Akathisia and an unusual symptomatic treatment: a case report.

We present a case of medication-induced akathisia in a 47-year-old woman with metastatic carcinoma of the ovary. Severe pacing and restlessness started after commencing a subcutaneous infusion with cyclizine 150 mg, haloperidol 2.5 mg and oxycodone 20 mg. She was also taking levomepromazine and fluoxetine orally at the time. By making changes to her medication, her symptoms resolved gradually. During the time of convalescence, she gained great symptomatic relief from using exercise pedals and it allowed her to go about usual everyday activities, such as eating and reading, while continuously treading the pedals.

Problem and management of noisy rattling breathing in dying patients.

Noisy rattling breathing in dying patients is a symptom control problem which has attracted only a fleeting mention within the literature. This study investigated palliative care nurses' feelings about the problem and the management of noisy rattling breathing in dying patients. The aspects studied were based on the literature and multidis-ciplinary team discussion, and included nurses' feelings about the distress caused by noisy rattling breathing, their perceived confidence in providing related nursing care and their thoughts and feelings about the established care options. Data were gathered from a convenience sample of twenty three palliative care nurses by means of a questionnaire. This data was analysed using descriptive statistics. The results revealed that nurses perceived relatives to be particularly distressed by noisy rattling breathing, Several nurses felt that they lacked confidence in providing related nursing care and there was a felt need for clinical guidelines. The limitations of the study are discussed and the conclusion highlights the need for further research into this symptom control problem.