Author/Editor		Salobir, Urša
Title		Paliativna oskrba in pristop k zdravljenju slabosti, bruhanja in zaprtja pri bolnikih z napredovalim rakom
Translated title		Palliative care and management of nausea, vomiting and constipation in patients with advanced cancer
Type		članek
Source		Zdrav Vars
Vol. and No.		Letnik 41, št. 3-6
Publication year		2002
Volume		str. 100-7
Language		slo
Abstract		Palliative care is an active total care of patients whose disease does not respond to curative treatment any more. Control of pain, other symptoms, and psychological, social and spiritual problems is paramount. The goal of palliative care is to achieve the best possible quality of life for patients and also for their carers. Nausea, vomiting and constipation are very common symptoms in patients with advanced cancer, but they often remain unrecognized by doctors. Antiemetics are antagonists of neurotransmitters involved in vomiting reflex. The choice of antiemetic should aim at the most likely cause of nausea and vomiting, i. e, at neurotransmitters which are most likely involved. Reversible causes should be sought for and treated. It is reasonable to combine antiemetics with different site of action. In the management of constipation, prevention is very important. When prescribing a potentially constipating drug, patients should be warned and laxatives should be prescribed. It is also important to exclude faecal impaction. The choice of laxative depends on stool consistency, cause of constipation and acceptability of the laxative for the patient. It is reasonable to combine a predominantly softening laxative with a stimulant laxative.
Summary		Paliativna oskrba je aktivna celostna oskrba bolnikov z napredovalo boleznijo, ki se ne odziva več na kurativno zdravljenje. V tem obdobju postane bistveno lajšanje bolečine in drugih spremIjajočih simptomov, a tudlajšanje psihičnih, socialnih in duhovnih težav bolnika. Vsa prizadevanja so usmerjena k izboljševanju kakovosti življenja ter večanju bolnikove samostojnosti. Skrb pa je usmerjena tudi na bolnikove bližnje. Slabost bruhanje in zaprtje so zelo pogosti simptomi pri bolniku znapredovaloboleznijo, kijih pogosto spregledamo. Antiemetiki so po svojem delovanju zaviralci nevrotransmiterjev. Priporočljivoje, da antiemetik predpišemoglede na najverjetnejši vzrok slabosti in bruhanja; to je glede na nevrotransmiterje, ki so najverjetneje udeleženi. Če je vzrok odpravljiv, zdravimo tudi specifično. Če je potrebno, lahko kombiniramo antiemetike; ki imajo različno prijemal išče. Pri obravnavi zaprtja je pomembno, da ravnamo preventivno in bolniku ob zdravilu, ki ga lahko povzroči obstipacijo, predpišemo tudi odvajalo in ga na zaprtje opozorimo. Važno je tudi, da izključimo fekalno impakcijo. Pri izbiri odvajala upoštevamo konsistenco blata, vzrok za zaprtje in sprejemljivost odvajala za bolnika. Pogosto je smiselno kombinirati pretežno stimulativno odvajalo s pretežno mehčalnim.
Descriptors		PALLIATIVE CARE ONCOLOGIC NURSING NAUSEA VOMITING CONSTIPATION