Palliative Care Flashcards
(24 cards)
What is palliative care?
Improving the quality of life of patients with life threatening illnesses by preventing and relieving suffering, treating pain and other physical, psychosocial and spiritual problems
What is included in this?
Pain control Emotional help Practical help Financial help Advanced care planning Bereavement care
What kind of symptoms do people in palliative care have?
Pain Fatigue/weakness Poor mobility SOB Poor appetite Sore/dry mouth N+V
List the steps of pain management.
- Paracetamol (1g 4x daily) or NSAID (500mg 2x daily)
- Codeine 30-60mg 4x daily or Co-codomol
- Strong opiate e.g morphine
- Add paracetamol/NSAID to morphine
Hallucinations, drowsiness and myoclonus are symptoms of what?
Opioid toxicity
What happens to patients once they are started on morphine?
They become dependant and cannot be suddenly withdrawn i.e opioid tolerant
What drug can reverse the effects of morphine instantly?
Naloxone
What is a severe side effect of morphine?
Respiratory distress
What 2 types of morphine should be given?
Background/modified release - given 2x daily
Breakthrough/immediate release - given PRN
How do you get dose of breakthrough morphine?
Divide background by 6
Name some types of non-drug pain relief.
Radiotherapy
Chemo
Surgery
Orthotics
What does the KIS include?
Resus wishes, place of death, ‘just in case’ drugs, power of attorney
How do you recognise a dying patient?
Becoming weaker, not eating or drinking, sleep more, can’t take oral medicines
What must you always make sure?
That there is no reversible features
What does a syringe driver do?
Smoothest delivery of drugs via SC route
Max 3 drugs
Can also add anti-emetic
How often is a syringe driver changed?
Daily
How do you work out SC dose of morphine?
Divide PO dose by 2
Pain/SOB
Morphine 2mg SC hourly
Distress
Midazolam 2mg SC hourly
Nausea
Levomepromazine 2.5mg every 8 hours
Secretions
Buscopan 20mg hourly
Benefits of giving fluids?
Reduce dry mouth, constipation, delirium
Burdens of giving fluids?
Fluid overload, oedema, worsening secretions
How is death verified?
Reaction to voice or pain Resp efforts Check eyes Feel pulses for 1 minute Auscultate heart and lungs for 1 minute Record date and time
