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Palliative Care > Lesson 4 > Flashcards

Lesson 4 Flashcards

(85 cards)

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1
Q

ALS feeding tube placement

A

should be placed before vital capacity drops below 50% predicted

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2
Q

Hypercalcemia rx

A

first step: IV hydration
then, diuretics and bisphosphonates

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3
Q

most common type of delirium for hospitalized elderly

A

mixed delirium

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4
Q

TCA with less anti-cholinergic effects

A

desipramine
nortriptyline

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5
Q

neonate pain rating scale

A

CRIES

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6
Q

FLACC pain scale rating

A

2 months to 7 years old

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7
Q

methadone maintenance therapy

A

dose methadone q6 to q8
opioid prn

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8
Q

hard stool in rectal vault rx

A

enema

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9
Q

most closely correlated to driving performance

A

Clock Drawing Test

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10
Q

opiate

A

any drug that is natural product of opium poppy plant

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11
Q

list of opiates

A

morphine
codeine
thebaine

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12
Q

synethic opioid

A

fentanyl

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13
Q

Buddhist beliefs re: meds

A

meds that contain animal byproducts may be resitrictdd

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14
Q

Buddhist beliefs re: death

A

believe patient is not completely dead until several hours after pronounced, so don’t want body to be moved quickly

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15
Q

depression meds with increased risk of seizures

A

bupropion
maprotiline

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16
Q

depression rx

A

SSRI
then try another SSRI
then try another med

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17
Q

first-line rx for neuropathic pain

A

SNRIs
TCAs
gabapentinoids

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18
Q

NSAIDs

A

COX inhibitors
prolong bleeding time

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19
Q

methadone mechanism of action

A

NMDA antagonist
full mu receptor agonist
MAO inhibitor

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20
Q

methadone oral bioavailability

A

80%

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21
Q

methadone metabolites

A

no active metabolites

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22
Q

adjust methadone dose at what CrCl?`

A

<10%

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23
Q

atheist/agnostic physicians more likely to

A

make decisions to hasten death

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24
Q

more religious physicians less likely to

A

discuss end of life decisions with patients

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25
fatigue steroid treatment
dexamethasone most studied
26
fatigue med
megestrol
27
stimulants for fatigue studied in what patient population?
cancer patients
28
SVC syndrome management for patient on hospice
elevated head supplemental O2 consider steroids, diuresis consider outpatient radiation
29
WHO pain ladder
non-opioids weak opioids strong opioids
30
weak opioid examples
codeine tramadol
31
hip fracture in hospice patients, traction
does not reduce pain not recommended
32
hip fracture in patient >75 with hgb<12
transfuse
33
majority of hospice patients with hip fracture who go to hospital
get surgery
34
pancreatic cancer pain management
celiac plexus block
35
celiac fibers
antero-crural
36
splanchnic fibers
retro-crural
37
headache due to increased ICP
NSAIDs corticosteroids
38
clarithromycin effect on cyt p450
suppression
39
fentanyl patch onset of pain relief
12 hours may take 24 to 48 for full pain relief
40
dosing interval for fentanyl patch
q72 hours
41
skin care
avoid hot water powder applied first, then cream
42
cultural preference scale
ABCD
43
neuroma-related pain from amputated limb
ultrasound guided radio frequency ablation
44
non-specific nausea first line treatment
metoclopramide
45
NSAIDs available in IV form
meloxicam diclofenac ibuprofen ketorolac
46
FICA
results have been shown to closely correlate with QOL tools assessing spirituality
47
FICA stands for
Faith and belief Its importance Community (religious/spirituality) Addressing how patient would want you to incorporate this
48
Naproxen
propionic acid derivative (same class as ibuprofen)
49
Citalopram side effect
QTc prolongation check EKG before and after starting med dose not to exceed 40 mg
50
Tramadol should not be
stopped abruptly
51
Tramadol method of action
mu-opioid agonist
52
most validated instrument to assess functional level in palliative care patients
Palliative Performance Scale
53
ECOG used for
performance status in cancer patients
54
Lansky score
functional status for children
55
methylnaltrexone used for
constipation, itching
56
prevalence of elder abuse/neglect in last year
10%
57
steroid which causes hiccups
dexamethasone
58
first line rx for hiccups
chlorpromazine
59
relational risk for addiction
having a friend with addiction
60
NSAID with highest CV risk
diclofenac
61
opioid effect on respiratory system
morphine decreases minute ventilation by decreasing RR
62
sodium phosphate enema side effects
dehydration hyperphosphatemia, hypocalcemia, hypokalemia avoid in those with CHF, renal dysfunction, cirrhosis
63
anterior cord syndrome
can be side effect of celiac plexus block loss of motor, pain, light touch, temp sensation
64
CCB side effect
constipation
65
dextromethorphan can cause
serotonin syndrome
66
post-mastectomy pain syndrome associated with
younger age prior history of headaches more extensive disease immediate post-op pain
67
weak opioids
codeine tramadol hydrocodone/acetaminophen
68
pain assessment Likert scale
any change is considered clinically significant
69
change of 2 points on numeric pain rating scale
considered clinically significant
70
antidepressant discontinuation syndrome
flu-like sx electric zaps/shock sensation in head
71
pill esophagitis causes
tetracyclines potassium iron NSAIDs bisphosphonates
72
reiki
hands/touch transfer "universal energy" from practitioner's palms to encourage healing
73
context-sensitive half-life
time taken for blood plasma concentration of drug to decline by one half following infusion at steady state
74
highest rate of suicide
non-hispanic Native American youth have highest rate
75
bereaved suicide rate (males vs. females)
higher in males
76
use of antipsychotics in individuals with dementia associated with
increased mortality increased risk of stroke
77
constipation as side effect of opioids occurs in what percent of patients?
40-95%
78
melanoma poor prognostic findings
elevated LDH elevated serum calcium
79
NSAID with highest CV risk
diclofenac
80
POLST
more details than advance directives
81
GBM poor prognostic lab findings
thrombocytosis anemia
82
MELD components
INR bilirubin creatinine etiology of cirrhosis sodium
83
Child Pugh components
INR albumin bilirubin ascites encephalopathy
84
minimum life expectancy for placement of intrathecal pain pump
three months
85

Palliative Care (4 decks)

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