summary with 200 words each question making 1200 words total
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NorlanderChapter6PhysicalSymptomManagement.pptxTo comfort always
A Nurse’s guide to end of life care
Chapter 6: Physical symptom management
Common symptoms
Dyspnea
Constipation
Diarrhea
Nausea / Vomiting
Loss of appetite / Weight loss
Anxiety
Fatigue
Depression
Chapter 6: physical symptom management
Medical history assessment
Tell me about your health
What is the history of your illness?
Tell me about your most distressing symptoms
Are you having problems with nausea, constipation, breathlessness, poor appetite or anything else?
What helps these symptoms?
What makes these symptoms worse?
Chapter 6: physical symptom management
Symptom assessment
How symptoms have affected the patient’s activities of daily living and relationships
Assessment questions
Have your symptoms affected your ability to be independent?
Have your symptoms affected your family or loved ones?
Have you experienced changes in your routines because of your symptoms?
Chapter 6: physical symptom management
Dyspnea
Subjective experience
Look at the cause
Common approaches
Diuretics
Oxygen
Opioids
Inhalers / nebulizers
Remedies
Fan / open window
Reposition patient
Chapter 6: physical symptom management
Constipation
Opioid use
Decreased mobility
Decreased appetite
Treatment
Prevention
Laxatives
Dietary
Chapter 6: physical symptom management
Diarrhea
Less common symptom
Treatment
Antidiarrheal medication
Fluid replacement
Dietary interventions
Chapter 6: physical symptom management
Nausea / Vomiting
Caused by a variety of problems
Treatment
Thorough assessment
Does a pattern exist?
Does it occur after certain medications or meals?
Based on underlying cause
Chapter 6: physical symptom management
Loss of appetite / Weight loss
Find out how the patient feels
Is the family more concerned than the patient?
Treatment
Pharmacologic interventions can stimulate appetite
Megestrol (Megace)
Prednisone
Chapter 6: physical symptom management
Anxiety
Multitude of issues can trigger feelings of anxiety
Fear of the future
Fear of pain
Can be seen in several ways
Increased agitation
Increased restlessness
Increased breathlessness / hyperventilation
Profuse sweating
Treatment
Benzodiazepines
Massage / comfort touch
Chapter 6: physical symptom management
Fatigue
Loss of energy
Tiredness
Can suffer from boredom and lack of stimulation because of inactivity
Treatment
Pharmacologic interventions
Help patient and family adapt to the patient’s fluctuating energy level
Encourage patient’s favorite activities
Chapter 6: physical symptom management
Depression
Persistent feelings of hopelessness and helplessness
Express feelings of despair and worthlessness
Linked with pain
Treatment
Pharmacologic interventions
Counseling
Relaxation and guided imagery
Chapter 6: physical symptom management
Guiding patients
Assure patients that their symptoms needs will be addressed
Explain therapies in terms patient and families can understand
Prepare patients and families for what might come next
Listen carefully to what the patient and family say about symptoms
Engage the patient and family in the care plan
