Palliative Care

Palliative care for a dying patient needs to be well planned and managed to ensure that all aspects of care giving are taken care of. The plan provides a reference for nurses and other practitioners who are involved in giving care to the patient. This is so as to ensure that they all know what needs to be done and does not. The plan also includes the relatives or family of the patient who need to be involved in the process not only to give emotional support but also physical support to the patient. However, this is just a plan and the nurse’s actions are independent and governed by the scope of practice of the state and specific country as well as the comfort levels of the nurse. The common management needs for a dying patient are comfort,
These include physical needs, emotional and spiritual needs, social needs, communication needs as well as family needs. The care plan is as follows;
A. Providing comfort – In most instances, the dying patient in need of palliative care is often in pain. It is thus important to ensure that the pain is controlled and managed.
• Provide a continuous dosage of opioids for the pain. The dosage should be given round the clock. It should also be administered in intervals to the patient in order to alleviate their pain. The opioids can be administered via a PCA pump. Other than that, the patient should be given boluses as an additional dosage in cases when the patient is experiencing pain whilst their opioids dosage has already been administered. The boluses need to be given to the patient as
Management of the deliriums and restlessness – The restlessness may be as a result of a number of things. It may be because of stool impaction, bladder distention or from pain. This part of the plan involves protecting the patient from injury and supporting the family. The first step would be to give a dosage of opioids to the patient in order to rule out the possibility that they may be in pain. The next step is to assess the distention of the bladder. In case there is an issue, the nurse needs to insert an indwelling catheter. If it is appropriate to do so, the next step is to assess for impaction. The patient may need to be given antipsychotics or even benzodiazepines such as haloperidol or chlorpromazine and lorazepam or midazolam respectively. It is also important to maintain an environment that is calm around the patient. One can play the favorite music of the patient and dim any bright lights. The patient should be comforted by speaking softly and saying supportive