Palliative Care Nursing Exam
Questions And Answers
Palliative care - Delirium - ✔✔Hypoactive delirium = Consideration for misdiagnosis
of depression, dementia or fatigue - sluggish, drowsy
Hyperactive delirium = Increased psychomotor activity - rapid mood changes, agitated
- Educate and reassure both patient and family about the nature of the problem
- Review medication; identify for any infection; improve hydration and attention to
the environment of the patient
Predisposing factors - delirium - ✔✔- Age >65 years
- Cognitive status = Dementia, depression, multiple co-morbidities, advanced illness
- Functional status = dependence, immobility, low levels of activity
- Sensory impairment
- Impaired nutrition
Two roads of terminal restlessness - ✔✔Usual road = That most patients follow presents
as decreasing level of consciousness that leads to coma and death
Difficult road= That a few patients follow as an agitated delirium due to CNS excitation, with
or without myoclonic jerks that leads to coma and death
, Palliative Care - Dyspnoea - ✔✔Occurs more frequently as disease progresses, when it
may be associated with progressive weakness and/or changes in biomechanics of the chest
wall
- Oxygen may not relieve symptoms - can be offered as a therapeutic trail - symptomatic
benefit vs. burden
Dyspnoea and treatable causes - ✔✔- Anemia
- Congestive heart failure
- Chronic obstructive airway disease
- Respiratory tract infection
- Pleural effusion
- Superior vena cava
- Tumor obstruction
- Bronchospasm
Palliative Care - Constipation - ✔✔Increase in prevalence and severity of
constipation increases as a patient becomes more functionally dependent
- Failure to manage constipation can lead to reduced adherence to medication,
avoidable admissions and distressed emotions
Palliative Care - Cachexia - ✔✔Multifactorial syndrome that is defined by an ongoing loss
of skeletal muscle mass that cannot be fully reversed by conventional nutritional support and
leads to progressive functional impairment
Cachexia Symptoms - ✔✔- Loss of total body mass
- Decreased muscle strength, pronounced muscle wasting
- Reduced muscle mass
- Fatigue
- Anxiety
Questions And Answers
Palliative care - Delirium - ✔✔Hypoactive delirium = Consideration for misdiagnosis
of depression, dementia or fatigue - sluggish, drowsy
Hyperactive delirium = Increased psychomotor activity - rapid mood changes, agitated
- Educate and reassure both patient and family about the nature of the problem
- Review medication; identify for any infection; improve hydration and attention to
the environment of the patient
Predisposing factors - delirium - ✔✔- Age >65 years
- Cognitive status = Dementia, depression, multiple co-morbidities, advanced illness
- Functional status = dependence, immobility, low levels of activity
- Sensory impairment
- Impaired nutrition
Two roads of terminal restlessness - ✔✔Usual road = That most patients follow presents
as decreasing level of consciousness that leads to coma and death
Difficult road= That a few patients follow as an agitated delirium due to CNS excitation, with
or without myoclonic jerks that leads to coma and death
, Palliative Care - Dyspnoea - ✔✔Occurs more frequently as disease progresses, when it
may be associated with progressive weakness and/or changes in biomechanics of the chest
wall
- Oxygen may not relieve symptoms - can be offered as a therapeutic trail - symptomatic
benefit vs. burden
Dyspnoea and treatable causes - ✔✔- Anemia
- Congestive heart failure
- Chronic obstructive airway disease
- Respiratory tract infection
- Pleural effusion
- Superior vena cava
- Tumor obstruction
- Bronchospasm
Palliative Care - Constipation - ✔✔Increase in prevalence and severity of
constipation increases as a patient becomes more functionally dependent
- Failure to manage constipation can lead to reduced adherence to medication,
avoidable admissions and distressed emotions
Palliative Care - Cachexia - ✔✔Multifactorial syndrome that is defined by an ongoing loss
of skeletal muscle mass that cannot be fully reversed by conventional nutritional support and
leads to progressive functional impairment
Cachexia Symptoms - ✔✔- Loss of total body mass
- Decreased muscle strength, pronounced muscle wasting
- Reduced muscle mass
- Fatigue
- Anxiety
