Palliative Care and Symptom Management Flashcards

Which intervention is most effective for managing malignant bowel obstruction in a patient with poor prognosis who is not a surgical candidate?

Answer: Octreotide plus corticosteroids plus antiemetics

Octreotide reduces intestinal secretions, corticosteroids reduce perilesional edema, and antiemetics manage nausea — this triad palliates MBO without surgery.

Methylnaltrexone (Relistor) treats opioid-induced constipation by:

Answer: Blocking peripheral mu-opioid receptors in the GI tract without reversing central analgesia

Methylnaltrexone is a peripherally acting mu-opioid receptor antagonist that reverses GI opioid effects without crossing the blood-brain barrier.

Which prognostic tool is validated to estimate survival in weeks to months for palliative care patients?

Answer: Palliative Performance Scale (PPS)

The Palliative Performance Scale integrates ambulation, activity, self-care, oral intake, and consciousness to provide a validated survival estimate.

Anticipatory grief is best described as:

Answer: Grief experienced before an expected loss occurs

Anticipatory grief occurs before the death and encompasses the losses already experienced and those expected, affecting both patients and families.

Which measurement best indicates that a patient is at high risk of imminent death (hours to days) in the inpatient palliative setting?

Answer: Decreased urine output, mottling, irregular respirations, and unresponsiveness

Decreased urine output, mottled skin, irregular breathing patterns, and unresponsiveness are reliable clinical signs of imminent death within hours to days.

Which action is central to the NURSE communication framework used in delivering serious news to cancer patients?

Answer: Naming, understanding, respecting, supporting, and exploring emotions

The NURSE acronym (Name, Understand, Respect, Support, Explore) guides clinicians in empathically acknowledging and responding to patient emotions.