Question

If you were diagnosed as terminally ill and had unbearable pain, what treatment modalities would you be willing to try? What treatment modalities would you refuse? Discuss and explain your rationale

Answer 1

I Wii try to terminally ill patients with severe chronic pain should provide treatment that permits these to close their lives with dignity and purpose. Analgesic both opioid and non opioid are available and when properly used can provide effective relief of pain for most terminally ill patients. Hoping for the best while planning for the worst .the importance of pain management at the end of life is a professional ,moral,and ethical obligation. Although pain may not be the most prevalent symptoms at this end of life ,it is the most feared .pain steals both the quality and satisfaction of remaining life,contribute to anxiety, depression, despair, loss of self efficacy and interference with medical decisions making. For many families the last memory of their loved one may either be that of a "peaceful" and comfortable transition or that of a painful and agonizing end.

Pain should be assessed

Location

Duration

Onset

Character

Severity

Relieving factor

And associated symptoms.

Identifying the underlying pain mechanism should direct appropriate treatment .As the end of life nears and cognition decrease.

Commonly used agents antidepressants and anticonvulsant .morphine

Fentanyl

Hydromorphone

Methadone

Oxycodone

Morphine has been the most widely used medication for Cancer pain and is considered a mainstay in end of life care.

Fentanyl a synthetic opioids may be better tolerated at end of life when renal function declining.

Hydromorphone is semisynthetic opioid five to six times more potent parenterally then morphine..

Refuse;

A person terminal illness ,has the right to refuse medical treatment to avoid "protracted physical suffering"

Terminal I'll patient to execute a "living will" to refuse medical treatment for dying with dignity. Patient ,"any such person who has come of age and is of sound mind has a right to refuse medical treatment "

Refuse to surgery, drugs, treatment of any kind so as to avoid protracted physical suffering.

Rational;

Dying client would be among the most stressful event.

Physical comfort;

Essential part of nursing care as the patient approaches the end of their life. The patient may feel such as pain,skin irritation, fatigue,breathing problem, digestive problems. Proper positioning is the most crucial part in relieving pain.patient position should be change every 3 hours once.special mattress support under the elbows and heels .patient keep moisture and clean .important to avoid infection.

Emotional support;

Dying person manage mental and emotional distress. Alert near end of life might understandably feel depressed or anxious. The simple act of physical contact such as holding hand ,touch,gentle massage. Increase relaxation techniqueand reduce pain.

Spiritual needs;

Perform certain prayers as it will help the patient with their spiritual needs. Should be encourage families to share their memories of good times and also support family members.