2.11 Psychological Wellbeing, Death and Dying Flashcards

Question

Palliative care

Answer 1

Palliative- Care that is given to improve quality of life when a patient is facing a life-threatening illness. The relief of physical, mental and spiritual distress for people with an incurable illness. Pain control is an essential part of palliative care.

Answer 2

Sensory Hearing is usually the sense to disappear Touch decrease in sensation with decrease perception of pain Taste and smell will decrease with the disease progression Blurring of vision, sinking and gazing of eyes Blink reflex absent Eyelids remain half open

Answer 3

Gastrointestinal System Slowing of GI tract and possible cessation of function Accumulation of gas Abdominal distention and Nausea Loss of Sphincter control Bowel movement may occur before imminent death or at time of death

Answer 4

Musculoskeletal System Gradual loss of the ability to move Sagging of jaw resulting from loss of muscle tone Difficulty speaking Difficulty maintaining body alignment Loss of gag reflex Jerking or twitching from large doses of opioids

Answer 5

Cardiovascular System Increased heart rate: later slowing and weakening of pulse Irregular rhythm Decrease in blood pressure Delayed absorption of drugs administered IM or SC

Answer 6

Respiratory System Cheyne- stokes Respiration Inability to cough or clear respiratory secretions Grunting, gurgling or “death rattle” Irregular breathing, gradually slowing down to terminal gasps Coolness and Mottling Absence of respiration

Answer 7

``` Integumentary System Mottling of hands, feet, arms and legs Cold clammy skin Cyanosis on nose, nail beds and knees Waxen color (pallor) as blood settles to dependent areas ```

Answer 8

Urinary System Gradual decrease in urinary output Incontinent of Urine Unable to urinate

Answer 9

``` One to three months Withdrawal from the world and people Decrease food intake Increase in sleep Going inside self less communication ```

Answer 10

``` One to two weeks Disorientation Agitation Talking with the unseen Confusion Picking at clothes ```

Answer 11

``` Days or hours Intensification of 1–2-week signs Surge of energy Decrease in blood pressure Eye glassy, tearing, half open Irregular breathing, stop/start Restlessness or no activity Purplish knees, feet hands blotchy Pulse weak and hard to find Decrease urine output May be incontinent ```

Answer 12

Minutes Fish out of water breathing Cannot be awakened

Answer 13

An actual or potential situation in which a valued object, person, body part or emotion is loss or changes and can no longer be seen. Temporary or permanent.

Answer 14

Kubler-Ross (Stages of Coping ) Caplan (Stress and Loss) Lindermann : (Categories and Symptoms)

Answer 15

Age- individuals response to loss is influence by age Social support ( e.g. partners of people who die with AIDS feel excluded by the deceased families Culture and spiritual practices Spiritual beliefs

Answer 16

Grieving sets in when there is a loss Takes up energy and can interfere with health and delayed healing However, it is needed for the psychological well being during the healing process of death

Answer 17

1. Shock and disbelief 2. Developing awareness of the loss ( painful, sad, guilt shame, helplessness, emptiness) 3. Restitution and Recovery (prolong and gradual)

Answer 18

Normal Responses to grief Dynamic Individual moves through a series of stages towards resolving emotions. Individualized Each loss is different, so is the individuals response Pervasive Encompass all aspects of person Normative Will follow a set of expected steps Adaptive grief Healthy response that is helpful in assisting the person to accept the reality of death

Answer 19

Chronic Grief When intensity does not diminish after the first year Conflicted Grief Unresolved issues, ambivalent feelings toward deceased Absent Grief Carrying on as though nothing has happened Maladaptive or dysfunctional grief Delayed or exaggerated, may relate to real or perceived loss 1. may occur when grief not resolved from prior experience 2. Grief may have been blocked in some way 3. Feelings and behaviors become exaggerated /disruptive to persons lifestyle

Answer 20

``` Person cannot resume normal activities or behavior (ADL, Work, Social Life) Severe & Continued Profound distress Increase in intensity Continues for a long time Psychotic, depression, suicide risk Needs professional help ```

Answer 21

``` Normal grief Natural response to a loss. Expected feelings and behaviors Emotions intense but gradual. Several months to several years ``` ``` Dysfunctional grief Difference is related to the length of time Intensity of the emotion Maladaptive dysfunction Prolonged and overwhelming. ```

Answer 22

Individual emotional response to the loss of a significant person May occur before actual death Unique to the individual When you are confronted with the death of a patient or loved one, we are forced to deal with our own mortality Anxiety may cause us to focus on your end of life

Answer 23

Perfect your listening skills Be alert for and respond to nonverbal cues with appropriate touch and eye contact Encourage and except expression of feelings Reassure the person is not wrong for feelings of anger, guilt, relief other feelings that may feel unacceptable Increase self awareness ( conscious of own attitudes regarding death) Continue to communicate with dying patients even in coma state Encourage family to do the same

Answer 24

Family need to know their loved one is receiving both emotional and physical care. Be kind and considerate of family Order Meals, sleeping arrangements, suggest calling a friend or pastor Allow them to participate in their love one care Therapeutic communication Listening more than talking. Allow them to express their feelings

Answer 25

``` Provide clean bed linen, Change incontinent patient Use draw sheet when turning the patient Reposition the patient q 2hrs. to make sure they are comfortable Protect bony prominences and elevate HOB if fluid accumulates in the throat Low lighting Gentle massage to improve circulation Ice chips and sips of water Oral care (soft brush or sponge) Clean eyes and nose of secretions Oxygen as prescribed for dyspnea ```

Answer 26

``` Nurse document time of death Notifies physician on call Call the family if not there already (give them time with the body) Be mindful of rituals and mourning practices Permission for autopsy or organ donation Care of possessions Transport to the morgue Then document ```

Answer 27

Nurses need to take time for self reflection and emotional well-being Nurses must analyze their own feelings and values related to loss and the expression of grief Being a professional is knowing when to get away from the situation to care for yourself

2.11 Psychological Wellbeing, Death and Dying Flashcards

(54 cards)