Challenging Symptoms

Abstract

Dry mouth, hiccups, fevers, pruritus, and sleep disorders are symptoms often found in palliative care patients. They can be challenging to treat and require the palliative advanced practice registered nurse (APRN) to have a working knowledge to effectively manage them. Pruritus can be challenging, and determining the cause when possible can help tailor treatment. Hiccups and dry mouth are common; although seemingly benign, they can affect quality of life. Fever may require scheduled antipyretic treatment at end of life if it is distressing. Sleep disorders can also cause distress, but there are a variety of potential treatment options that may require titration/rotation. Appropriate assessment tools for these common symptoms are reviewed in this chapter. Nonpharmacological, pharmacological, and interventional treatments are discussed, always while emphasizing the importance of all interventions being individualized to the patient’s needs and goals of care.