Death And Dying Flashcards

(67 cards)

1
Q

What is loss?

A

The undesired change or removal of a valued object, person, or situation.

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2
Q

What is actual loss?

A

Includes death of a loved one or relationship, theft, deterioration, destruction, and disaster.

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3
Q

Define perceived loss.

A

An internal loss, such as losing innocence or purity after telling a lie.

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4
Q

What does physical loss refer to?

A

Injuries such as limb amputation or loss of function.

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5
Q

What are psychological losses?

A

Losses affecting hope, faith, or dreams, commonly seen in areas of sexuality, fairness, and trust.

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6
Q

What is external loss?

A

Actual losses of objects of monetary value.

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7
Q

Define environmental loss.

A

A change in the familiar, even if perceived as positive, like moving to a new home.

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8
Q

What constitutes loss of significant relationships?

A

Actual loss of spouses, siblings, family members, or significant others through death, divorce, or separation.

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9
Q

What is grief?

A

The physical, psychological, and spiritual responses to a significant loss.

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10
Q

What is mourning?

A

Actions associated with grief, such as wearing black or being silent.

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11
Q

Define bereavement.

A

The period of mourning and adjustment after a loss.

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12
Q

What factors affect grief?

A
  • Significance of loss
  • Support system
  • Unresolved conflicts
  • Circumstances of loss
  • Previous loss
  • Spiritual/cultural beliefs and practices
  • Timeliness of death
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13
Q

How do children perceive death?

A

They often believe death is temporary and later understand it happens but think it doesn’t apply to them.

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14
Q

What challenges do adolescents face in grief?

A

They struggle with emotional maturity and may feel responsible for siblings after a parent’s death.

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15
Q

What is uncomplicated grief?

A

The natural response to the loss of a person or object with expected feelings and behaviors.

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16
Q

Define complicated grief.

A

Prolonged acute grief characterized by intense emotions and length of time, potentially leading to depression or isolation.

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17
Q

What is chronic grief?

A

Begins as normal grief but continues for the long term.

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18
Q

What is masked grief?

A

Grief expressed through other behaviors, such as increased drinking instead of sadness.

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19
Q

Define delayed grief.

A

Grief that is put off until a later time.

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20
Q

What is anticipatory grief?

A

Grief experienced before a loss occurs, such as a spouse grieving during a long illness.

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21
Q

Who proposed the three stages of grief?

A

George Engel.

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22
Q

What are the three stages of grief according to Engel?

A
  • Shock and disbelief
  • Developing awareness of the loss
  • Restitution and recovery
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23
Q

What does John Bowlby’s attachment theory describe?

A

The reaction to strong emotional bonds and the need to work through processes to avoid complicated grief.

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24
Q

List the four stages of grief according to Bowlby.

