9780323028219

Palliative Practices : An Interdisciplinary Approach

by
  • ISBN13:

    9780323028219

  • ISBN10:

    0323028217

  • Edition: 1st
  • Format: Paperback
  • Copyright: 2005-02-23
  • Publisher: Mosby

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Summary

The first book of its kind, this must-have resource examines the integration of palliative interventions from a disease-specific approach, providing practical guidance on caring for patients who follow a progressive, chronic disease trajectory prior to death. This uniquely practical book addresses all aspects of palliative care, going beyond theoretical information to advise practitioners on the most effective management of common symptoms and providing physical, psychological, and spiritual comfort to patients and families. The multidisciplinary focus of care is reflected by collaborative contributors and diverse authorship of an oncology/palliative care nurse practitioner, a physician, and a social worker. Expert authors in the field of palliative care - an oncology/palliative care nurse practitioner, an MD, and a social worker - represent the collaborative nature of caring for chronically ill patients. The most common illnesses that cause death in the United States are addressed in separate chapters on specific disease states: Cardiovascular, Pulmonary, Nephrology, Oncology, and Neurology. Case studies at the conclusion of each chapter illustrate important patient scenarios in the context of clinical practice. Comprehensive drug information for symptom management and comfort measures is provided in an appendix, as well as palliative care assessment tools and helpful website resources. An entire chapter is devoted to cancer pain. Objectives at the beginning of each chapter introduce the reader to concepts that will be addressed in that chapter. Each chapter ends with multiple-choice objective questions to test the reader's comprehension, with answers and rationales provided in the back of book. Prognostic tables demonstrate precisely how and when to integrate palliative interventions into the course of an advanced illness, identifying prognostic indicators where appropriate. Other important topics are covered with chapters on sleep, ethics, cultural and spiritual issues, and the dying process.

Author Biography

Kim K. Kuebler, MN, RN, ANP-CS: Adult Nurse Practitioner, Primary/Oncology/Palliative Care, Private Practice Adjuvant Therapies, Inc., Atlanta, Georgia Mellar P. Davis, MD, FCCP: Director of Research, The Harry R. Horvitz Center for Palliative Medicine, Taussig Cancer Center, The Cleveland Clinic Foundation, Cleveland, Ohio Crystal Dea Moore, MA, MSW, PhD: Social Work Program Director, Assistant Professor of Social Work, Department of Sociology, Anthropology, and Social Work, Skidmore College, Saratoga Springs, New York

