Non-Pain Symptom Management Flashcards
7 cards from real CHPN practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Non-Pain Symptom Management flashcards as text
A terminally ill patient is experiencing agitated delirium with hallucinations and combativeness. Which medication is FIRST-LINE for managing hyperactive delirium in hospice?
Answer: Haloperidol (antipsychotic)
Haloperidol is the first-line agent for hyperactive delirium in palliative care due to its efficacy in reducing psychotic symptoms with minimal sedation.
Which of the following is a REVERSIBLE cause of delirium that should be assessed in a hospice patient experiencing acute confusion?
Answer: Urinary retention or fecal impaction
Urinary retention and fecal impaction are common, treatable causes of delirium in palliative patients that should be assessed before attributing confusion to disease progression.
A patient in the last days of life develops terminal restlessness unresponsive to haloperidol. What is the NEXT appropriate intervention?
Answer: Add a benzodiazepine such as midazolam for refractory agitation
Midazolam is added for refractory terminal restlessness when haloperidol alone is insufficient, providing anxiolysis and sedation.
When educating a family about terminal delirium, which statement BEST reflects evidence-based understanding?
Answer: Delirium is common near death and may represent a transitional state; the patient is often unaware of their behavior
Terminal delirium is a normal part of the dying process; patients are typically unaware of their behavior, and families need reassurance that it does not mean suffering.
A hospice patient on chronic opioids develops myoclonus (muscle twitching). Which is the MOST likely cause?
Answer: Accumulation of opioid metabolites, particularly morphine-6-glucuronide
Opioid-induced myoclonus results from accumulation of neuroexcitatory metabolites (e.g., morphine-3-glucuronide) especially in renal impairment.
A patient with terminal cancer develops anxiety and existential distress. Which combination approach is MOST consistent with palliative care philosophy?
Answer: Combine pharmacologic treatment (e.g., lorazepam) with psychosocial support, chaplaincy, and dignity therapy
Palliative care addresses total suffering through an integrated approach combining medications, psychosocial support, and spiritual care.
Which assessment tool is specifically designed to identify delirium in palliative care patients?
Answer: Confusion Assessment Method (CAM)
The CAM is the gold-standard validated tool for detecting delirium and distinguishing it from dementia or depression.