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what is palliative care?
holistic approach to care which provides relief from distressing symptoms and allows patients to live as actively as possible until death
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what is end of life care?
pt who are expected to die within the next 12 months
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what does palliative care integrate?
- physical
- spiritual
- social
- cultural psychological aspects
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what is the EoLC pathway?
- step 1- discussions as the end of life approaches
- step 2- assessment, care planning and review
- step 3- co-ordination of care
- step 4- delivery of high quality services in different settings
- step 5- care in the last days of life
- step 6- care after death
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what are common palliative care conditions?
- chronic neurological conditions
- COPD
- heart failure
- renal failure
- elderly/ frail
- cancer
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explain lung fail
- increase in fluid build up
- reduced cough reflex
- build up of fluid causes death rattle
- fluid reduced gaseous exchange
- hypoxaemia and pneumonia
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explain heart failure
- systemic hypoxia causes cardiac arrhythmias
- weak pulse
- resulting in- weak, drowsy, poorly perfused, drenched in sweat or clammy
- pale skin due to falling BP
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explain reduced metabolism
- often off food due to reduced metabolism
- can be worsened by meds
- blood divert away from GI tract, consipation or possibly diarrhoea
- opioids slow down GI tract and could worsen abdominal pain
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explain renal failure
- hypotension leads to renal failure, kidneys under perfused.
- toxin build up in blood, further stressing the heart
- toxin build up may cause inflammation similar to sepsis
- this caused by prostaglandin release which can also fever
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explain nervous system failure
- senses are dulled, touch pressure and hearing amoungst last to go
- vision dulled, may only be able to see light and dark
- can be unresponsive with eyes open
- can be twitching, grimacing or displaying other signs of pain
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