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Flashcards in 50 - end of life Deck (15)
1

challenges in EOL

- lack of prior relationship
- limited info on PTs baseline
- little info about PTs wishes
- time constraints

2

how to err in the ER

on the side of intervention if lacking info

3

keys in initial assess

- ID desires
- look up old records
- goals of vist

4

common acute pain causes in palliative

- vert. body fractures
- nerve root
- tumor

5

***how to determine breakthrough dose

24 hour dose / 10 given PO

6

oral to IV conversion

2:1

7

opiod convesion for 10mg morphine

codeine 100
morphine 10
oxy 5
hydromorph 2

8

potential causes for dyspnea

- obst. - upper or bronch
- large pleural effusions
- PE
- pneumo
- CHF/COPD exacerbations

9

how to help dyspnea sensations

- O2
- narco 2.5mg SC
- anxiolytics

10

meds for N/V in pallaitive

bowel/gastric
- DOPA agon
- not much use for gravol
chemo
- 5-HT3 block - odansetron
-

11

how to mgmt constipation

start from bottom
- enema or disimpaction
then above
- lactulose
- Mg citrate
- poly glycol

12

mgmt of delerium

- Tx reversable causes
- halperidol
- maybe benzos

13

mgmt of secretions/death rattle

- scopolamine or glycopyrrolate

14

steps to break bad news

1. 5-10 minutes of quiet
2. sit
3. introduce self and role
4. find out what they know
5. explain in clear simple language what happened
6. leave plenty of silence
7. acknowledge their emotions

15

issues to address after death

1. viewing deceased
2. gather belongings
3. ask who should be contacted
4. ask to notify the funeral home
5. address organ donation
6. if need coroner- tell fam
7. offer medical autopsy if appropriate