Brainscape's Knowledge GenomeTM

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


See full index

N498 > Lecture 11 - Palliative > Flashcards

Lecture 11 - Palliative Flashcards

1
Q

What is the WHO definition of palliative care?

A

Care offered early in the course of the illness, in conjunction with other therapies that are intended to prolong life, and includes investigations to better understand and manage distressing clinical complications

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

What are 3 important concepts of palliative care?

A

Relief from pain, dying as part of the normal process of living, and to neither hasten nor prolong death

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

What does the model to guide palliative care suggest?

A

The initial focus of care is on therapy to modify disease, eventually replaced by palliative care. Then comes end-of-life care, followed by death. Death is followed by bereavement

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

What are common signs of imminent death?

A

Progressive weakness, bed bound, sleeping, decreased intake, darkened and decreased urine output, dysphagia, delirium, decreased LOC, noisy respiration, change in breathing pattern, mottling, cooling of extremities, dehydration

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

Which diseases are accompanied by chronic pain?

A

RA, liver failure, kidney failure, HIV, cancer, HF

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

Describe somatic pain

A

A localized achy, dull, throbbing or sore pain that arises from MSK

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

Describe visceral pain

A

A diffuse, difficult to localize, often referred gnawing, squeezing, cramping pain that arises from visceral organs

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

Describe neuropathic pain

A

A shooting, burning, tingling, stabbing pain that often follows a nerve path but can be diffuse due to injury to CNS or PNS

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

Pain assessment includes what acronym?

A

OPQRSTUV

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

What is the O component of pain assessment?

A

Onset - when did the pain (or new pain) begin? How long does it last? How often does the pain occur?

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

What is the P component of pain assessment?

A

Provoking/palliating - What brings the pain on? What makes the pain better? What makes the pain worse?

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

What is the Q component of pain assessment?

A

Quality - What does the pain feel like? Describe the pain.

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

What is the R component of pain assessment?

A

Region/radiation - Where is the pain? Can you point to the pain? Does the pain spread anywhere?

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

What is the S component of pain assessment?

A

Severity - What is the intensity of the pain? (Use age appropriate visual analog scale) On a scale of 0-10? Are there any other symptoms that accompany the pain?

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

What is the T component of pain assessment?

A

Treatment - What medications/ treatments are you currently using? How effective are these? What have you used in the past?

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

What is the U component of pain assessment?

A

Understanding impact - How is the pain affecting you/ your family? Sleep? Activity? What do you believe is causing the pain?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the V component of pain assessment?

A

Values - What is your comfort goal/ acceptable level of pain? (Use 0-10 scale or visual analog)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are other factors that impact chronic pain?

A

Decreased/increased sensitivity, analgesic medication history, beliefs about pain and treatment, mental health, drug abuse, heart disease, diabetes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is Stage 1 of WHO’s analgesic ladder?

A

Non-opioids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are 2 examples of Stage 1 medications?

A

Acetaminophen and Cox-2 inhibitors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is acetaminophen?

A

Non-opioid used for analgesic and antipyretic effects, not anti-inflammatory or anticoagulant.

22
Q

What are potential complications of acetaminophen?

A

Hepatic and renal toxicities as well as overdose

23
Q

What are Cox-2 inhibitors?

A

Non-opioid used for anti-inflammatory effects that can be used for patients with thrombocytopenia and has lower GI effects

24
Q

What is a potential complication of Cox-2 inhibitors?

A

Risk of stroke and MI

25
Q

What is a ceiling effect?

A

When a drug reaches its maximum effect. Increasing dose does NOT increase the therapeutic effect of the medication. Often the adverse effects of the drug continues to increase, outweighing the benefit of continuing medication

26
Q

NSAIDS do have a ceiling effect. True or False?

A

True

27
Q

What is the major benefit of using non-opioids?

A

It does not cause respiratory depression

28
Q

What are examples of adjuvant drugs in pain management?

A

TCA, anticonvulsant, and dexamethasone

29
Q

What are 2 things to watch for when starting TCA?

A

Risk for falls related to orthostatic hypotension and dry mouth related to anticholinergic effects

30
Q

What are 2 things to be aware of when administering TCA?

A

Use with caution for those with UTI’s and potential to cause sedative effects if using with opioids

31
Q

What are anticonvulsants?

A

An adjuvant medication that treats neuropathic pain and causes CNS depressant effects and has a higher benefit vs. side effect ratio

32
Q

What is dexamethasone?

A

An adjuvant medication that can be used in cancer care that is useful in treating neuropathic pain

33
Q

What is Stage 2 of WHO’s analgesic ladder?

A

Weak opioids

34
Q

What is a side effect you must treat with using codeine?

A

Constipation

35
Q

There is a ceiling effect for morphine. True or False?

A

False - dose can continue to be escalated to provide relief when pain increases

36
Q

How strong is hydromorphone?

A

7x more potent than morphine

37
Q

What is fentanyl?

A

Opioid for pain management that has a slow onset of action, causes less constipation, and available in a patch

38
Q

X can alter the rae of dose delivery of fentanyl. What is X?

A

Diaphoresis

39
Q

What route is ideal for opioid administeration?

A

Oral, as it gives more consistent and prolonged analgesia

40
Q

What is an addiction?

A

Loss of control over drug use accompanied by chronic neurobiological, psychological dependence on drugs

41
Q

What are signs of drug withdrawal?

A

Diaphoresis, nausea & vomiting, severe body aches, abdominal pain, twitching/ muscular spasms, and increase in vital signs

42
Q

What are 4 examples of mechanical management of pain?

A

Transcutaneous electrical nerve stimulation (TENS), therapeutic touch, application of heat/ cold: decrease muscle spasm and massage

43
Q

What are 5 examples of behavioral management of pain?

A

Distraction activities, music, biofeedback, imagery/visualization and play therapy

44
Q

Children of what age range metabolize morphine more rapidly than adults?

A

6 months to 5 years

45
Q

What are 5 ways to manage constipation?

A

Stool softener, colonic stimulant, colonic osmotic laxative, suppository, and enema

46
Q

What is dyspnea?

A

Subjective discomfort related to breathing present in 40-80% of end-of-life patients

47
Q

Where is dyspnea common?

A

With altered fluid volume such as ascites, CHF, pleural effusion and restrictive lung disease

48
Q

What are 2 pharmacological interventions to manage dyspnea?

A

Benzodiazepines and low dose opioids

49
Q

How would you position a dyspneic patient to optimize breathing?

A

Semi to high Fowlers to facilitates lung expansion. If ambulatory, sitting position maximize air expansion, lean forward. Side lying if patients who have secretions

50
Q

What is delirium?

A

Cognitive impairment with 1) sudden onset, 2) fluctuating level of consciousness, sleep-wake cycle, psychomotor behaviour, confusion

51
Q

Which class of drugs is ideal for delirium?

A

Antipsychotics

52
Q

Which drug class can treat delirium but may contribute to cognitive impairment?

A

Benzodiazepines - it can contribute to agitation

N498 (3 decks)

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