Palliative Care 101
What is palliative care? a) Post-mortem care b) Hospice care c) Any care that takes place after DNR decision d) Care for people with a serious illness that focuses on improving quality of life by reducing suffering and supporting patient and family.
d) Care for people with a serious illness that focuses on improving quality of life by reducting suffering and supporting patient and family.
True or false: opioids are very effective regardless of type of pain.
What is false?
A patient is eligible for hospice if they have a life-limiting illness, are not pursuing curative treatment, and have a prognosis of _______ months or less.
What is 3?
Who is on a palliative care team? a) Physicians and nurses b) Whoever the patient wants on the team c) Physicians, NPs, Nurses, PSW, SWs, chaplains, Pharmacist d) The PCP and consultants
c) Physicians, NPs, Nurses, PSW, SWs, chaplains, Pharmacist
True or false: Untreated or undertreated pain can result in permanent nervous system damage, causing chronic neuropathic pain.
What is true? (Central facilitation - nerves are undamaged but abnormal signaling system evolved)
True or false: A patient must have a DNR completed to qualify for hospice.
What is True!
Code status discussions should be intiated by the ________ team.
What is any professional in the circle of care?
When is palliative care appropriate? a) After the patient is deemed palliative b) At any age and any stage of a serious illness c) In adults over age 50 with a prognosis <6months d) In organ donors
b) At any age and any stage of a serious illness
These types of medications are first-line in neuropathic pain.
What are TCAs, anticonvulsants, neuropathic agents
True or false: Patients no longer receive chemotherapy, or hydration when they are transitioned to hospice.
What is it depends!
True or false: IV fluids are appropriate at the end of life to maintain hydration.
What is false - but not always?
Why involve palliative care? a) Increases quality of life b) Decreases rates of depression c) Increases life expectancy in some disease processes d) Reduces hospital costs e) Decreases hospital length of stay and reduces readmission rates f) Earlier hospice referrals g) Increases patient and family satisfaction h) All of the above
h) All of the above!
This route of medication is ideal for long-acting coverage in patients whose pain is already well-controlled and oral route has been lost.
What is subcutaneous route?
These are common symptoms of what: confusion that is new, agitation, somnolence, hallucinations, paranoia that is new, hypersensitivity to touch (allodynia), unable to pinpoint pain when before pain was specific. .
What is delirium?
7 out of 10 Canadians say they would prefer to die at home, but only ____% actually do.
What is 13%? ( In 2021–2022, 13% of Canadians died at home with palliative care—an increase from 7% in 2016–2017) Stats Can
When is a specialty-level palliative care consult most appropriate? a) When a patient has questions about hospice b) With difficulty-to-control symptoms, conflicts over goals of care, or complicated discharge planning c) When a patient is deemed paliative and will die in the hospital d) In a patient with no life-limiting illness who needs management of their opioid addiction e) All of the above
b) With difficulty-to-control symptoms, conflicts over goals of care, or complicated discharge planning
The oral hydromorphone dose equivalent to oral morphine 15 mg.
What is oral hydromorphone 3 mg (H:M = 1:5)
True or False: A patient who has a completed DNR form may not return to the hospital under any circumstances.
What is false?