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20-27% Symptom Assessment and Management 15-22% Pain Assessment and Management 15-20% Last Days/Hours/Imminent Death Care 12-15% Care of the Person and Family 7-10% Interprofessional/Collaborative Practice 7-10% Education 5-8% Loss, Grief and Bereavement Support 5-8% Ethics and Legal Issues 5-8% Professional Development and Advocacy
EXAM DATE: Sat APRIL 5, 2014REVIEW TIME START : Sat March 22, 201423 weeks til review time 138 days total til review time minus 18 x 4 = 72 shift worked during 76 total to study until review time
BREAKDOWN OF % 165 QUESTIONS
BREAKDOWN OF %/# OF STUDY DAYS
Symptom (24%) = 18 Pain (18%) = 14 Last Days (17%) = 13 Person & Fam (12%) = 9 Interpro (7%) = 5 Edu (7%) = 5 Grief (5%) = 4 Ethics (5%) = 4 Pro devel & advo (5%) = 4
TIMELINE (START/END DATES)
Review during WORK days!!
SUNDAYS off from studying!
6 FLEX DAYS (by studying into Review period)
Symptom = Oct 12 - Nov 18 Pain = Nov 19 - Dec 16 Last Days = Dec 21 - Jan 11 Persons & Fam = Jan 17 - Feb 4 Interpro = Feb 5 - Feb 13 Edu = Feb 14 - Feb 24 Grief = Feb 25 - Mar 4 Ethics = Mar 5 - Mar 12 Pro devel & Advo = Mar 13 - Mar 21
Symptom Assessment and Management 18 DAYS - Oct 12 - Nov 18
Professional Development and Advocacy 4 DAYS - Mar 13 - Mar 21
Pain Assessment and Management14 DAYS - Nov 19 - Dec 16
Last Days/Hours/Imminent Death Care 13 DAYS - Dec 21 - Jan 11
Care of the Person and Family 9 DAYS = Jan 17 - Feb 4
Inter professional/Collaborative Practice 5 DAYS - Feb 5 - Feb 13
Education 5 DAYS - Feb 14 - Feb 24
Loss, Grief and Bereavement Support 4 DAYS - Feb 25 - Mar 4
Ethics and Legal Issues 4 DAYS - Mar 5 - Mar 12
For each symptom look at: possible causes comprehensive assessment data ongoing assessment assessment tools interventions collaborative care planning Common medications used special considerations for children, elderly, special needs (cognitively impaired, communication disorders, language barriers) impact on overall well-being
Symptoms - neuro DAY 1 i) aphasia ii) dysphasia iii) extrapyramidal symptoms iv) lethargy or sedation v) paresthesia or neuropathies vi) seizures
Emergencies/ Incidents: DAY 13- acute bowel obstruction; - cardiac tamponade; - delirium; - abnormal laboratory values (e.g., hypercalcemia, hyperkalemia); - falls; - hemorrhage; - opioid or medication toxicity; - pulmonary embolism and pleural effusion; - respiratory depression/distress; - seizures; - spinal cord compression; and - superior vena cava syndrome.
Common types of medications in EOL care : DAY 16 steroids, anticholinergics, prokinetics, neuroleptics, antidepressants, antipsychotics, chemotherapy pharmacological and physiological use potential side effects, interactions or complications, time trials medication administration techniques (breakthrough doses, routes, scheduling, titration, pumps)
Non - pharm approaches : DAY 15 radiation therapy surgery physiotherapy rehabilitation therapy complementary therapies
Promoting personal/spiritual growth: DAY 17life review/legacy, reconciliation strategies, presence).
Non-cancer diagnoses: DAY 14 AIDS COPD ALS CHF
Symptoms - cognitive DAY 2 i) agitation and terminal restlessness ii) confusion iii) delusions iv) delirium v) dementia vi) hallucinations vii) paranoia
Symptom - cardiovascular: DAY 3i) angina ii) arrhythmia iii) edema iv) syncope
Symptom - respiratory: DAY 4 i) congestion/excess secretions ii) cough iii) dyspnea iv) apnea v) hemoptysis vi) hiccoughs
Symptom - GI: DAY 5i) nausea and vomiting ii) constipation iii) diarrhea iv) bowel incontinence v) bowel obstruction - partial obst vi) dysphagia vii) jaundice
Symptom - nutrition and metabolic: DAY 6i) anorexia ii) cachexia iii) decreased intake of food/fluids iv) dehydration v) electrolyte imbalance
Symptom - GU: DAY 7 i) bladder spasms ii) urinary incontinence iii) urinary retention
Symptom - immuno DAY 8i) medication reactions/interactions- allergic response- anaphylaxiii) infection- sepsis- pneumonia- herpes- stomatitis- candidiasis- urinary tract infection iii) pyrexia
Symptom - musculoskeletal: DAY 9i) pathological fractures ii) weakness iii) muscle spasm
Symptom - skin and mucous membranes: DAY 10 i) candidiasis ii) malignant wounds (e.g., fungating, fistulas) iii) mucositis iv) pressure areas v) pruritus vi) xerostomia
Symptom - psychosocial and spiritual: DAY 11i) anxiety ii) anger iii) denial iv) * depression v) fear vi) guilt vii) suicidal or homicidal ideation viii) grief vix) suffering x) distress xi) meaning and purpose of life and illness xii) hope xiii) forgiveness/acceptance xiv) love and relatedness xv) transcendence
Symptom - other: DAY 12 i) ascites ii) fatigue/asthenia iii) lymphedema iv) myelosuppression (e.g., anemia, neutropenia, thrombocytopenia) v) myoclonus vi) sleep disturbances
Symptom Assessment and Management 18 DAYS - Oct 12 - Nov 18
Emanuel, L., & Librach, S. (2011). Palliative care: Core skills and clinical competencies (2nd ed.). Philadelphia: Saunders.Ferrell, B. R., & Coyle, N. (Eds.). (2010). Oxford textbook of palliative nursing (3rd ed.). New York: Oxford University Press.Pereira, J. L. (2008). The pallium palliative pocketbook. Edmonton: The Pallium Project.Victoria Hospice Society. (2006). Medical care of the dying (4th ed.). Victoria, BC: Author.
Pain Assessment and Management14 DAYS - Nov 19 - Dec 16
Types of pain: DAY 4- Total pain- factors- phantom pain- incidental
Physiology of pain DAY 3- transduction; - transmission; - modulation; - perception.
Classifications of pain DAY 1-2- acute; - chronic; - malignant; - non-malignant; - neuropathic; and - nociceptive (somatic and visceral).
Comprehensive pain assessment DAY 5-7- possible causes- validated tools- initial and ongoing assessment- special considerations for elderly and children; special needs (cognitive impairments, communication disorders, language barriers)
Stepped approach to assessment & management: DAY 5-7 based on type & severity
Barriers to assessment & management (individual, family & HCP) DAY 5-7- myths- misconceptions- health-system barriers
Medication administration techniques : DAY 8-12- breakthrough doses- routes- scheduling- titration- pumps- *indications for opioid rotation- *equianalgesic conversions
Commonly used medications DAY 8 -12- potential side effects- interactions - complications.- antimigraine
Adjuvants DAY 13- pharmacological and physiological use- bisphosphonates- NSAIDS- corticosteroids,- anticonvulsants,- antidepressants,- antipsychotics- chemotherapy
Non-pharm interventions DAY 14- radiation therapy- surgery- physiotherapy- rehabilitation therapy- complimentary therapies
Exam Breakdown
Subject Breakdown
Symptom Assessment & Management
Bibliography
Pain Assessment & Management
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