Death

Question 1

Actual Loss

Answer 1

can no longer be felt, heard, known, or experienced

Question 2

Perceived Loss

Answer 2

uniquely defined by the person; often overlooked by others

Question 3

Maturational Loss

Answer 3

changes expected in the developmental process

Question 4

Situational Loss

Answer 4

sudden, unpredictable external even; usually multiple losses

Question 5

Grief

Answer 5

the emotional response to loss

Question 6

Mourning

Answer 6

outward social expression of a loss

Question 7

Bereavement

Answer 7

the inner feelings and outward reactions of the survivor

Question 8

Hospice provides services for bereavement for

Answer 8

13 months

Question 9

Kubler-Ross’s stages of dying:

Answer 9

Denial, Anger, Bargaining, Depression, Acceptance

Question 10

Denial

Answer 10

this is not happening to me, thinking its the wrong person

Question 11

Anger

Answer 11

mad at everything

Question 12

Bargaining

Answer 12

Pleading

Question 13

Depression

Answer 13

once reality sets in, feeling overwhelmed

Question 14

Acceptance

Answer 14

teaching moment

Question 15

Anticipatory Grief

Answer 15

“letting go”; you know it’s coming

Question 16

Complicated Grief

Answer 16

“can’t move on”; something goes wrong

Question 17

Disenfranchised Grief

Answer 17

cannot openly acknowledge or share the loss

Question 18

Factors Influencing Loss & Grief:

Answer 18

Human development; Psychosocial perspectives; Socioeconomic status; Personal relationships; Nature of the loss; Culture and ethnicity; Spiritual beliefs

Question 19

Assessment

Answer 19

Type and stage of grief; Grief reactions (“Symptoms of Normal Grief”); Factors that affect grief (“Assessment of Factors Influencing Grieving”); End-of-life decisions – Advanced Directives; Nurse’s experiences – are you reacting appropriately?; Client expectations – Ask, “What is most important that we do for you while you are in our care?

Question 20

Nursing Diagnosis

Answer 20

Anticipatory grieving; Dysfunctional grieving; Hopelessness; Powerlessness; Spiritual distress

Question 21

Planning

Answer 21

Goals and outcomes; Setting priorities; Continuity of care

Question 22

When caring for a dying patient, it is important to devise a POC that helps the client *

Answer 22

die with dignity and offers family members the assurance their loved one is cared for with care and compassion.

Question 23

Implementation

Answer 23

Therapeutic communication; Promoting hope (strategies for promoting hope); Facilitating mourning

Question 24

Palliative Care

Answer 24

Philosophy is “total care”. Goal is to prevent, relieve, reduce, or sooth symptoms of disease without effecting a cure.

Question 25

Symptom Control

Answer 25

– Discomfort, fatigue, nausea, constipation, diarrhea, incontinence, poor nutrition, dehydration, altered breathing

Question 26

Maintaining Dignity and Self Esteem

Answer 26

– Positive sense of self – separated from illness

Question 27

Preventing Abandonment and Isolation

Answer 27

Fear of dying alone

Question 28

Providing a Comfortable and Peaceful Environment

Answer 28

Promotes relaxation, better sleep & decreased symptoms

Question 29

Supportive Care:

Answer 29

Support the grieving family - Teach them what to expect; Hospice care options (6 months)

Question 30

One to Three Months Prior to Death

Answer 30

• Withdrawal, decrease food intake, increase in sleep, going inside of self, less communication

Question 31

One to Two Weeks Prior to Death

Answer 31

• Disorientation – agitation, talking to unseen, confusion, picking at clothes; Physical - B/P lowers, pulse & temp fluctuates, perspiration, skin color changes – blue/purplish, breathing changes, sleeping but responding, C/O body tired & heaving, not eating, taking little fluids

Question 32

One to Two Days to Hours Prior to Death:

Answer 32

Surge of energy, restlessness or no activity, breathing slows and irregular, congestion, pulses hard to find, eyes glassy & semi-open, hand & feet are purplish, decreased urine output, incontinent bowel / bladder, non-responsive

Question 33

Minutes Prior to Death:

Answer 33

Fish out of water breathing; cannot be awakened

Question 34

Care after death (postmortem care)

Answer 34

maintain dignity & respect !

Question 35

Grieving nurse

Answer 35

you too will suffer loss and mourn death…it’s okay!

Question 36

Evaluation of Client Care

Answer 36

evaluate the grief process not the death experience

Question 37

Evaluation of Client Expectations

Answer 37

determine how well goals and outcomes were accomplished.