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Cardiac

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Demonstrate the ability to assess, manage and critically evaluate the palliative care needs of patients with Heart Disease/ Cardiovascular Disorders.
The palliative care needs should be discussed with the patient as soon as possible once their condition begins to deteriorate so they are aware of expectations and can contribute to the person-centred care and be looked after they way they want.
Assessment of the Activities of Daily Living will be carried out to draw up a care plan. Further to this the Liverpool care pathway can be used in the last 48 hours of the patient’s life. ▪ Maintaining a safe environment- treat patient as an individual, speak to family to get them involved with caring for the patient. ▪ Communication- speak to patient, spend time with them reassuring them. ▪ Breathing- give 02 to relieve breathlessness, use protective creams around the nose, position the patient for optimum air respiration ▪ Eating and drinking- the patient will be too tired to eat and has lost appetite, cleaning of the oral cavity as saliva dries up will keep the patient comfortable. ▪ Elimination- commode nearby, the patient maybe too tired to carry out a bowel motion and can become constipated. The use of senna can be used to help relieve this. The patient may suffer from a loss of dignity and self-respect leading to depression at an inability to go to the toilet to urinate. Catheterisation maybe considered. ▪ Washing and dressing- a light wash and dry and change of clothing will help to keep the patient dry and comfortable, this depends on the patients condition as disturbing him/her could cause more ▪ Controlling temperature- maintaining a cool room temperature can help relief breathlessness ▪ Mobilisation- patient will be lethargic and fatigued so the use of a wheelchair may be required, assistance with sitting up in the bed etc may also be necessary. A hospital bed maybe considered in a community setting to improve comfort. ▪ Sleeping- allow patient to sleep and readjust medication rounds when necessary, be flexible in this approach as patients comfort is of prime importance. ▪ Death and dying- keep the patient as comfortable as possible, give analgesia when required to relieve pain. Morphine can be given when required and a syringe driver can be set up

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