Answer: C
Palliative care attempts to improve the quality of life of patients with life-threatening, incurable, or debilitating chronic illnesses through the prevention and relief of suffering and treatment of pain. Palliative care usually consists of an interdisciplinary team of experts that offers various support systems for patients and their physicians near the end of life. Palliative care provides care to not only hospice-eligible patients but also patients with incurable, debilitating chronic illnesses such as COPD and congestive heart failure that require symptom control but with a less clear course to death. Even though the prognosis at any point in time is uncertain, these diseases are not curable, and goals of care may be better served by enhancing the quality of remaining life for affected patients, keeping them as active as possible, and controlling symptoms.
Patients undergoing palliative care may experience dyspnea from conditions such as severe heart failure. Diuretics (A) may relieve this shortness of breath and therefore should be administered. Palliative care can be administered to any patient with an incurable or debilitating chronic illnesses. Being in hospice care (B) is not a requirement. Rapid opioid dose escalation (D) is the most important principle in patients with cancer on opioids. Doubling of the dose may be required until successful analgesia is reached.
Reference
Abbott JT, Stone S: End of Life Care, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 7. St. Louis, Mosby, Inc., 2010, (Ch) 201:p 2569-2580
