Chapter 23 Flashcards

(37 cards)

0
Q

behaviors used to incorporate loss into one’s life

A

mourning

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1
Q

individuals response to loss

A

grief

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2
Q

superimposed losses without adequate time for grieving can create crisis known as…

A

bereavement overload

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3
Q

nurse responsibility of dealing with loss

A

help pts family adjust in a healthy manner

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4
Q

active and evolving process as one copes with grief

A

bereavement

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5
Q

life transitions in later life

A
  • significant roles
  • financial security
  • independence
  • physical health
  • mental stability
  • life - death
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6
Q

proposed dual processes model weaving loss and restoration

A

loss-restoration model

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7
Q

includes concentrated thinking about life before loss or with person and circumstances and events surrounding death or loss

A

loss oriented coping

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8
Q

includes death new things, distracting oneself from grief, assuming new roles, transcendence

A

restoration-oriented coping

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9
Q

model of grief

-physical and psychological manifestations

A

beginning

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10
Q

grief model

-day to day functioning may be altered

A

middle

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11
Q

grief model

-individual re emerges refocused and adjusted to the loss

A

end

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12
Q

loss response model

A
  • impact
  • functional disruption
  • informing others
  • engaging emotions
  • reorganizing structures
  • reframing memories
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13
Q

ways to move toward integration of the loss

A
  • inform others
  • each time the story is told it becomes more real
  • movement toward a new steady state
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15
Q

typical grief progression

A
  • chaos
  • make sense out of chaos
  • movement toward integration of loss
  • engagement and expression of emotions
  • role replacement
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16
Q

type of grief:

  • response to real or percieved loss before it occurs
  • may see sudden change in attitude toward the thing or person to be lost
  • selling home or possessions, moving to nursing home
  • preoccupation with the loss, detailed planning
17
Q

type of grief:

  • somatic and psychological changes occur
  • often occurs in waves
  • preoccupation with loss
  • self blame or guilt may be present
  • functional disruption
  • simple things seem complex
18
Q

in what stage of grieving is grief work most effective

19
Q

type of grief:

  • lingering status
  • can be triggered
  • each deals in different ways
  • may be healthy or a sign of complicated grieving
A

chronic grief

20
Q
  • reestablishment of equilibrium is disrupted
  • guilt, anger, ambivalence
  • insomnia
  • depression
  • cognitive difficulties
  • social withdrawal
  • can be misinterpreted as dementia
A

complicated grief

21
Q
  • relationship is not recognized
  • grief is not sanctioned
  • suicides, hiv/aids, pets, gradual losses caused by chronic conditions
  • situations often distance an individual from the family, making open grief impossible
A

disenfranchised grief

22
Q

disenfranchised grief is often accompanied by…

A

complicated grief

23
Q

what to watch out for with disenfranchised grief

A

self destructive behaviors

24
Q

factors affecting coping with loss

A
  • physical
  • psychological
  • social
  • specific to dying and death
25
characteristics of good coppers
- avoid avoidance - confront realities and take appropriate actions - focus on solutions - redefine problems - consider alternatives - good communication with others - seek and use constructive help - accept support - keep up their morale
26
pt suspects they are dying, but it is never openly discussed
suspected awareness
27
pt does not know they are dying
closed awareness
28
there is "let's pretend' atmosphere (real feelings are kept hidden)
mutual pretense
29
acknowledges the reality of the approaching death
open awareness
30
interventions for loss
- gently established rapport - be ready to listen - offer support and direction - encourage the griever to talk and tell story of relationship it had been
31
kubler-ross stages of grief
- denial - anger - bargaining - depression - acceptance
32
6 c's for promoting a good death
- core - control - composure - communication - continutioy
33
in paliative care, research basis and plan of care is based on...
pain
34
barriers to completing advanced directive
- inaccesible documents - level of education - income - younger age - race
35
treatment administered when other palliative treatments are not sufficiently effective , a suffering pt unconscious in the proximity of death
terminal sedation
36
signs of impending death
1. coolness 2. increased sleeping 3. incontinence 4. disorientation 5. restlessnes 6. decreased urine output 7. altered breathing pattern 8. noisy respirations
37
when a nurse encourages the griever to share stories with others after a loss, the nurse is employing which intervention?
collaboration