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mental health Flashcards

1
Q

S/sx of final days

A

person starts to withdraw, decrease socialization, decreased LOC, increased sleeping, decreased ability to swallow
physical signs: loss of bladder & bowel, decrease of urine, change in temp, skin appearance and breathing pattern

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2
Q

how to support the family

A

provide privacy, encourage, accept and allow for expressions of grief and sadness
create peaceful environment (soft lightening, decrease clutter)

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3
Q

signs of impending death

A

irregular breathing, extremities cool to touch, mottling in color, non responsive to voice and touch

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4
Q

signs of death

A

absence of breathing & heart rate for 3 minutes, eyes fixed and slightly open, color change

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5
Q

family reactions to a fatal illness

A 
discovery and diagnosis
induction and remission
maintenance
recover
relapse
terminal stage
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6
Q

care of body after death

A

avoid using strings (leaves indentations)
use wide gauze to loosely wraparound fingers
don’t use chin strap
put something small under head for normal positioning
do not put body face down
if plastic bags are used keep loose at the head

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7
Q

going through stages of grief before death, preparations

A

anticipatory grieving

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8
Q

outward expression of our grief, what others see

A

mourning

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9
Q

out internal suffering, what others don’t see

A

grief

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10
Q

when dealing with death and dying what must you do

A

must first examine own mortality, be compassionate and caring and be a good listener

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11
Q

ability to cope is based on what

A

post experience, methods of coping, support systems and suddenness

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12
Q

Elizabeth Kubler-Ross stages of dying

A 
denial "no, not me"
rage/anger "why me"
bargaining "yes me, but"
depression "yes me"
acceptance "its all right"
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13
Q

what are the three cardinal rules for death and dying cultural beliefs and practices

A

ask the pt about cultural practices
respect values and traditions
accommodate requests whenever possible

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14
Q

Davidson normal grief response

A

shock and numbness ‘failure to accept reality”
searching and yearning “guilt”
disorientation “ loneliness, isolation”
reorganization “accepts or is resigned to the loss”

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15
Q

normal grief response

A

is predictable but can dkip, have overlapping and repeats

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16
Q

abnormal grief

A

if after 3 years…
deceased room and belongings intact, talk about loss as though it has just happened, inability to remember the deceased, preoccupied with thoughts of deceased, talks about deceased as though still alive

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17
Q

nursing dx

A

anticipatory grief

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18
Q

prolonged grief

A

no resumption of normal activities of daily living within 4-8 weeks of a loss

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19
Q

when should someone find help

A

don’t begin to feel better over time
abuse alcohol or meds to help feel better
think about suicide

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20
Q

the persistent effect the birth of a special needs child brings

A

chronic sorrow

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21
Q

the final stages for chronic grief

A

restitution (acceptance)

22
Q

stages of chronic sorrow

A 
defense mechanisms (denial and disbelief)
phase of developing awareness, characterized by overwhelming emotion
restitution/acceptance
23
Q

does chronic grief prevent parents from feeling jow, happiness, satisfaction, and accomplishment for the child they love

A

no it does not

24
Q

what are the 2 pathological reaction patterns of chronic grief

A 
extreme guilt (look for signs of excessive over protectiveness)
parents may be intolerant of the child and deny relationship
25
Q

the sudden unexpected death of any infant or child typically under two years of age in which an autopsy does not show an explainable cause of death

A

SIDS

*a syndrome, the 1st sx is death

26
Q

predisposing factors for SIDS

A

age 2-4 months, most at 6 months

increased in winter months, SGA, premature, males, after 1st born

27
Q

SIDS is a Dx of what

A

exclusion

always assume SIDS not abuse

28
Q

common finding of SIDS

A

petechiae on thalamus, lung & brain, pulmonary edema, abnormal thalamus
usually frothy pink mucous coming from mouth and nose

29
Q

sudden and unexplained death of infant in which cause of death is found later

A

SUID

30
Q

what is the triple risk theory for SIDS

A

vulnerable infant
critical developmental period (0-6 months)
exogenous stressor

31
Q

children and death

A

tell the truth immediately, must be told by parent or someone close, be direct and honest, parents should show emotion
childs sadness often short lived but is intermittent

32
Q

signs of regression

A

bedwetting, thumb sucking, are often seen byt temporary (NORMAL)

33
Q

infant understanding of death and their response

A

unable to conceive death, aware of lack of gratification of needs, react to pain and discomforts

34
Q

toddler understanding of death and their response

1-3 years

A

developing awareness of absence “all gone”

talk about person as though still alive, very ritualistic, frequently regress, may display physical aggression

35
Q

preschool understanding of death and their response

3-5 years

A

death is perceived as temporary (can die and come back like cartoons)
engage in strange activities (return to pets burial site and dig them up to confirm death)
think their thoughts can cause death
play therapy is very beneficial
may turn to parent of opp. sex for comfort

36
Q

school age understanding of death and their response

6-12 years

A

realize the truth about death, know irreversible and universal, personify death (boogyman, ghost) develop rituals to avoid death
preoccupied with details
greatest fear is fear of unknown
plan elaborate funerals for pets

37
Q

adolescent understanding of death and their response

13-19 years

A

mature concept and understanding of death
attitudes about death formed by parents, religion and peers
tempt fate to prove immorality
may reject funeral customs with exception of when a classmate or friends die
desire to protect parents (usually send parents away when know death is near)
greatest fear is loss of body image

38
Q

when an individual can look back on a relationship with the lost entity and accept both the pleasures and the disappointments

A

resolution

39
Q

bereavement overload

A

may not be able to complete one grieving process before another loss occurs

40
Q

is there an increased risk of suicide in the elderly

A

yes when related to unresolved grief and loneliness

41
Q

drug therapy for elderly

A

should only be used short term and with the smallest effective dose possible
should not exceed 3 weeks

42
Q

what is the key variable to aid in recovery for the elderly

A

social support

43
Q

concept of caring

provide emotional, physical, supportive and finical assistance to terminal patients and families

A

hospice

44
Q

nationally available program for dealing with the needs of the newly widowed

A

widowed persons service

45
Q

peer support group for families experiencing the death of a child through miscarriage, ectopic pregnancy, stillbirth, or neonatal death

A

bayside helping hands

46
Q

peer support group for parents who have experienced the loss of a child of any age

A

compassionate friends

47
Q

directory listing of multiple bereavement support groups located through the state

A

directory of bereavement resources (Delaware grief awareness)

48
Q

the risk of complicated grief increases with what

A

the death of a spouse, death of a child, death by suicide, or sudden unexpected death

49
Q

the risk of dysfunctional grief is highest when what

A

a person has had a previous unresolved grief or has inadequate support

50
Q

Nursing Dx for grief

A

delayed or inhibited grief: don’t deal with reality of loss
prolonged greif: no resumption of normal ADLs within 4-8 weeks
exaggerated grief response: Sx of grief are exaggerated (anger turned inward on self = depression)

school (27 decks)

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