Compliance with Rx
· Problems identified as causing failure of adherence to clinical
o No named doctor being in charge of patients care.
o No named nurse being in charge of patients care.
o Being in pain most or all of the time.
o Not being told on discharge when to resume their normal activities.
· Factors in communication which improve patients’ adherence to
o Clinician understands the patient.
o Clinician’s tone of voice.
o Clinician elicits all the patient’s health concerns.
o Patient is comfortable asking questions.
o Patient perceives that sufficient time is spent with the clinician.
· Health outcomes depend on the extent to which patients adhere to
their clinical advice.
· Correctable factors are all matters of communication: letting
patients know why their Rx is being given & what benefits they stand
to gain, what pros & cons there may be, what options exist, & doing so
in a ways which builds trust & collaboration.
Adjustment to loss & bereavement
· Phases of bereavement – shock, distress, adjustment, moving on.
Legal & ethical issues relating to consent to Rx
· Doctors seeking consent for a particular procedure must be competent
in the knowledge of how the procedure is performed & its problems.
· For agreement to Rx to be legally accepted it must meet 3
o Consent must be informed to an adequate standard.
o Patients must be competent to consent to Rx.
o Patients must not be coerced into accepting Rx against their wishes.
· It i...
... middle of paper ...
the chest cavity. Most commonly used to examine lymph nodes in
patient with lung cancer for disease staging.
· Thoracoscopy – endoscopic procedure to inspect the pleural cavity.
Allows examination & biopsy of pleural lesions, drainage of pleural
effusions & talc pleurocesis.
Indications for mechanical ventilation of patients with respiratory
· Significant respiratory acidosis resulting from increased PaCO2.
· Arterial hypoxaemia that is refractory to supplemental oxygen via an
Domiciliary oxygen & nebuliser therapy in lung disease
· Domiciliary oxygen – home oxygen therapy.
· Nebulisers – instrument used to apply liquid in form of fine spray.
Additional therapies for cancer
· Immunotherapy – BCG inoculation & monoclonal Ab
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