ABC of Palliative Care by Marie Fallon, Geoffrey Hanks

By Marie Fallon, Geoffrey Hanks

This fresh variation of ABC of Palliative Care pulls jointly the main updated details in this advanced, multidisciplinary zone in a pragmatic, trouble-free demeanour. totally up-to-date, it offers with the very important social and mental features for palliative care of individuals with incurable ailments together with caliber of existence, communique and bereavement issues.

This authoritative, sensible identify can be priceless to the expanding numbers of medical professionals, senior and professional nurses, and all these well-being execs who take care of melanoma sufferers in the sanatorium, at domestic or in a hospice.

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Giving a stimulant in combination with a softening laxative may reduce colic. The most popular stimulants are senna and dantron. Patients given dantron may experience reddish discoloration of the urine and perianal rash, particularly in incontinent patients. ) Rectal laxatives Suppositories or enemas are sometimes necessary but should never accompany an inadequate prescription of an oral laxative. They are appropriate for treating faecal impaction and for conditions such as spinal cord compression, when long term use may be necessary.

Management Anticholinergic drugs must be discontinued if at all possible. Prokinetic drugs may restore gastric emptying if the lumen is patent and the autonomic nerves are intact, but they may cause colic if there is an upper gastrointestinal obstruction. In normal circumstances, using a proton pump inhibitor or H2 blocker can reduce the volume of gastric secretions, and parenteral administration can help some patients with obstruction. Ingested air can be de-foamed with dimethicone (tablets or compounded with an antacid).

Parenteral corticosteroids are sometimes used for additional symptomatic relief of bowel obstruction. This is a difficult area to study and currently there is a lack of good evidence for the most appropriate role and dosing regimen. qxd 28/6/06 11:30 AM Page 35 Constipation, diarrhoea, and intestinal obstruction fluid administered should be assessed carefully. High levels of intravenous and subcutaneous fluids may result in more bowel secretions, thus it is necessary to keep a balance between the efficacy of the treatment and the side effects such as increased vomiting, abdominal distension, and pain.

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