Ka maikaʻi ʻole o ka naʻau - mālama palliative

He mea nui e kamaʻilio me kāu poʻe lawelawe olakino a me kou ʻohana e pili ana i ke ʻano o ka mālama ola hope āu e makemake ai ke mālama ʻia ʻoe no ka maikaʻi ʻole o ka puʻuwai.

ʻOi pinepine ka maikaʻi ʻole o ka puʻuwai puʻuwai ma hope o ka manawa. ʻO ka poʻe he nui ka puʻuwai puʻuwai e make i ke ʻano. Hiki ke paʻakikī ke noʻonoʻo a kamaʻilio e pili ana i ke ʻano o ka mālama āu e makemake ai i ka hopena o kou ola. Eia nō naʻe, ke kūkākūkā ʻana i kēia mau kumuhana me kāu kauka a me nā mea aloha e hiki ke kōkua iā ʻoe i ka maluhia o ka noʻonoʻo.

Ua kūkākūkā paha ʻoe i ka lawe ʻana o ka naʻau a me ka hoʻohana ʻana o kahi mea kōkua ventricular me kāu kauka.

I kekahi manawa, e kū mua ʻoe i ka hoʻoholo inā e hoʻomau i ka hana maʻamau a i ʻole ka hana hoʻomāinoino i ka holo pono ʻole o ka puʻuwai. A laila, makemake paha ʻoe e kūkākūkā i ke koho o ka palliative a i ʻole hōʻoluʻolu me kāu poʻe lawelawe a me nā mea aloha.

Makemake nā poʻe he nui e noho i ko lākou mau home i ka hopena o ke ola. Hiki pinepine kēia me ke kākoʻo o nā mea aloha, nā mea mālama, a me kahi papahana hoʻokipa. Pono paha ʻoe e hana i nā loli i kou home i mea e maʻalahi ai ke ola a palekana iā ʻoe. ʻO nā keʻena ʻo Hospice i nā haukapila a me nā wahi hānai ʻē aʻe kahi koho.

ʻO nā ʻōkuhi mālama mua nā palapala e hōʻike ana i ke ʻano o ka mālama āu e makemake ai inā ʻaʻole hiki iā ʻoe ke ʻōlelo no ʻoe iho.

ʻO ka luhi a me ka hanu ʻole nā ​​pilikia maʻamau i ka hopena o ke ola. Hiki ke kaumaha i kēia mau ʻōuli.

Paha paha ʻoe i ka hanu a pilikia i ka hanu ʻana. Hiki i nā ʻōuli ʻē aʻe ke hoʻopili i ka umauma, me he mea lā ʻaʻole lawa kāu ea, a i ʻole me he mea lā e haki ʻia ʻoe.

Hiki i ka ʻohana a mea mālama paha ke kōkua iā:

• Paipai i ke kanaka e noho kū i luna
• Ke hoʻonui nei i ka ea i loko o kahi lumi e ka hoʻohana ʻana i ka peahi a i ʻole wehe i ka puka aniani
• Kōkua i ke kanaka e hoʻomaha a ʻaʻole panic

Ma ka hoʻohana ʻana i ka oxygen e kōkua iā ʻoe e hakakā i ka hanu a mālama i kahi kanaka me ka hōʻeha puʻuwai hopena maikaʻi. ʻO nā hana palekana (e like me ka puhi ʻole ʻana) he mea nui ia i ka hoʻohana ʻana i ka oxygen ma ka home.

Hiki iā Morphine ke kōkua i ka hanu. Loaʻa iā ia ma ke ʻano he pila, wai, a i ʻole papa i hoʻokahe ʻia ma lalo o ke alelo. E haʻi aku kāu mea hāʻawi iā ʻoe pehea e lawe ai i ka morphine.

