Interventions |
Correct interventions |
|
| Fentanyl transdermal patch 50micrograms. |
Mr Silver is actively dying. Many terminally ill patients often develop
difficulty swallowing oral medications as they get closer to the end. At
this point, oral opioids should be converted to parenteral forms. Patients
who have been on oral benzodiazepines also need to be converted to parenteral
benzodiazepines if they are anxious. |
| Atropine drops orally; 2-4 drops as needed. |
Patients in the last 24-48 hours of life may develop noisy breathing
(death rattle)due to inability to clear bronchial secretions. This patient
has noisy breathing (death rattle) due to increased secretions and would
benefit by anti-muscarinic agents like atropine, scopolamine and glycopyrrolate.
|
| Placing the patient in the left recumbent position. |
Fortunately, the death rattle is not bothersome to patients. It is often
the family members who are distressed by the death rattle. Helpful interventions
for palliating the patient’s death rattle include using anti-muscarinic
agents as needed, placing the patient in the left recumbent positioning,
and providing reassurance and education of the family members. |
| Diazepam 5 mg tablets every 12 hours rectally. |
|
Incorrect interventions |
|
| Scheduled respiratory toileting |
Routine suctioning is not indicated and often distressing to terminally
ill or actively dying patients. |
