Pain Management & Loss, Grieving and Death

Question 1

a sensation where a person experiences discomfort, distress or suffering due to overstimulation of sensory nerves

Answer 1

Pain

Question 2

the 3 major components of the nervous system

Answer 2

Peripheral nerves (transmission stage)
Spinal cord (transduction stage)
Brain (interpretation stage)

Question 3

The brain responds to pain by sending messages that moderate the pain in the spinal cord the descending control system.
This system is active through out to inhibit pain by producing endorphins

Answer 3

Descending Control System

Question 4

Pain may be described in terms of what

Answer 4

location
duration
intensity
etiology

Question 5

For ex-ample, cardiac pain may be felt in the shoulder or left arm, with or without chest pain

Answer 5

referred pain

Question 6

often perceived in an area remote from the organ causing the pain

Answer 6

visceral pain

Question 7

When pain lasts only through the expected recovery period

Answer 7

acute pain

Question 8

also known as persistent pain, is prolonged, usually recurring or lasting 3 months or longer, and interferes with functioning

Answer 8

chronic pain

Question 9

may result from the direct effects of the disease and its treatment, or it may be unrelated

Answer 9

cancer pain

Question 10

mild pain are what numbers from 1-10

Answer 10

1-3

Question 11

moderate pain are what numbers from 1-10

Answer 11

4-6

Question 12

severe pain are what numbers from 1-10

Answer 12

7-10

Question 13

Designating types of pain by etiology can be done under the broad categories of

Answer 13

nociceptive pain and neuropathic pain

Question 14

experienced when an intact, properly functioning nervous system sends signals that tissues are damaged, requiring attention and proper care

Answer 14

Nociceptive pain

Question 15

originates in the skin, muscles, bone, or connective tissue. The sharp sensation of a paper cut or aching of a sprained ankle are common examples

Answer 15

somatic pain

Question 16

results from activation of pain receptors in the organs and/or hollow viscera tends to be characterized by cramping, throbbing, pressing, or aching qualities

Answer 16

Visceral pain

Question 17

associated with damaged or malfunctioning nerves due to illness typically chronic; it is described as burning, “electric-shock,” and/or tingling, dull, and aching

Answer 17

Neuropathic pain

Question 18

follows damage or sensitization of peripheral nerves

Answer 18

Peripheral neuropathic pain

Question 19

results from malfunctioning nerves in the central nervous system

Answer 19

Central neuropathic pain

Question 20

FACTORS AFFECTING PAIN

Answer 20

Ethnic and Cultural Values
Developmental Stage
Environment and Support People
Previous Pain Experience

Question 21

an actual or potential situation in which something that is valued is changed or no longer available

Answer 21

loss

Question 22

can be recognized by others

Answer 22

actual loss

Question 23

experienced by one person but cannot be verified by others

Answer 23

perceived loss

Question 24

often perceived losses because they are not directly verifiable. For example, a woman who leaves her employment to care for her children at home may perceive a loss of independence and freedom

Answer 24

Psychological losses

Question 25

experienced before the loss actually occurs. For example, a woman whose husband is dying may experience actual loss in anticipation of his death

Answer 25

anticipatory loss

Question 26

the total response to the emotional experience related to loss, manifested in thoughts, feelings, and behaviors associated with overwhelming distress or sorrow

Answer 26

grief

Question 27

the subjective response experienced by the surviving loved ones

Answer 27

Bereavement

Question 28

the behavioral process through which grief is eventually resolved or altered; it is often influenced by culture, spiritual beliefs, and custom

Answer 28

Mourning

Question 29

experienced in advance of the event such as the wife who grieves before her ailing husband dies

Answer 29

Anticipatory grief

Question 30

occurs when a person is unable to acknowledge the loss to other people

Answer 30

Disenfranchised grief

Question 31

exists when the strategies to cope with the loss are maladaptive and out of proportion or inconsistent with cultural, religious, or age-appropriate norms

