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pro death & dying

process of death and dying

5 stages of dying denial and isolation, anger,bargaining, depression, acceptance
denial and isolation refuses to believe loss, not ready to deal w/ problems, artificial cheerfulness, doesnt hear the rest of the message
nursing intervention for DENIAL AND ISOLATION be there, verbally support, TCT, find supportive family member
anger something had just happened that is unfair and unjust, often displaced
nursing interventions for ANGER be there, allow anger, dont take it personal, deal with pt needs, help pt find outlet, allow as much control as possible
bargaining attempts to negotiate trade with GOD or fate. try to delay the inevitable common expressions
nursing intervention for BARGAINING support, allow behavior, dont rationalize with pt, listen, offer spiritual support
depression defense muchanisms are no longer effective. great sense of loss. tool to prepare for impending loss. cant deny illness, grieves, talk freely/withdrawl
common expressions for DEPRESSION sadness, crying, quiet, request no visitors, poor appetite, using little energy, dont see need to attend to ADL's
acceptance cant begin until the shock of loss is over. realization that health is permanently gone. at peace. may contemplate past and review accomplishments in life. comes to term with loss
common expressions for ACCEPTANCE make plans, give personal items to loved ones,at peace, ready to go
end of life issues: SPIRITUAL WELL--BEING hopelessness, suffering,transcendence
end of life issues: SOCIAL WELL-BEING roles and relationships change, inc. care giver stress, inc sexual needs, financial burden
end of life issues: PSYCHOLOGICAL WELL-BEING fears/anxiety, control, leisure activities, appearance
end of life issues: PHYSIOLOGIC terminal restlessness, anorexia, sleepy, dec in functional abilities
developmental concepts concerning death: OLDER ADULT fears prolonged illness, encounters death of friends, peers and family members
how do older adults view death freedom from pain, reunion with deceased family and friends, fears becoming a burden
purpose of autopsy examination of body after death to determine exact cause of death learn more about disease
nursing care of dying patient be supportive, pain control, stool softener, grooming, HOB up, relieve respiratory difficulties
respiratory arrest no spontaneous respirations
cardiac arrest no pulse, no BP, flat ECG
Biological death cells no longger capable of life, necrosis of organs
brain death flat EEG, cerebral cortex is irreversibly destroyed
signs of brain death exclude hypothermia as cause of coma, rule out residual drug or alcohol, confirm absence of brain stem function
how do you comfirm absence of brain stem function no corneal light reflex, no pupillary reflex, no oculocephalic reflex, no gag reflex
physiologic effect of dying process: GI & GU system decreased activity of GI tract, constipation, incontinence
Created by: kamia2010