1. CLINICAL REVIEW FOR THE GENERALIST HOSPICE & PALLIATIVE NURSE Symptom Management WEEK 3
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6. Pharmacologic Interventions for Anorexia/Cachexia Class of drug Examples Comments Gastrokinetic agents Metoclopramide (Reglan) Useful w/ c/o nausea + early satiety (“I feel full”) Corticosteroids Dexamethasone (Decadron) Effective in short-term (w/side effects) Progesterone Analogs (hormonal treatment) Megestrol acetate (Megace) Somewhat effective for some pts. (expensive) Cannabinoids Dronabinol (Marinol) Effective in low doses Alcohol Beer or sherry May improve appetite + morale in some pts. Vitamins Multivits., Vit. C Anecdotal evidence for improved appetite (placebo?)
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23. New Drug: Relistor (methylnaltrexone ) Naloxone Relistor (naloxone w/ + charge on Nitrogen atom)
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54. Unstageable wound— cannot see base of wound – Black eschar in wound bed-needs debriding Dry, Black eschar on heel—do not remove Do not “reverse stage”—As a wound heals, it remains the same stage—a stage 3 is “a healing stage 3”, not a stage 2 .
Shear is caused by gravity pushing down on the body and resistance (friction) between the patient and a surface, such as the bed or chair. E.g. elevation of head of bed, and sliding down in chair.
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