Table of Contents

UNIT I ISSUES SPECIFIC TO PALLIATIVE CARE
1(118)
Palliative Care Perspectives
3(26)
Barry M. Kinzbrunner
Introduction
3(1)
Definitions
3(4)
Hospice Care and the Medicare Hospice Benefit
7(4)
Palliative Care Programs
11(10)
The Future
21(3)
Summary
24(5)
Advance Care Planning
29(20)
Crystal Dea Moore
Introduction
29(1)
Advanced Illness Conversations
29(1)
Strategies to Improve Communication Quality
30(7)
Advance Care Planning
37(4)
Personal Awareness and Self-Care
41(4)
Summary
45(4)
Evidence-Based Interventions
49(14)
Dana N. Rutledge
Evolution of Evidence-Based Practice
49(5)
Tools of Evidence-Based Practice
54(1)
Implementing Evidence-Based Practice
55(5)
Summary
60(3)
Pharmacology
63(20)
Mellar P. Davis
Introduction
63(1)
Pharmacodynamics
64(5)
Pharmacokinetics
69(4)
Non-Linear Pharmacokinetics
73(1)
Dosing Regiments in Pharmacokinetics
73(1)
Importance of P-450 Enzyme System in Pharmaceutical Management
74(1)
Ethnicity and Special Populations
75(1)
P-450 Specific Enzymes
75(1)
Metabolism Through Glucuronidation
76(1)
Multiple Drug Transporters
77(1)
Polypharmacy and Drug Interactions
77(1)
Pharmacokinetics in Special Populations
78(1)
Summary
79(4)
The Interface Of Sleep
83(36)
Kathy P. Parker
Introduction
83(1)
Normal Sleep
83(8)
Impaired Sleep and Sleep Disorders
91(4)
Sleep in the Palliative Care Setting
95(3)
Factors Associated With Impaired Sleep
98(5)
Management of Impaired Sleep
103(7)
Summary
110(9)
UNIT II SPECIFIC DISEASE STATES AND SYMPTOM MANAGEMENT
119(170)
Cardiovascular
121(36)
Nancy M. Albert
Cardiovascular Disease
121(2)
Pathophysiology of Advanced Heart Failure
123(4)
Immune System Up-Regulation
127(1)
Management of HF Symptoms
128(4)
Prognostic Indicators for Palliative Interventions
132(3)
Interventions Before Palliation
135(13)
End-Of-Life Care
148(2)
Summary
150(7)
Pulmonary
157(24)
James Varga
Joshua Cox
Introduction
157(4)
Pulmonary Function Tests
161(2)
Staging
163(1)
Common and Frequent Symptoms
164(3)
Dyspnea
167(1)
Exacerbations
167(1)
Monitoring
168(2)
Pharmacologic Treatment
170(4)
Nonpharmacologic Treatment
174(1)
Pulmonary Rehabilitation
175(1)
Anxiety and Depression
175(1)
Summary
176(5)
Nephrology
181(16)
Michael Germain
Lewis M. Cohen
Introduction
181(1)
Symptom Burden
181(2)
Common Symptoms
183(1)
Discussion of Specific Symptoms and Their Management
184(6)
Advance Care Planning
190(1)
End-Of-Life and Hospice Care
191(1)
Discontinuing Dialysis
191(1)
Future Research
192(5)
Oncology
197(50)
Mary Magee Gullatte
Roberta Kaplow
Debra E. Heidrich
Introduction
197(1)
The Cost of Cancer
197(2)
Culturally Competent Palliative Practices
199(1)
Health Disparities
199(1)
Cellular Pathophysiology of Advanced Cancer
200(1)
Cancer Staging
201(1)
Metastatic Sites and Associated Symptoms
202(6)
Oncologic Emergencies
208(1)
Hypercalcemia of Malignancy
209(3)
Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)
212(2)
Increased Intracranial Pressure
214(3)
Spinal Cord Compression
217(3)
Superior Vena Cava Syndrome
220(2)
Treatment-Related Oncologic Emergencies
222(2)
Symptom Management in Advanced Malignancy
224(13)
Summary
237(10)
Cancer Pain
247(22)
Mellar P. Davis
Jan L. Frandsen
Introduction
247(1)
Pain Syndromes
248(3)
Pain Assessment
251(4)
Treatment
255(8)
Summary
263(6)
Neurology
269(20)
Mellar P. Davis
Bushra I. Cheema
David Oliver
Pamela Sue Spencer
Amyotrophic Lateral Sclerosis
269(10)
Huntington's Disease
279(4)
Summary
283(6)
UNIT III THE DYING PROCESS, GRIEF, AND BEREAVEMENT
289(112)
Ethical Issues
291(18)
Tom Tomlinson
Introduction
291(1)
Ethical Issues in the Transition to Palliative Care
291(7)
Ethical Issues Within Palliative Care
298(6)
Summary
304(5)
Cultural and Spiritual Issues
309(26)
Diane B. Loseth
Crystal Dea Moore
John A. Mulder
Chad S. Peterson
Introduction
309(1)
Cultural Impacts on Palliative Care
309(13)
Spiritual Issues in Palliative Care
322(7)
Summary
329(6)
The Dying Process
335(44)
Catherine Vena
Kim Kuebler
Sandra E. Schrader
Introduction
335(1)
Dying in America
335(1)
Theories on Death and Dying
336(2)
Dimensions of Dying
338(13)
Diagnosing Dying
351(11)
Approaches to Care
362(6)
Summary
368(11)
Grief and Bereavement
379(22)
Helen Kathleen Brophy McHale
Introduction
379(1)
Death and Loss
380(1)
Types of Grief
381(4)
Stage Theories
385(1)
Reactions to Grief
386(1)
The Impact of Grief
386(5)
Professional Responsibilities
391(2)
Assistance
393(3)
Summary
396(5)
ANSWERS
401
APPENDIXES
A Medications by Disorder
418(24)
Kim Kuebler
James Varga
Mellar P. Davis
B Medication Routes and Metabolism
442(5)
Kim Kuebler
James Varga
Mellar P. Davis
C Palliative Care Assessment Tools
447(24)
Marilyn O'Mallon
Kim Kuebler
D Websites
471
Kim Kuebler

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