Corticosteroids in Hospice and Palliative Care (Reading & Sharing)

  • Corticosteroids may be used to treat a variety of conditions and symptoms in the palliative care patient, including cerebral edema, spinal cord compression, pain, nausea/vomiting, malignant bowel obstruction, fatigue, and loss of appetite.
  • Although steroids can be very effective, they are associated with frequent and significant adverse effects, particularly with prolonged used. Common effects of even short-term steroid use include disturbed sleep, hyperglycemia, delirium or agitation, fluid retention, gastric ulceration, and increased susceptibility to infection. Prolonged steroid use may lead to osteoporosis, myopathy, and cataracts.
  • Corticosteroids such as prednisone and methylprednisolone are associated with important adverse cardiovascular effects such as sodium and fluid retention, expanded extracellular fluid volume, hypokalemia, and increased BP (possibly associated with an increase in peripheral vascular resistance), all of which increase the risk of cardiac decompensation. However, dexamethasone has some mineralocorticoid activity with less risk of sodium retention, which may make it a safer alternative than some of the other drugs in this class. Additional concerns with corticosteroids include the risk of interaction with anticoagulants and gastrointestinal side effects in the patient taking aspirin.
  • To be CONT. and Modify…
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Heredity vs. Environment, Which is More Important?

The debate over the relative importance of nature and nurture, of heredity and environment, is centuries old. If undesirable traits are determined by heredity, there is not much anyone can do to improve human health or performance. Nowadays, most scientists avoid the debate. They say instead that heredity determines potential capacities, and it sets limits. A child who is born retarded can not grow up to be a Nobel prize winner. But scientists emphasize that both heredity and environment are important and that how a person turns out depends on a complex interaction between the two. An analogy may make the point clearer. It takes moisture and cold to make snow; you can not say that the moisture has twice as much influence as the cold in producing the snow, or half, because both elements are essential.

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Breast Cancer – Carcinoma of the Breast (Reading & Sharing)

Breast cancer refers to both in situ and invasive carcinoma of the breast. Breast cancer can be of either ductal or lobular types. Breast canceris nearly exlusively the disease of women, with only 1% of breast cancers occuring in males. It is the most frequently diagnosed cancer in women and leading cause of death due to cancer in women 20-59 years old. More than 50% occurs in women over age 61.

Risk factors include hormone exposure, family or personal history, lifestyle factors, exposure to radiation; smoking; obesity; early menarche; late menopause; postmenopausal hormone therapy; excessive alcohol use; nulliparity; 5% to 6% are associated with a genetic mutation.

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All About Nursing · Hospice & Palliative Care · Nursing Continue Education

Palliative Care (宁养服务)

Palliative care is available to acutely ill patients, may be provided along with disease-specific, life-prolonging treatment. Meticulous attention to be prevention and relief of pain and other burdensome symptoms is a basic part of quality palliative care. Yet, comprehensive palliative care includes much more. Psychosocial and spiritual care, counseling, and guidance in choosing among treatment options, and assisting with practical support for patients and caregivers are all equally fundamental components of comprehensive palliative care. It is critical to stress that palliative care should be provided from the time of diagnosis of a serious, debilitating, or life-limiting illness. Palliative care should be an integral part of healthcare aimed to achieve best possible outcomes including optimal quality of life, function, and opportunities for personal growth across the life span. Palliative care can and should be provided along with any disease-modifying treatments. And, yes, for some people with advanced illness, palliative care may be the main focus of care.

寧養服務適用於任何人——無論什麼年齡, 種族, 文化, 背景或宗教, 而且大多數服務是免費的。您可以在病情的任何階段使用寧養服務,這並不僅僅是為生命即將到達終點的人而設。使用寧養服務並不意味著生命沒有希望,您已經“放棄”或您的家庭不在乎您。您可以在接受寧養服務的同時繼續治療。

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