Term
| Refers to the final weeks of life just before death |
|
Definition
|
|
Term
| an interdisciplinary approach for improving quality of life for patients and families who are confronting life-liiting illness with the goal to prevent and provide relief of suffering from pain and other symptoms |
|
Definition
|
|
Term
| occurs when the patient has trouble breathing normally at the end of life |
|
Definition
|
|
Term
| dyspnea can be caused by a number of factors including: |
|
Definition
| chemotherapy, heart failure, abdonminal ascites and infection |
|
|
Term
| most common administer opioid for patients receiving end of life care |
|
Definition
|
|
Term
| agents that may be used to reduce the respiratory secretions |
|
Definition
| glycopyrrolate or scopolamine patch |
|
|
Term
| inovolves a patient's loss of appetie and desire to eat |
|
Definition
|
|
Term
| nonpharmacologic interventions for nausea |
|
Definition
| sipping ginger ale, eating crackers, practicing relaxation techniques |
|
|
Term
| _ are not recommended for dehydration at end of life becaus they will generally make the patient more uncomfortable |
|
Definition
|
|
Term
| Patients at the end of life may experience restlessness and/or confusion as the result of |
|
Definition
| infection, electrolyte abnormalites, medications, illness progression and pain |
|
|
Term
| If patients's actions become uncontrollable or put the patients at risk, sedation may be necessary, in cases such as this _ is generally used |
|
Definition
| haloperidol or chlorpromazine |
|
|
Term
| benzodiazepines such as _ may also be used to relieve restlessness, agitation or anxiety |
|
Definition
|
|
Term
| to be effective, pain managemnt shoud be reasses at least _ with modifications in treatmen and dosage being made as needed |
|
Definition
|
|
Term
| physiologic changes that occur at the end of life |
|
Definition
| dyspnea, hypotension, anorexia, nausea and dhydration, restlessness and altered levels of consciousness, pain |
|
|
Term
| legal documents that allow individuals to choose ther prefered treatment plan while they ar mentally able to ensure that their wishes will be carried out even when they are unable to make decisisons themselves |
|
Definition
|
|
Term
| all advance directives must be: |
|
Definition
| in writing, signed by the paiten, witnessed and notarized |
|
|
Term
| the physician or other HCP performs the last act, usually in the form of an intentional drug overdose |
|
Definition
|
|
Term
| occurs when the physician or another healtchare team member provides the lethal dose of medication but the paitne administers the medication |
|
Definition
|
|
Term
| palliative care for children with a chronic disorder should begin at: |
|
Definition
|
|
Term
| the top three barriers to advance care planning for chilren ar |
|
Definition
| unrealistic parent expectations, differneces int he understanding of the child's prognossis between clinicians and patient/parents, and lack of parent readiness to have the discussion |
|
|
Term
| most common symptoms at the end fo life is |
|
Definition
|
|
Term
| other symtpoms common at the end of life include |
|
Definition
| anxiety, constipation, delirium, dyspnea, nausea, sleep disturbances and loss of skin integrity |
|
|
Term
| for paitens without an DNR order _ must be administered by default |
|
Definition
|
|
Term
| ANH may cause more discomfort for the patients, including: |
|
Definition
| increasing the patients risk for esophageal perforation infiltration of formula into the lung, infection and edema |
|
|
Term
|
Definition
| artificial nutrition and hydration |
|
|
Term
| examples of complementary health approches |
|
Definition
| gentle touch therapy, music therapy, massage and animal assisted therapy |
|
|
Term
| four contexts fo patients' awareness of their condition |
|
Definition
| closed awareness, suspected awareness, mutual pretense awareness, open awareness |
|
|
Term
| the patients are unaware of their impending death even though the healthcare team and family have the information |
|
Definition
|
|
Term
| no one directly tells the patients about their condition but they begin to suspect that the are near death |
|
Definition
|
|
Term
| the patients, family, and healthcare team all know that the patients condition is terminal but no one discusses it |
|
Definition
| mutual pretense awareness |
|
|
Term
| The patients, family, and healthcare team know about the patients impending death and openly discuss it as needed |
|
Definition
|
|
Term
| problems of patients nearing death will vary but may include |
|
Definition
| difficulty swallowing, urinary incontinenc, bowel incontinenc, poor sleep patterns, inadequate tissue perfusion, confusion, anxiety about death, impaired skin integrity, acute pain |
|
|
Term
| for post mortem care, care of the body should not take place until the paitne is |
|
Definition
|
|
Term
| chfibromyalgia is a chronic syndrome charcterized by |
|
Definition
| multisite musculoskeletal pain, stiffness, fatigue, sleep disturbances, and difficulty concentration |
|
|
Term
| Pain related to firbromyalgia occurs in specific body sites that occur in the |
|
Definition
| neck, spine, shoulders, hips, elbows and knees |
|
|
Term
| a disorder of pain processing |
|
Definition
|
|
Term
| pain associated with fibromyalgia results from central amplification of pain signals, includign: |
|
Definition
| spontaneous nerve activity, enlarged receptive fields and abnromal levels of neurotransmitters |
|
|
Term
| Patients with fibrmyalgia also experience |
|
Definition
|
|
Term
| sensitivity to stimuli that are not normally painful |
|
Definition
|
|
Term
| Infections such as _ may lead to fibromyalgia |
|
Definition
| hepatitis C virus, HIV, coxsackie B virus, parovirus |
|
|
Term
| The overwhelming majority of individuals with fibrmyalgia are _ |
|
Definition
|
|
Term
| being a woman betwee the ages _ is considered a risk factor for firbrmyalgia |
|
Definition
|
|
Term
| Other risk factors for fibromyalgia include |
|
Definition
| hx of chronic pain, family hx of fibromyalgia, having a psychatric disorder such as anxiety or depression, having other chronic pain conditions such as ostoarthritis, rheumatoid arthrits or lupsu |
|
|
Term
| primary clinical symptoms associated with fibromyalgia are |
|
Definition
| multisite pain, sleep disturbances, and fatigue |
|
|
Term
| six or more pain sites froma total of nine positble sites |
|
Definition
|
|
Term
|
Definition
| head, upper or lower back, spine, chest, abdomen, arms/and or legs |
|
|
Term
| pain related to fibromylagia is typically describes as _ and is not the result of inflammation or damage, patients may also exhibit enhanced sensitivity to _ |
|
Definition
| deep, gnawing, stabbing or burning; heat, cold, and pressure |
|
|
Term
| Pain and stiffness related to fibromyalgia are often worse in the _ or after _ |
|
Definition
| morning, excessive phyical activity |
|
|
Term
| systemic symptoms of fibromyalgia include |
|
Definition
| mood disorders, tenderness, stiffness and cognitive dysfunction |
|
|
Term
| Environmental sensitivity or hypervigilance related to fibrlmyalgia is common and manifests as |
|
Definition
| intolerance to bright lights, cold temperatures, loud noises or odors such as perfume |
|
|
Term
| other comorbid painful conditions associated with fibromyalgia include |
|
Definition
| headaches, numbness in the hands and feet, irritable bowel syndrom, restless legs synderom, and painful menstrual periods |
|
|
Term
| multisite pain condition with six or more pain sites from a total of nine possible sites plus moderate to sever sleep problems or fatigue and the presens of symptoms for at least 3 months |
|
Definition
|
|
Term
| Drugs that have been approved by the FDA for the treatment of fibromyalgia |
|
Definition
| duloxetine (cymbalta), milnacipran (savella) and pregablin (lyrica) |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Duloxetine and milnacipran are |
|
Definition
| selective serotonin norepinephrine reuptake inhibitors (SNRIs) |
|
|
Term
| common side effects of SNRIs are |
|
Definition
| nausea, dry mouth, consitpation, dizziness, hot flashes, and insomnia |
|
|
Term
| both _ interact with many drugs, so the healthcare team shoudl bcarefully survey the patien's medications before initiating therapy |
|
Definition
| duloxetin and milnacipran |
|
|
Term
| recommended for patients with significant depression with fibromyalgia |
|
Definition
|
|
Term
| recommended for paitents with significant fatigue or cognitive dysfuncion related to fibromyalgia |
|
Definition
|
|
Term
| a GABA analog with anticonvulsan, analegesic and anxiolytic properties |
|
Definition
|
|
Term
| Pregabalin is given orally at a low dose, the dose can be titrated to a maximum dosage of |
|
Definition
|
|
Term
| common side effects of pregabalin |
|
Definition
| ataxia, dizziness, somnolence, weight gain and blurry vision |
|
|
Term
| other pharmacologic therapies for fibromyalgia pain are |
|
Definition
| tramadol with/without acetaminophen |
|
|
Term
| weak opioid withmild SNRI activity |
|
Definition
|
|
Term
| tricylic antidpressants such as _ have also been used to facilitate sleep |
|
Definition
|
|
Term
| the two primary noonpharmacologic therapies linked to successful treatment of fibromyalgia are |
|
Definition
| aerobic exercise and strength training |
|
|
Term
| Aquatic exercises may be helful with fibromyalgia dn t'ai chi has bee shown to improve: |
|
Definition
| symptoms, physical function, quality of sleep, self0efficacy and mobility |
|
|
Term
| childeren and adolescents may develop a form of fibromyalgia called |
|
Definition
| juvenile primary fibromyalgia syndrome |
|
|
Term
| the primary goals of fibromyalgia treatment are to |
|
Definition
| reduce pain adn fatigue, increase restrative sleep, improve physical function |
|
|
