Ch. 11: Death and Dying

Question 1

When death is expected or a possible outcome

Answer 1

Anticipatory grief

Question 2

Extends for more than a year following the loss

Answer 2

Complicated grief

Question 3

Describe parental grief

Answer 3

• Intense, long lasting, complex
• Secondary losses r/t death of child (ex: absence of hope and dreams, disruption of the family unit, loss of identity as a parent)

Question 4

Infants/toddlers: What kind of concept of death?

Answer 4

Little to none

Question 5

Infants/toddlers: What prevents their [mainly referring to toddlers] understand death?

Answer 5

Egocentric thinking

Question 6

Infants/toddlers: How are their emotions?

Answer 6

Mirror parental emotions

Question 7

Infants/toddlers: How do they react?

Answer 7

In response to changes brough about by being in the hospital

EX: Change of routine, painful procedure, immobilization, less independence, separation from family

Question 8

Infants toddlers: May regress to an _______

Answer 8

Earlier stage of behavior

Question 9

Preschool children: Do they have egocentric thinking?

Answer 9

Yes

Question 10

Preschool children: Why may the child feel guilt and shame?

Answer 10

Magical thinking allows for the belief that thoughts can cause an event such as death

Question 11

Preschool children: How do they interpret separation from parents?

Answer 11

As punishment for bad behavior

Question 12

Preschool children: How do they view dying?

Answer 12

Temporary because of lack of a concept of time and because the dead person may still have attributes of the living (eating, sleeping, breathing)

Question 13

School-age children: Start to respond to ____ or ____ explainations

Answer 13

Logical or facutal

Question 14

School-age children: What kind of concept of death do they have? What age specifically [since school age ranges from 6-12..what age specifically out of here]?

Answer 14

Adult concept of death–inevitable, irreversible, universal

Applies to older school age children..9-12

Question 15

School-age children: What kind of fears do they experience?

Answer 15

Fears of the disease process, death process, the unknown, and loss of control

Question 16

School-age children often have fears of the disease process, death process, the unknown, and loss of control. How do they display this fear?

Answer 16

Uncooperative behavior

Question 17

School-age children may be curious about _____ and what happens to the ____ after death

Answer 17

Funeral services and what happens to the body after death

Question 18

Adolescents: What kind of concept of death?

Answer 18

Adult-like

Question 19

Adolescents: Why may they have difficulty accepting death?

Answer 19

Because they are discovering who they are, establishing an identity, and dealing with issues of puberty

Question 20

Adolescents: Who do they rely more on: peers or parents and what may this result in?

Answer 20

Rely more on PEERS–may result in the reality of a serious illness cause adolescents to feel ISOLATED

Question 21

Adolescents: May be unable to relate to ____ and ____ with parents

Answer 21

Unable to relate to PEERS and COMMUNICATE with parents

Question 22

Adolescents: Why may they become increasing stressed?

Answer 22

By changes in physical appearance due to medications or illness than the prospect of death

Question 23

Adolescents: What may they experience?

Answer 23

Guilt and shame

Question 24

What is the last sense to go?

Answer 24

Hearing

Question 25

Is it okay for the nurse to attend the funeral of the child who died?

Answer 25

Yes

Question 26

Is it okay for the nurse to maintain contact with the family of the child who died?

Answer 26

Yes

Question 27

How should the nurse refer to the deceased child?

Answer 27

Still refer to the child by their name

Question 28

A nurse is caring for a child. Which of the following are physical manifestations of impending death? (SATA)

A. Height sense of hearing
B. Tachycardia
C. Difficulty swallowing
D. Sensation of being cold
E. Cheyne-Stokes respirations

Answer 28

C, E

A: Decrease in senses of SMELL, SIGHT, and HEARING are physical manifestations of death
B: Patient would have BRADYcardia, not tachycardia
C. CORRECT
D. A clients sensation of HEAT when the body feels cool is sign of approaching death
E. CORRECT

Question 29

A nurse is teaching a parent about complicated grief. Which of the following statements by the nurse is appropriate?

A. It is considered complicated grief if you are still grieving 6 months after your loss
B. Personal activities are affected when experiencing complicated grief
C. Parents will experience complicated grief together
D. Complicated grief self-resolves in 12 months

Answer 29

B

Question 30

A nurse is teaching a parent of a preschool child about factors that affect the child’s perception of death. Which of the following should be included in the teaching?

A. Preschool children have no concept of death
B. Preschool children perceive death as temporary
C. Preschool children often regress to an earlier stage of behavior
D. Preschool children experience fear related to the disease process

Answer 30

B

A= what toddlers do
B. CORRECT bc they perceive it has temporary
C= what toddlers do
D= what school age children do

Question 31

A nurse often cares children who are dying. Which of the following is an appropriate action for a nurse to take to maintain their effectiveness? (SATA)

A. Remain in contact with family after their loss
B. Develop a professional support system
C. Take time off work
D. Suggest that a hospital representative attend funeral
E. Demonstrate feelings of sympathy toward the family

Answer 31

A, B, C

D= nurse should be encouraged to go to funeral as an act of support for family
E= a nurse should develop the ability for EMPATHY when dealing with dying clients

Question 32

A nurse is caring for a child who has terminal illness and review palliative care with an assistive personal (AP). Which of the following statements by the AP indicates understand of this review?

A. I’m sure the family is hopeful that the new medication will stop the illness
B. I’ll miss working with this client, now that only nurses will be caring for him
C. I will get all the clients personal objects out of his room
D. I will listen and respond as the family talks about their child’s life

Answer 32

D

Question 33

How should nursing personnel be staffed for caring for the client/family of the dying client?

Answer 33

Provide consistency among nursing staff caring for the client/family

Question 34

How should lighting in the room be for the dying client?

Answer 34

Soften lights