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Palliative Care

  1. Assess patient's symptoms in detail. Have patient rate pain on a 0-to-10 scale.
  2. Assess patient's skin, respirations, oral cavity, bowel and bladder functions, food and fluid intake, body weight, and medication use.
  3. Administer pharmacologic therapies for pain, anxiety, and terminal restlessness. Provide nonpharmacologic therapies for pain.
  4. Provide general comfort measures, including bathing, lip and eye care, and frequent repositioning.
  5. Provide oral hygiene every 2 to 4 hours.
  6. Treat nausea with anti emetics. Replace lost fluids with clear liquids and ice chips.
  7. Prevent constipation with a high-fiber diet, increased fluid intake, regular exercise, and a daily suppository (if ordered). Treat diarrhea with a low-residue diet. Assess for fecal impaction.
  8. Confer with physician about use of a catheter or diapers to treat total urinary incontinence.
  9. Help patient conserve energy by taking frequent rest periods, doing activities when patient feels more energetic, and reducing steps involved in activities of daily living.
  10. Provide vigilant skin care.
  11. Provide adequate ventilation and oxygenation by placing patient in semi-Fowler's or Fowler's position, suctioning excessive secretions, repositioning as needed, administering oxygen, and keeping the room cool and dry.
  12. Establish presence with patient to allay anxiety and panic felt with air hunger. Share control with patient by offering choices whenever possible.
  13. Control terminal restlessness by keeping patient's room quiet, adequately lit, and at a comfortable temperature; allowing family members to maintain close contact; and using least-sedating medications, doses, and routes to control restless behavior.
  14. Reassess patient to determine effectiveness of interventions in relieving symptoms.
  15. Assess for spiritual needs; offer chaplain visit;  time for quiet reflection or prayer
  16. Consider if palliative care service consult is beneficial to patient and family. Discuss with physician if appropriate.
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