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UNIT
OVERVIEW:
Pain is commonly
associated with suffering at the end-of-life. However, fatigue,
anorexia/cachexia, nausea, vomiting and constipation, delirium and dyspnea
are the most common other physical symptoms contributing to distress at
the end-of-life. Management involves a diagnostic evaluation of the
symptom's etiology, treatment of the cause when reasonable, and treatment
of the symptom with nonpharmacological and adjunctive pharmacological
measures (Ross & Alexander, 2001).
This unit provides
basic knowledge required to treat moderate to severe pain as well as the
other physical symptoms experienced by the terminally ill. The most
frequent physical symptoms are presented in order of their occurrence.
Controlling these symptoms improves the quality of life for terminally ill
patients.
The
following two articles from the American
Family Physician by Drs. Ross and Alexander will assist you in the management of
non-pain symptoms in patients at end-of-life. Click on the citations below
to retrieve the article in PDF file form:
UNIT
OBJECTIVES
Following completion
of this unit the resident will be able to:
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Recognize
barriers to the practice of effective pain management.
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Describe how
to perform a
comprehensive assessment of physical pain in a terminally ill
patient.
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Describe
how to manage acute and chronic pain effectively.
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Calculate
equianalgesic pain medication doses.
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List the major
side effects of opioids and interventions to minimize their occurrence.
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Formulate a plan
of care for severe physical pain in the terminally ill
patient.
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Differentiate
addiction, physical dependence and tolerance of opioids.
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Discuss the most
common physical non pain symptoms experienced by patients at the
end-of-life.
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Describe
how to conduct a
comprehensive assessment of non pain symptoms in a terminally ill
patient.
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Describe effective interventions for non pain symptoms exhibited by a patient at
the end-of-life.
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INDEX:
Unit
Pretest
Module 1 - Fatigue
Module 2 -
Anorexia and Cachexia
Module 3 - Pain
management
Module 4 - Nausea, vomiting, constipation
Module 5 -
Altered mental states, delirium
Module 6 -
Dyspnea
Unit
Posttest |
