By Marie Fallon, Geoffrey Hanks
This fresh version of ABC of Palliative Care pulls jointly the main updated details in this advanced, multidisciplinary region in a pragmatic, hassle-free demeanour. totally up-to-date, it bargains with the vital social and mental facets for palliative care of individuals with incurable ailments together with caliber of lifestyles, communique and bereavement issues.
This authoritative, functional name may be precious to the expanding numbers of medical professionals, senior and professional nurses, and all these future health pros who care for melanoma sufferers in the clinic, at domestic or in a hospice.
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Qxd 28/6/06 11:29 AM Page 25 7 Nausea and vomiting Kathryn Mannix Nausea and vomiting are related but separate symptoms; nausea is a sensation of the desire to vomit, which causes misery and withdrawal; vomiting is the action of expelling gastrointestinal contents via the mouth and is usually an involuntary reflex. Retching is a rhythmic contraction of the diaphragm, abdominal wall, and intercostal muscles, which propels vomit towards the mouth. These are common symptoms in patients in palliative care, affecting up to 70% of people with advanced cancer and causing distress to considerable numbers of people with AIDS, heart failure, renal failure, and other life limiting conditions.
Patients should be encouraged to keep active to prevent secondary muscle wasting as a result of immobilisation What can be expected from treatment of cachexia? Cachexia is a multifactorial syndrome, the precise aetiology of which can vary from patient to patient. Thus it would be unreasonable to expect any single therapy to be effective in all patients. Improved nutritional status might increase physical function and thus quality of life and perhaps survival. Some patients might respond to combination therapy with weight stabilisation and resulting stable or improved physical function or quality of life.
Nasogastric intubation does not relieve nausea and may exacerbate nausea by irritating the pharynx. Use of a nasogastric tube to empty the stomach before surgery is entirely appropriate, however, and occasionally it may be appropriate to use intermittently. This depends entirely on the individual patient. In patients with high obstruction, a venting PEG may palliate frequent vomiting. It is important that patients and families understand that intermittent vomiting is likely to continue despite the control of nausea and colic.