HNN319 Lecture Notes - Lecture 4: Palliative Care, Glasgow Coma Scale, Syringe Driver
9 Jun 2018
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WEEK FOUR: PALLIATIVE CARE.
• Describe the principles of palliative care.
• Describe the nurses role in palliative care for patients with life limiting illness
• Identify potential and actual problems related to palliative care.
• Discuss the role of the nurse in patient management related to palliative care.
• Implement nursing interventions related to palliative care and evaluate care.
• Describe, perform and document insertion of a butterfly cannula for palliative pain relief.
• Describe, perform and document setting up of NIKI syringe driver for palliative pain relief.
• Demonstrate understanding of the application of the Glasgow Coma Scale in the clinical
context.
• Perfor a ursig hadover of a patiets stroke aageet usig the ISBA‘ tool.
COMMON NEEDS & PREFERENCES PALLIATIVE PATIENTS.
• Management of physical symptoms such as pain, weakness, fatigue and dyspnoea
• Management of psychological symptoms- stress, depression, powerlessness.
• need for social support
• Culturally specific needs related to language problems and information disclosure
preferences
• Need for information about treatment, diagnosis or prognosis
• Spiritual and existential concerns including hope, loss of meaning and uncertainty
• Financial concerns such as loss of income and medical costs
• Legal concerns such as preferences for end-of-life care and advanced care directives.
KEY CONSIDERATIONS.
• All people with life-limiting illnesses have a right to health care that's appropriate to their
needs.
• Not everyone with a life-limiting illness will require access to a specialist palliative care
service. For many people, care needs can be met by community and personal resources and
the support of primary health care services.
• As a health care professional, you are likely to come into contact with people in a variety of
settings who may benefit from palliative support. All health care professionals, therefore,
need knowledge and skills in providing palliative care.
IMPROVING QUALITY OF LIFE FOR PEOPLE WITH SERIOUS ILLNESS.
• Pain, symptom approach, team work, open communication.
• Maintain best outcome for pt and family regardless of diagnosis and prognosis.
• Can be positive- fight for health.
• Uncertainity- treatments, burden, how do I want to live? What do I want to enjoy?
• Quality of life: What is a good day for you? Increase understanding ie embarrassment.
• Palliative- treatment prolong life or remission. Focusing more treatment to maintain life.
• Team work: rewarding and challenging through family, treatment and spiritual issues,
expertise as quality of life has multiple dimensions.
• Pt will not be person before physically- grief. Promote flexibility.
• Burden=illness not the pt and palliative care is to enable support during treatment of illness.
• Not giving up but changing the focus from burden to illness treatment and enjoyment of life.
Choose the new direction of life.
• Keep the same medical team ie GP to enable trust for a quality of life.
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Document Summary
Spiritual and existential concerns including hope, loss of meaning and uncertainty. Financial concerns such as loss of income and medical costs. Legal concerns such as preferences for end-of-life care and advanced care directives. Key considerations: all people with life-limiting illnesses have a right to health care that"s appropriate to their needs, not everyone with a life-limiting illness will require access to a specialist palliative care service. All health care professionals, therefore, need knowledge and skills in providing palliative care. Increase understanding ie embarrassment: palliative- treatment prolong life or remission. Focusing more treatment to maintain life: team work: rewarding and challenging through family, treatment and spiritual issues, expertise as quality of life has multiple dimensions, pt will not be person before physically- grief. Promote flexibility: burden=illness not the pt and palliative care is to enable support during treatment of illness, not giving up but changing the focus from burden to illness treatment and enjoyment of life.