A
  • Shock and numbness
  • Yearning and searching
  • Disorganization and despair
  • Reorganization
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25
What are Theresa Rando's six tasks associated with grieving?
* Recognizing the loss * Reacting to the separation * Recollecting memories * Relinquishing the old attachment * Readjusting to the new environment * Reinvesting in self
26
What are William Worden's four tasks of grieving?
* Accepting the reality of the loss * Working through the pain and grief * Adjusting to the environment without the deceased * Emotionally relocating the deceased and moving on
27
What is the cyclical nature of mourning according to Stroebe and Schut?
People oscillate between loss-oriented responses and restoration-oriented responses.
28
What is the Continuing Bond Model?
The idea that bereavement is never fully resolved.
29
What is brain death?
Occurs when blood flow to the brain stops, neurons are not firing, and the client has no brainstem reflexes.
30
Identify signs of brain death.
* Fixed pupils * Absent corneal reflex * Absent gag reflex * Absence of oculocephalic and oculovestibular reflexes
31
What is a persistent vegetative state?
Loss of higher cerebral functions where the person does not purposefully respond to stimuli.
32
What are the physiological stages of dying 1-3 months before death?
Withdrawal from the world, increased sleep, and decreased appetite and food intake.
33
What occurs 1-2 weeks before death?
Loss of ability to maintain blood pressure, changes in temperature, and increased congestion.
34
What is Cheyne-Stokes respiration?
A cyclic pattern of breathing consisting of periods of apnea followed by gradual increases in respiration.
35
What are the psychological stages of dying according to Elisabeth Kubler-Ross?
* Denial * Anger * Bargaining * Depression * Acceptance
36
What is palliative care?
Aggressively planned comfort care addressing end-of-life concerns and enhancing quality of life.
37
Define hospice care.
Care focused on quality of life for the terminally ill, allowing death with dignity at home.
38
What are advance directives?
Instructions stating a person’s wishes regarding healthcare if they become incapacitated.
39
What is a living will?
A document providing specific healthcare instructions for particular situations.
40
What is a power of attorney for healthcare?
Identifies a person to make healthcare decisions when the individual is unable to do so.
41
What is a do not resuscitate (DNR) prescription?
An order to not attempt resuscitation in the event of cardiac or respiratory failure.
42
What is assisted suicide?
Making available what is needed for a patient to end their own life.
43
Define active euthanasia.
Direct action of giving an overdose to end a life.
44
What is passive euthanasia?
Occurs due to lack of action, such as withholding food or fluids.
45
What is an autopsy?
A medical examination of the body to determine the cause of death.
46
When is a coroner's investigation required?
For sudden, violent, or suspicious deaths outside of a hospital.
47
What is an autopsy?
A medical examination of the body to determine the cause of death. ## Footnote An autopsy requires signature from the next of kin, except in suspicious or unwitnessed deaths.
48
What does Kentucky law require regarding sudden or suspicious deaths?
The Coroner’s Office must investigate any sudden, violent, or suspicious death. ## Footnote Notification is required for deaths outside a hospital or hospice setting or within 36 hours of hospital admission.
49
When should the coroner be notified regarding a patient in restraints?
If a client dies in restraints or within 24 hours of being restrained. ## Footnote The nurse shouldn't remove any lines or tubes from the body if going for autopsy.
50
What is the Uniform Anatomical Gift Act?
It provides guidance on tissue, eye, and organ donation. ## Footnote The act was amended in 2009 to prevent others from overriding an individual’s prior decision on organ donation.
51
What should a nurse do if a family expresses interest in organ donation?
Obtain a referral to an organ procurement organization. ## Footnote In Kentucky, this would be the Kentucky Organ Donation Association (KODA).
52
What are the key components to assess when a patient is dying or has experienced a loss?
* Common grief reactions * Knowledge base of the patient and significant others * History of loss * Coping abilities and support systems * Meaning of the loss or illness * Differentiate between grief and depressive disorder * Physical assessment * Cultural and physical assessment
53
What are some nursing diagnoses related to loss and grieving?
* Grieving * Complicated Grieving * Chronic Sorrow * Spiritual Distress * Self-Care Deficit * Denial * Hopelessness * Powerlessness
54
What are some outcomes/goals for patients and families dealing with grief?
* Involve family and client in goals * Less anxiety * Better pain control * Open communication with healthcare providers * Spiritual peace
55
What interventions can a nurse provide for a grieving client?
* Encourage expression of feelings * Provide therapeutic communications * Provide pain control * Offer music and massage/touch therapies
56
True or False: A DNR means allowing the patient to die in pain or distress.
False. ## Footnote A DNR does not mean that care for comfort, such as oxygen, should not be provided.
57
What is the 'Gift of Presence' in nursing care?
The act of being with those in pain and offering emotional support during their time of grief. ## Footnote It emphasizes the importance of presence over trying to eliminate the pain.
58
What is included in postmortem care?
* Care of the patient’s body after death * Arranging transportation to the morgue or funeral home * Determining the disposition of the patient’s belongings
59
What occurs during livor mortis?
Dependent parts of the body appear bluish and mottled. ## Footnote It is a postmortem change that occurs due to blood settling.
60
What is rigor mortis?
The stiffening of the body after death due to muscle contraction from lack of ATP. ## Footnote It occurs about 2-4 hours after death and disappears about 96 hours after death.
61
Fill in the blank: After death, the nurse should place _______ identification tags on the patient.
2
62
What should a nurse do to care for themselves when dealing with dying patients?
* Understand their own attitudes, fears, and beliefs concerning death * Talk with colleagues about feelings * Form a support group * Engage in self-care activities
63
What is a key aspect of grief assessment during a client's hospitalization?
* Family support * Spiritual or religious needs * Cultural beliefs * Loss history * Coping abilities
64
What might be included in a nursing diagnosis related to a patient in a coma with organ donation considerations?
* Anxiety * Decisional Conflict * Spiritual Distress
65
What are some potential outcomes for a family facing organ donation discussions?
* Acceptance of the decision * Understanding of the process * Emotional readiness for donation
66
What are some interventions a nurse could perform in the context of organ donation discussions?
* Provide clear information about organ donation * Facilitate family discussions * Offer emotional support
67
How could a nurse evaluate the effectiveness of interventions provided to a grieving family?
By assessing the family's emotional state and coping mechanisms over time.