ʻO nā ʻōuli o ka luhi, ka pōkole o ka hanu, ka pau ʻole o ka makemake, a me ka nausea hiki ke paʻakikī i ka poʻe me ka puʻuwai puʻuwai e lawe i ka lawa o nā calories a me nā meaʻai. ʻO ka hoʻolilo ʻana i nā mākala a me ka pohō kaumaha kekahi ʻāpana o ke kaʻina maʻi maoli.

Hiki ke kōkua i ka ʻai ʻana i nā meaʻai liʻiliʻi. ʻO ke koho ʻana i nā meaʻai ʻoluʻolu a maʻalahi hoʻi i ka ʻai hiki ke maʻalahi i ka ʻai ʻana.

ʻAʻole pono nā mea mālama e hoʻowalewale i kahi kanaka me ka puʻuwai ʻole e ʻai. ʻAʻole kōkua kēia i ke kanaka e ola lōʻihi a ʻoluʻolu ʻole paha.

E kamaʻilio i kāu mea hāʻawi e pili ana i nā mea hiki iā ʻoe ke hana e kōkua i ka mālama ʻana i ka nausea a i ʻole ka luaʻi a me ka paʻa paʻa.

ʻO ka hopohopo, ka makaʻu, a me ke kaumaha ka mea maʻamau i waena o ka poʻe me ka hōʻeha puʻuwai hope loa.

• Pono kaʻohana a me nā mea mālama e nānā i nā hōʻailona o kēia mau pilikia. Ke noi nei i ke kanaka e pili ana i kona mau manaʻo a me kāna mau makaʻu hiki ke maʻalahi i ke kūkākūkā ʻana iā lākou.
• Hiki iā Morphine ke kōkua me ka makaʻu a hopohopo. Kūpono paha kekahi mau antidepressants.

ʻO ka ʻeha kahi pilikia maʻamau i ka hopena o nā maʻi he nui, e like me ka puʻuwai puʻuwai. Morphine a me nā lāʻau ʻeha ʻē aʻe hiki ke kōkua. ʻO nā lāʻau lapaʻau ʻeha ma mua o ka pā, e like me ka ibuprofen, ʻaʻole palekana pinepine no ka poʻe me ka puʻuwai puʻuwai.

Loaʻa paha i kekahi poʻe i nā pilikia me ka kaohi o ka maʻi ʻaʻai a i ʻole ka ʻōpū. E kamaʻilio me kāu mea hāʻawi ma mua o ka hoʻohana ʻana i nā lāʻau, laxatives, a i ʻole nā ​​suppositories no kēia mau ʻōuli.

CHF - palliative; Hoka puʻuwai Congestive - palliative; Cardiomyopathy - palliative; HF - palliative; Cardiac cachexia; Hoka hopena-ola-puʻuwai

Allen LA, Matlock DD. Ka hoʻoholo ʻana a me ka mālama palliative i ka maikaʻi ʻole o ka puʻuwai. I: Felker GM, Mann DL, hoʻoponopono. Hewa Ka Puʻuwai: He Hoa i ka Maʻi Puʻuwai ʻo Braunwald. ʻEhā ed. Piladelapia, PA: Elsevier, 2020: chap 50.

Allen LA, Stevenson LW. Ka mālama ʻana i nā mea maʻi me ka maʻi maʻi ʻōpū i kokoke i ka hopena o ke ola .. In: Zipe DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, eds. ʻO ka maʻi puʻuwai ʻo Braunwald: He puke aʻo no ka lāʻau Cardiovascular. 11th hua. Piladelapia, PA: Elsevier Saunders; 2019: chap 31.

ʻO Yancy CW, Jessup M, Bozkurt B, et al. 2013 ACCF / AHA alakaʻi no ka mālama ʻana i ka puʻuwai puʻuwai: kahi hōʻike o ka American College of Cardiology Foundation / American Heart Association Task Force e pili ana i nā kulekele hana. Kaapuni. 2013; 128 (16): e240-e327. PMID: 23741058 www.ncbi.nlm.nih.gov/pubmed/23741058.

• Hoka Puʻuwai