Health Variation 5 Palliative Care and End of Life

Running head: HEALTH VARIATION 5 PALLIATIVE CARE AND END OF LIFE 1
Health Variation 5 Palliative Care and End of Life.
Name:
Institution:
Tutor:
Date:

HEALTH VARIATION 5 PALLIATIVE CARE AND END OF LIFE 2
Health Variation 5 Palliative Care and End of Life.
Introduction
Palliative care can be defined as a holistic approach in dealing with signs that are beyond
the physical needs of a person so that the patient feels comfortable. In a certain case study, a
patient known as Mrs. Brown 62 years old presented with breathlessness that is due to COPD.
Effective management of breathlessness improves patient’s feelings of well-being and dignity.
Within the framework of this essay, there will be a discussion on the high priority nursing
strategies to manage Mrs. Brown’s case of breathlessness using the palliative approach.
Discussion
Medication is one of the best palliative approach that can be used to manage
breathlessness in Mrs. Brown. Several clinical trials have been conducted and results indicate
that there is a variety of drugs that subside breathlessness. The medicines can relieve symptoms
that worsens breathlessness such as pain as well as anxiety (Maddocks, Reilly, Jolley, &
Higginson, 2014). The nurse should prescribe or administer a group of drugs known as opioids.
Opioids are generally pain killers and are used to relieve pain due to breathlessness in Mrs.
Brown. Examples of opioids are morphine and they work by blocking transmission of pain
messages between neurons thus prevent them from reaching the brain .Mrs. Brown will therefore
not experience pain for some time. Since Mrs. Brown is anxious of potential death, it is
important to manage the anxiety since it worsens the symptoms. The group of drugs/medicines
that can be used to manage anxiety is Benzodiazepines. Benzodiazepines is a group of drugs that
work by stimulating neurotransmitter GABA in specific (Kvangarsnes, Torheim, Hole, &
Öhlund, 2013). The function of neurotransmitters is to transmit impulses from one to another.

HEALTH VARIATION 5 PALLIATIVE CARE AND END OF LIFE 3
They are usually released from the brain. The function of the released GABA (Gamma Amino
Butyric Acid) is to slow and calm things down. This reduces anxiety in patients and would be of
importance to Mrs. Brown. Examples of the benzodiazepines that can be prescribed to Mrs.
Brown include lorazepam and diazepam. In case of agitation, then Midazolam can be used.
Bronchodilators can be used to aid breathlessness. A good example is salbutamol which
clinical trials have indicated as effective in assisting patients with breathlessness. One of the
causes of breathlessness is narrow airways that makes it quite difficult for air to move in and out
of the lungs. The solution in this case is the administration of bronchodilators (Farquhar, 2017).
These drugs usually produce a relaxing effect on muscles which then widen and this makes
breathing easier. Furthermore, they assist in clearing of mucus and reducing inflammation. Other
important drugs include carbocisteine or saline nebulizers and corticosteroids. The saline
nebulizers utilize their ultrasonic power to fragment solutions into finer particles. In the case of
breathlessness, mucus blocks airways and therefore this drugs can be used to cough up the
sputum so that that airways are clear (Ekström, Nilsson, Abernethy, & Currow, 2015).
Eventually, it will be much easier for the patient to breath. Corticosteroids on the other hand
mimic the action of cortisol, a hormone that reduce inflammation of airways and this bolsters
breathing among patients with chronic conditions. If breathlessness persists, it is recommended
to switch medication that is given continuously by a syringe driver. Finally, palliative oxygen
can be used to manage breathlessness where oxygen is supplemented form an artificial source
like a tank then delivered through gas masks or cannula.
Even though drugs are effective in management of breathlessness, some of them like
opioids are very addictive since they elicit excitation among the users. Nurses ought to be very
careful and monitor the patients so that they only takes the recommended dose.