Herbert’s heart failure continues to progress. He has been admitted to hospital with pulmonary oedema. While in the hospital, his cardiologist refers him to the local specialist palliative care team.
Herbert discusses some of his main symptoms with the palliative care physician who introduces possible interventions for managing these symptoms.
Thinking Points
- What symptoms does Herbert describe?
- What are some of the causes of these symptoms?
- What are his treatment goals?
- The palliative care physician recommends both pharmacological and non-pharmacological interventions for managing Herbert’s breathlessness. Identify the supporting evidence and the likely mechanism of action for the following interventions:
- Opioids
- Relaxation
- Fans
- Activity pacing
- Oxygen therapy.
- Herbert expresses some concern about taking morphine for his breathlessness.
- Was the physician’s response adequate? Provide reasons for your answer.
- What further suggestions do you have for addressing personal concerns about palliative treatments?
- What other pharmacological agents should be considered to treat Herbert’s breathlessness? Provide a rationale for your answer.