Oncology: OSCE Flashcards
End of life care
End of life care is care in the last months - years of life. Is should help you live as well as possible until you die and to die with dignity. It allows you to express wishes & preferences in the plan of your care and also provide support to other people who are important to you.
1) Palliative care: this means controlling your symptoms rather than aiming to cure your disease. Include physical, psychological, spiritual and social for u and family.
You can receive this care:
- at home
- in a care home
- hospital
- hospice
2) Start thinking about plan for your care in advance, as u may not be able to make decisions about your Tx when you become severely ill.
You may want to consider:
- making a will
- writing an advance statement: lets those close to u know about the type of care u would like & where u would like it if u couldn’t decide for yourself.
- advanced decision to refuse treatment: allows u to refuse some or all form of medical care when u are unable to make ur own decision/ tell doctors
- Lasting power of attorney: legally appoint someone to make decisions about your care if u become unable
- whether u want to be resuscitated if ur heart stops
ICE
- Support from GP, hospice (visit during day)
- Marie Curie
- Telling family & friends. Dying Matters website
General outline for describing a procedure
What is it?
Reasons for doing it?
Preparation
The procedure
After procedure
Complications
Getting results
Going home
More info & safety net
Explaining bronchoscopy.
What is it?
procedure to look into windpipe & lungs. Doctor will use bronchoscope to look down throat and into ur windpipe & airways. You will be asleep.
Reasons for doing it?
investigate symptoms, look, take some cells (biopsy).
Preparation
Admit to hospital on day, tell u when u need to stop eating & drinking. On admission you will have some tests.
- Blood, heart tracing (ECG), chest x-ray, swabs
- consent form
- a anaesthetic doctor will assess ur fitness for the procedure
The procedure
you will be taken to theatre and put to sleep.
After procedure
taken to a recovery room, may need to give u oxygen whilst you recover. Monitoring until the nursing staff are happy then back to ward. Soon be allowed to eat & drink
Complications
- Sore throat: few days
- Coughing up blood: small amounts for a few days
- damage to teeth
- chest infection
- Narrowing of widepipe (bronchospasm)
Getting results
- After procedure someone will discuss with u how it went. Of u had a biopsy it may take 2+ weeks to find results. Need to attend outpatient clinic, please ask about follow up before go.
Going home
- same day or overnight depending on your recovery.
More info & safety net
Answer questions
contact ward if you have ↑ SOB, vomiting, high temp,↑ blood loss.
General outline for describing a procedure
What is it?
Reasons for doing it?
Preparation
The procedure
After procedure
Complications
Getting results
Going home
More info & safety net
Explain colonoscopy
What is it?
routine test to examine the lining of your bowl. This is done by passing an endoscope (a flexiable tube, about the thickness of ur finger) which has a camera & a light at one end. It is passed into the back passage and carefully move through the bowel.
Reasons for doing it?
- look at bowel: diagnose symptoms or check previous diagnosis (bleeding, pain, diarrhoea, change in bowel cancer, bowel cancer screening pathway,, exiting condition (Crohns)
Preparation
Bowel must be empty, follow special diet for a few days.
Take a laxative before test. Drink lots of fluids on day of procedure.
- give consent
The procedure
Sedation (makes u feel sleepy, u can chose to have that), injection of painkillers, entonox
- takes about 30 mins, lie on couch
- you should not feel pain
After procedure
- recovery area
Complications
serious complications are rare, biggest risk is damage to bowel: infection, bleeding or perforation
Please not the test may have to be abandoned or may be incomplete if u find the procedure too uncomfortable or if bowel preparation was incomplete.
Getting results
if biopsy or polyp removed it can take 2 weeks for result
Going home
If sedated you should have someone escort u home for 24 hrs and should not drive, ride a bicycle, operate machinery, drink alcohol, make important decisions.
More info & safety net
Call GP or nearest A&E if you experience severe abdo pain, fever or pass large amounts of blood.
Endoscopy
prep: no eat 4-6 hours
Lie on cough, plastic mouthguard to protect teeth.
Air is passed into stomach that makes it easier to see- make u feel like u want to burp
- 10 mins but leave 2 hours.
- sedation available
- no pain but can be uncomfortable
SE:
Can cause damage to gut which can causes bleeding, infection or a whole. Consult a doctor if any other following happen 48 hours after gastroscopy:
Tummy pain
Temp
difficulty breathing
Vomiting blood
