Management of the effects of palliative treatment - for Palliative Nurses

Sponsored by: Kyowa Kirin

KKI/UKIRE/MOV/0008 July 2019

This module was written by StudyPRN and funded by Kyowa Kirin as a service to medicine. Kyowa Kirin had no input into course content.

This resource, composed of 13 clinical cases, assesses the user’s knowledge and understanding of the management of the effects of palliative treatment.

Successful completion of the resource provides 1 hour of CPD delivered by Learna Ltd.

Resource Content

“Palliative care is an approach that improves the quality of life of patients and their families facing the problems associated with life-threatening illness … and treatment of pain and other problems, physical, psychosocial and spiritual” (WHO, 2008).

Consequently when patients are undergoing treatment during the palliative phase of their illness they can be prone to complications. These may be related to:

  • The primary disease i.e. chest pain secondary to primary lung cancer
  • Secondary or metastatic disease related i.e. signs of liver failure secondary to liver metastases or neurological symptoms from brain metastasis.
  • Complications of the treatment of the cancer i.e. pain post radiotherapy, neutropenic sepsis secondary to chemotherapy.
  • Non-malignant disease i.e. gastro-oesophageal reflux as a result of a long standing hiatus hernia.

It is important to recognise common complications, know the symptoms, investigations and management particularly as some of the complications can be life threatening and may be reversible if diagnosed and treated early. Opioid toxicity and raised electrolytes i.e. calcium, sodium, potassium can all be life threatening if not recognised and treated in a timely fashion. Pain from radiotherapy can be very distressing. Bleeding from the primary tumour, liver metastases, and bone marrow infiltration is yet another possible complication of the effect of palliative treatment i.e. with radiotherapy or due to disease progression.

Aims and objectives:

Recognise and manage common complications of palliative treatment of malignant disease including:

  • Constipation – its diagnosis, investigation and management
  • Opioid induced constipation
  • Opioid related toxicity
  • Signs and symptoms of metastases including bone disease (causing pain and raised calcium)
  • Hypercalcaemia – its diagnosis, investigation and management
  • Hyperkalaemia - its diagnosis, investigation and management
  • Hypernatraemia – its diagnosis, investigation and management
  • Radiation induced pain flare