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S3 1538 > S3 M8/9 Grief/End of Life > Flashcards

S3 M8/9 Grief/End of Life Flashcards

1
Q

Grief

A

Multifaceted

Reaction to loss, real or perceived

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2
Q

3 types of loss

A

Actual
Perceived
Anticipatory

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3
Q

Kubler Ross
Stages of grief

test

A 
Denial
Anger
Bargaining
Depression
Acceptance
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4
Q

Acceptance should happen within _ months

A

6

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5
Q

Maladaptive grief

A

Distorted or exaggerated

Chronic or prolonged

Delayed

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6
Q

Anticipatory grief

A

anticipating a negative circumstance

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7
Q

Nursing interventions for grief

A

Understand process

Develop Therapeutic communication

Active listening

Be non-judgmental

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8
Q

Most important part of moving through grief stages

A

Be open and communicative

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9
Q

Are grief stages definite

A

NO

pt can spend different amounts of time and go back and forth between stages

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10
Q

3 Assessments of client

A

Perception
Support
Coping

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11
Q

Still birth

A

Loss up to 1 month old

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12
Q

With still birth provide memories

A 
lock of hair
photograph (ask parent first)
name band
encourage hold/tough
dress infant
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13
Q

With still birth pt may

A

have misplaced anger
need time
not want contact

be open minded

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14
Q

Amputation may lead to

A

grief

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15
Q

With amputations encourage contact with

A

residual limb

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16
Q

To facilitate amputations ID

A

PT strengths and resources

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17
Q

Goal of assistive devices

A

Independent function

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18
Q

Goal with amputation patients and overall grief

A

Acceptance

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19
Q

Myocardial infarctions and grief

A

Diet
Lifestyle
Life meds

pt stuck in unexpected changes
realization of mortality

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20
Q

Associated problems with MI grief

A 
Fears
Loss of employment
Strain on marriage
Hostility toward changes 
Fear of another MI
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21
Q

Terminal illness grief

A

Anticipatory and mourning

22
Q

Normal emotions of terminal grief

A 
Denial 
Sadness
Anger
Fear
Anxiety
23
Q

With terminal illness _ is not always reached

A

Acceptance

24
Q

Emotions in terminal illness _ daily

A

fluctuate

25
Q

Nursing with terminal illness

A

support family unit

encourage meaningful interactions

professional support (Chaplin, grief counselor)

26
Q

Defined recommendations to improve end of life care

A

coverage
communication
planning
education

27
Q

DNR/POLST

A

DNR only good in hospital

POLST out of hospital DNR

28
Q

Advanced directive

A

Umbrella term for legal documents

29
Q

Living will

A

written while in good health

outlines medical care to be given

30
Q

Proxy directive

A

person authorized to make medical decision on your behalf when you cant

31
Q

Durable power of attorney

A

IDs the proxy decision maker for financial/general decisions

sometimes medical but not always
recommended to have a separate medical

32
Q

Assisted suicide legislation

A

10 states in the US

33
Q

Palliative

A

comprehensive symptom management of illness

34
Q

Hospice

A

Prep for death

35
Q

4 levels of hospice

A

routine home care - routine visits

inpatient respite care - spend short times in hospice facility, gives fam a break

continuous care - hospice providers provide 24h care

general inpatient care - pt moved to impatient care till symptoms are managed

36
Q

Hospice care principles

A

acceptance of death
pt and fam viewed as a single unit
pain and symptoms managed for pt
bereavement managed for fam

37
Q

Nursing management at end of life

A

COMMUNICATION is center

Develop comfort in communication about death
Tailor understanding to values of pt/fam
Time arrangements
Create right setting
Seat all at eye level
38
Q

Effective listening

A

Allow for silence
Ask if pt needs time
Assess understanding

39
Q

Things to avoid with comms

A

Distractions
Impulse to give advice
Canner responses “I know how you feel”

40
Q

Focus of End of Life

A

Pain

assess pain level

Manage Break through pain
Rescue dosing

41
Q

Hospice analgesics are given

A

Around the clock

not PRN

42
Q

End of life physiological changes

A

Dyspnea

Anorexia/Cachexia

Excess secretions

43
Q

Emotional fall throughs in end of life

A

Agitation
Delirium
Anxiety

44
Q

Preactive phase of dying

A 
restless
confusion
withdrawal
lack of appetite
breathing changes
45
Q

Active phase of dying

A

sleep
anger, laughing, agitation
pill rolling
breathing problems

46
Q

Death breathing

A

Chayne stokes pattern

47
Q

Body deterioration

A 
dark urine
BP drop
cold/numb extremities
body rigid
jaw drop
48
Q

Death

A

Cessation of resp
Cessation of cardio

HEARD

49
Q

Grief vs mourning

A

Feeling

expression of it

50
Q

Bereavement

A

Time for grieving

S3 1538 (15 decks)

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