NURS 498 Lecture Notes - Lecture 11: Ketamine, Osteoporosis, Itch
22 Mar 2018
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Spanish influenza: 1918- wiped out 5% of the population. Coronary artery disease/mi, copd, and trauma are probably the top three now. In 1963 she started to say that it was a speciality as an area. (but still not labeled as palliative care) Palliative care affirms life, promotes quality of life, supports the family and treats the person. Itchiness (morphine: respiratory depression, constipation, drowsiness sedation, addiction, hydromorphone is more effect and less toxic for poor kidney function. (so if creatinine is creeping up you will look at hydromorphone) Long acting: chronic pain, or pain gets stabilized. Radiotherapy, shrinks tumor, sometimes it buys people time. Bisphosphonates (pamidronate, zolendronate: osteoporosis, with cancer patients- they may develop hypercalcemia where the calcium leaks out of the bones. Can cause cardiac arrhythmias, muscle pain, seizures, constipation. As the symptoms progress we go to a bisphosphonate. Surgery- may see pathological fractures in bone cancers. Assessment of the abdomen and bowel sounds.
