Pain Management and Palliative Care Flashcards

A dying patient's family asks why the nurse is administering morphine for dyspnea when the patient is not in pain. The best response is:

Answer: 'Low-dose morphine reduces the sensation of air hunger in dying patients without hastening death when used appropriately.'

Low-dose opioids are evidence-based for relieving dyspnea in terminal illness by reducing the brain's response to hypercapnia and the sensation of breathlessness.

A patient receiving high-dose opioids for cancer pain is concerned about addiction. The nurse's best response is:

Answer: 'Physical dependence is expected with long-term opioids, but addiction (compulsive misuse despite harm) is rare in cancer pain patients taking opioids as prescribed.'

Distinguishing physical dependence (expected physiological adaptation) from addiction (psychological disorder with compulsive misuse) is essential patient education in pain management.

A patient in hospice care becomes increasingly confused, restless, and distressed in the final days of life. The nurse recognizes this as:

Answer: Terminal restlessness (terminal delirium), a common end-of-life phenomenon

Terminal restlessness is a common end-of-life syndrome characterized by agitation, confusion, and distress that often responds to low-dose haloperidol or benzodiazepines.

A palliative care patient declines a recommended blood transfusion, stating it conflicts with their religious beliefs. The nurse's appropriate response is:

Answer: Respect the patient's decision and document their refusal, ensuring informed consent principles are upheld

Competent adult patients have the right to refuse any medical treatment; the nurse's role is to ensure the decision is informed and to document it, respecting patient autonomy.

A family member asks the nurse to 'not tell my mother she has terminal cancer' to protect her feelings. The nurse should:

Answer: Explain that the patient has the right to know her diagnosis and discuss goals of care; involve the palliative care team

Patient autonomy requires truthful disclosure of the diagnosis; the nurse should involve the multidisciplinary palliative care team to facilitate sensitive family-patient communication.

A patient with advanced heart failure is transitioned to comfort-focused care. Which order would the nurse anticipate discontinuing?

Answer: Daily lipid-lowering statin therapy

Preventive medications like statins that serve no immediate comfort purpose are typically discontinued in comfort-focused care to reduce the pill burden and focus on symptom management.