological pain aids?

A 
o	Heat or cold packs
o	Extra pillows
o	Warn blanket
o	Guided meditation
o	Dogs/pets
o	Closing blinds, turning lights off – for migraines
o	Keeping noise at a minimum
o	Keeping them on their favourite side
22
Q

A cognitive disturbance resulting from an altered mental state, described in terms of disrupted consciousness and impaired cognition (thinking, perception, memory)

A

Delirium

23
Q

What is another word for delirium?

A

Terminal restlessness

24
Q

What are common causes of delirium?

A 
o	UTI/infections
o	New location
o	Med interactions
o	Pain
o	Electrolyte imbalances
o	Head injury
o	Tumour
o	Bleeds
25
Q

How does one assess for delirium?

A

History
Delirium chart
asking a family member

26
Q

What are some considerations for ABx use in palliative patients who may be delirious?

A

If they are close to death, better to just give antibiotics rather than try to determine agent - especially if blood cultures are needed

27
Q

What is a drug often given for delirious patients?

A

Haldol

28
Q

What are non-pharmacological ways to manage delirium?

A

Reorient if possible
music
talking through it

29
Q

What is the number one takeaway for delirious patients?

A

Safety first - make sure the patient is safe - use family members, restraints or bed alarms as necessary

30
Q

What are some societal factors that are leading nurses of all floors to need to understand palliative care?

A

Both kids are working and cannot care for parent
People are living longer and have more complex conditions
Aging population
Trajectories of death - e.g. CHF

31
Q

What are some complementary therapies?

A

Herbal therapies, manual therapies like reflexology and acupuncture

32
Q

Describe FNs healing Canadian Cancer society

A

Holistic approach to health
integrates traditional healing practices - e.g. special ceremonies, rituals and herbals
FNs healers believe that the body, mind and spirits must work in harmony and balance to be healthy

33
Q

Can smudging ceremonies occur in the hospital?

A

No, would need to find another area since the scent-free policy wins

34
Q

Describe a good death.

A
  • Free from avoidable distress and suffering for patient, family and caregivers
  • Patient’s and family wishes met
  • Consistent with clinical, cultural and ethical standards
35
Q

What are some reasons that it is hard to talk about EOL decisions?

A
  • People don’t like to talk about death
  • Fear of giving up
  • Don’t know options available to them
  • Uncertainty about client wishes
  • Cultural, spiritual and religious traditions
  • Previous experiences with death
  • Emotional component
36
Q

What are the requirements for MAID?

A
  • Competent adult person
  • Clearly consents to the termination of life
  • Not the result of outside pressure
  • The patient must be suffering from a terminal illness in an advanced state of decline and cannot be reversed
  • Pt must be suffering unbearably

N4400 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions