Pain Management of Cancer

Subject: Medical and Surgical Nursing I (Theory)

Overview

Hospices offer care to patients from the moment their condition is declared terminal until their death, whatever lengthy that may be. A branch of medicine known as aligiatry, sometimes known as pain management, pain medicine, pain control, or aligia, uses an interdisciplinary strategy to lessen suffering and raise the quality of life for people who have chronic pain. Palliative care, patients' right to self-determination, and medical experimentation are just a few of the decisions that must be made when providing end-of-life care. Particular importance is given to spiritual care in end-of-life care. Drowsiness, increased sleep, and/or unresponsiveness are warning signs that death may be imminent, as are confusion regarding the time, location, and/or identities of loved ones, as well as restlessness.

End of life care - Hospice

Hospice

Hospices offer care to patients from the moment their condition is declared terminal until their death, whatever the length of time may be between now and then. This does not imply that hospice care must be ongoing. In cases where their illness has stabilized and they are feeling well, patients occasionally prefer to take a break from hospice care.

Hospice care attempts to meet all of the needs of the patient while placing a high importance on their dignity, respect, and wishes.

Hospice care meets the patient's physical, psychological, social, emotional, practical, and spiritual needs as well as those of their family and caregivers. After all, holistic care is a term that is frequently used to describe these components.

Pain Management

A branch of medicine known as algiatry, pain management, pain medicine, or pain control uses an interdisciplinary strategy to lessen suffering and enhance quality of life for people who have chronic pain. Occupational therapists, clinical psychologists, pharmacists, nurse practitioners, and clinical nurse specialists make up the standard pain treatment team.

Other mental health experts and a mass age therapist may also be on the team. When the underlying trauma or pathology has healed and the patient is given medication like analgesics and anxiolytics by one practitioner, pain can sometimes disappear quickly. However, the management team's coordinated efforts are frequently necessary for the effective management of chronic pain.

End-of-life Care

End-of-life care is a term used in medicine, nursing, and other allied health professions to refer to the care of all people who have a terminal illness or terminal disease condition that has become advanced, progressive, and incurable, rather than just those who are in their final hours or days of life.

Palliative care, patients' right to make their own decisions, medical experimentation, the ethics and effectiveness of unusual or risky medical interventions, and even the ethics and effectiveness of continuing routine interventions are among the decisions that must be made when providing end-of-life care.

Spiritual Care in End of Life

Particular importance is given to spiritual care in end-of-life care. The task of providing spiritual care is shared by the entire palliative care team, with pastoral care workers serving as the team's leaders. However, other contexts and individual practice may adopt the palliative care approach to spiritual care.

Signs that Death May be Near

Some of the following signs may indicate that death is approaching:

  • Increased sleep, drowsiness, and/or inattentiveness
  • Uncertainty regarding the date, location, or identity of loved ones; restlessness,
  • fewer social interactions and disengagement,
  • less need for food and drinks, as well as a decrease in appetite
  • pee that has darkened or produced less urine
  • skin changing color and feeling cool to the touch, especially on the hands and feet.
  • breathing that makes rattling or gurgling noises that may be loud (death rattle); uneven and shallow breathing; reduced breaths per minute;
  • turning the head towards the direction of a light source (caused by decreasing vision).
  • increased pain control challenges (caused by progression of the disease).
  • Additional indicators that the end of life is close by include involuntary movements (also known as myoclonus), variations in heart rate, and loss of reflexes in the legs and arms.

Diseases Symptom Management

Some of the most typical issues that could develop in a patient's final days or hours include the following:

  • Pain
    Uncontrolled pain is a major dread of folks nearing the end of their lives. commonly treated with morphine, diamorphine, or other opioid drugs.

  • Delirium
    Utter agony and restlessness (e.g. thrashing, plucking, or twitching). usually managed with benzodiazepines like midazolam. Haloperidol is also frequently employed. Rehydrating the body can sometimes help with disease symptoms by reducing the impact of some toxic drug metabolites.

  • Respiratory Tract Secretions
    When patients are too weak to clear their throats, saliva and other fluids can build up in the oropharynx and upper airways, producing a distinctive gurgling or rattle-like sound. Although the patient doesn't appear to be experiencing any pain, those by their bedside may feel fear and uncertainty due to the association between the disease's symptom and impending death. Drugs like atropine, glycopyrronium, or scopolamine (hyoscine) may be used to control the secretions.

  • Nausea and vomiting
    Usually controlled with cyclizine, haloperidol, or other anti-emetics.

  • Dyspnea (breathlessness)
    Typically controlled using morphine or, diamorphine.

 References

  • https://www.disabled-world.com/medical/palliative/
  • docslide.us › Documents
  • Mandal, G. (August 2013). A Textbook of Adult Health Nursing (2nd ed.). Dilllibazar kathmandu: Makalu publication house. Retrieved August 2013
  • www.nhs.uk/Planners/end-of-life-care/Pages/hospice-care.aspx
  • https://quizlet.com/108553241/nursing-exam-4-flash-cards/
  • https://www.ncbi.nlm.nih.gov/pubmed/12964927
  • slideplayer.com/slide/8886724/
  • https://prezi.com/q_wgu3ahgv1s/hospices-movement/
Things to remember
  • Hospices offer care for patients from the time their illness is determined to be terminal until their death.
  • Aligiatry, also known as pain management, pain medicine, or pain control, is a field of medicine that uses an interdisciplinary approach.
  • Palliative care and patient autonomy are two decisions that must be made when providing end-of-life care.
  • Uncontrolled pain is one of those nearing the end of their lives' greatest fears.
  • Particular importance is given to spiritual care in end-of-life care.
Questions and Answers

Pain Management:

A branch of medicine known as aligiatry, sometimes known as pain management, pain medicine, pain control, or aligia, uses an interdisciplinary strategy to lessen suffering and raise the quality of life for people who have chronic pain. Occupational therapists, clinical psychologists, pharmacists, nurse practitioners, and clinical nurse specialists make up the standard pain treatment team.

Other mental health experts and a mass age therapist may also be on the team. When the underlying trauma or pathology has healed and the patient is given medication like analgesics and anxiolytics by one practitioner, pain can sometimes disappear quickly. However, the management team's coordinated efforts are frequently necessary for the effective management of chronic pain.

End-of-life care:

End-of-life care in medicine, nursing, and other allied health professions refers to medical attention given to people who are nearing the end of their lives as well as more broadly to all those who have a terminal illness or terminal disease condition that has become advanced, progressive, and incurable.

Palliative care, patients' right to make their own decisions, medical experimentation, the ethics and effectiveness of unusual or risky medical interventions, and even the ethics and effectiveness of continuing routine medical interventions are among the decisions that must be made when providing end-of-life care.

Spiritual care in end of life:

Particular importance is given to spiritual care in end-of-life care. The task of providing spiritual care is shared by the entire palliative care team, with pastoral care workers serving as the team's leaders. However, other contexts and individual practice may adopt the palliative care approach to spiritual care.

Signs that death may be near:

The following indicators may point to impending death:

  • Increased sleep, drowsiness, and/or inattentiveness
  • Uncertainty regarding the date, location, or identity of loved ones; restlessness,
  • Fewer social interactions and disengagement,
  • Less need for food and drinks, as well as a decrease in appetite
  • Pee that has darkened or produced less urine
  • The hands and feet in especially feel chilly to the touch; the skin may turn blue in hue;
  • Breathing that makes rattling or gurgling noises that may be loud (death rattle); uneven and shallow breathing; reduced breaths per minute;
  • Turning the head towards the direction of a light source (caused by decreasing vision).
  • Increased pain control challenges
  • Additional indicators that the end of life is close by include involuntary movements (also known as myoclonus), variations in heart rate, and loss of reflexes in the legs and arms.

Diseases Symptom management:

The following are some of the most common potential problems that can arise in the last days and hours of a patient's life:

  • Pain: Uncontrolled pain is a major dread of folks nearing the end of their lives. commonly treated with morphine, diamorphine, or other opioid drugs. Delirium, excruciating pain, and restlessness usually managed with benzodiazepines like midazolam. Haloperidol is also frequently employed. Rehydrating the body can occasionally help with disease symptoms by reducing the impact of some hazardous medication metabolites.
  • Respiratory Tract Secretions: When patients are too weak to clear their throats, saliva and other fluids can build up in the oropharynx and upper airways, producing a distinctive gurgling or rattle-like sound. Although the patient doesn't appear to be experiencing any pain, those by their bedside may feel fear and uncertainty due to the association between the disease's symptom and impending death. Drugs like atropine, glycopyrronium, or scopolamine (hyoscine) may be used to control the secretions.
  • Nausea and vomiting: Typically controlled with the aid of anti-emetics like haloperidol, cyclizine, or others.
  • Dyspnea (breathlessness): Usually under control with morphine or diamorphine.

 

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