Answer 31

pathologic or complicated grief

Question 32

commonly known as the five stages of grief

Answer 32

The Kübler-Ross model

Question 33

list the 5 stages of grief

Answer 33

Denial Anger Bargaining Depression Acceptance

Question 34

usually only a temporary defense for the individual. This feeling is generally replaced with heightened awareness of situations and individuals that will be left behind after death

Answer 34

denial

Question 35

person is very difficult to care for due to misplaced feelings of rage and envy. Any individual that symbolizes life or energy is subject to projected resentment and jealousy

Answer 35

anger

Question 36

hope that the individual can somehow postpone or delay death. Usually, the negotiation for an extended life is made with a higher power in exchange for a reformed lifestyle

Answer 36

bargaining

Question 37

individual may become silent, refuse visitors and spend much of the time crying and grieving. This process allows the dying person to disconnect oneself from things of love and affection

Answer 37

depression

Question 38

individual begins to come to terms with their mortality or that of their loved one

Answer 38

acceptance

Question 39

Factors Influencing the Loss and Grief Responses

Answer 39

Age Childhood Early and Middle Adulthood Late Adulthood

Question 40

disorder that occurs after the death of a significant other, in which the experience of distress accompanying bereavement fails to follow normative expectations and manifests in functional impairment

Answer 40

Complicated Grieving/Risk for Complicated Grieving

Question 41

if the loss has such impact on the individual and family that usual effective roles and interactions are negatively affected

Answer 41

Interrupted Family Processes

Question 42

if the client has great difficulty placing the loss in appropriate perspective to his or her other life activities

Answer 42

Risk-Prone Health Behavior

Question 43

related to the loss of relationships with others

Answer 43

Risk for Loneliness

Question 44

does not understand the concept of death, what ages

Answer 44

infancy-5 years

Question 45

understands that death is final believes own death can be avoided, what ages

Answer 45

5-9 years

Question 46

understands death as the inevitable end of life begins to understand own morality, what ages

Answer 46

9-12 years

Question 47

fears a lingering death, may seem to reach "adult" perception of death but be emotionally unable to accept it, what ages

Answer 47

12-18 years

Question 48

has attitude toward death influenced by religious and cultural beliefs, what ages

Answer 48

18-45

Question 49

accepts own morality encounters death of parents and peers experiences peaks of death anxiety, what ages

Answer 49

45-65 years

Question 50

fears prolonged illness sees death as having multiple meanings, what ages

Answer 50

65+ years

Question 51

Nurses need to ensure that the client is treated with _______

Answer 51

dignity

Question 52

3 types of awareness

Answer 52

closed awareness mutual pretense open awareness

Question 53

the client is not made aware of impending death. The family may choose this because they do not completely understand why the client is ill or they believe the client will recover. The primary care provider may believe it is best not to communicate a diagnosis or prognosis to the client. Nursing personnel may experience an ethical problem in this situation

Answer 53

Closed Awareness

Question 54

the client, family, and health care personnel know that the prognosis is terminal but do not talk about it and make an effort not to raise the subject. Sometimes the client refrains from discussing death to protect the family from distress

Answer 54

Mutual Pretense

Question 55

the client and others know about the impending death and feel comfortable discussing it, even though it is difficult. This awareness provides the client an opportunity to finalize affairs and even participate in planning funeral arrangements

Answer 55

Open Awareness

Question 56

signs of impending clinical death

Answer 56

loss of muscle tone slowing of the circulation changes in respirations sensory impairment

Question 57

List the Dying Person's Bill of Rights

Answer 57

-right to be treated as a living human being until death -right to maintain a sense of hopefulness -right to participate express feeling and emotions about the approaching death -right to participate in decisions concerning care -right to expect continuing medical and nursing attention -right not to die alone -right to be free from pain -right to have questions answered honestly -right not to be decieved -right to have help from and for family in accepting death -right to die in peace and with dignity -right to retain individuality and judged for their decisions -right to be cared for by people who will attempt to understand my needs and will be able to gain some satisfaction in helping them face their death