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foundations exam 2
death and dying
| Question | Answer |
|---|---|
| types of loss | actual, perceived, maturational, situational, anticipatory |
| actual loss | can be recognized by others |
| perceived loss | is felt by person but intangible to others |
| maturational loss | experienced as a result of natural developmental process |
| situational loss | experienced as a result of an unpredictable event |
| anticipatory loss | loss has not yet taken place |
| Physical loss vs psychological loss | psychological loss: an intangible, emotional loss related to feelings, identity, or relationships physical loss: a tangible, measurable loss, something that can be seen or physically verified |
| grief | internal emotional reaction to loss |
| bereavement | state of grieving from loss of a loved one |
| mourning | actions and expressions of grief, including the symbols and ceremonies that make up outward expression of grief |
| dysfunctional grief | abnormal or distorted; may be either unresolved or inhibited |
| clinical signs of impending death pt 1 | Difficulty talking or swallowing Nausea, flatus, abdominal distention Urinary and/or bowel incontinence or constipation Loss of movement, sensation, and reflexes Decreasing body temperature, with cold or clammy skin Weak, slow, or irregular pulse |
| clinical signs of impending death pt 2 | Decreasing blood pressure Noisy, irregular, or Cheyne-Stokes respirations Restlessness and/or agitation Cooling, mottling, and cyanosis of the extremities and dependent areas |
| Providing Care to Facilitate a Good Death | Guided by the values and preferences of the individual patient Independence and dignity are central issues Providing control Palliative care Focus on the relief of symptoms |
| Kübler-Ross’s Five Stages of Grief | Denial and isolation Anger Bargaining Depression Acceptance |
| Terminal Illness | An illness in which death is expected within a limited period of time |
| things to keep in mind in regards to a pt with a terminal illness | Effect on the patient Effect on the family The Dying Person’s Bill of Rights Palliative Care Hospice Care |
| Advance Directives include | living wills and durable power of attorney |
| Advance Directives indicate | who will make decisions for the pt in case the pt is unable the kind of medical treatment the pt does or doesn't want how comfortable the pt wants to be how the pt wants to be treated by others what the pt wants loved ones to know |
| Special Orders | POLST Allow natural death, do-not-resuscitate, or no-code orders Comfort measures only (CMO) Terminal weaning VSED Active and passive euthanasia Palliative sedation |
| POLST | Physician order for life-sustaining treatment form |
| VSED | Voluntary stopping of eating and drinking |
| Factors Affecting Grief and Dying | Developmental considerations Family Socioeconomic factors Cultural, sex assigned at birth, and religious influences Cause of death |
| Needs of Dying Patients | physiological needs psychological needs needs for intimacy spiritual needs |
| physiological needs | physical needs, such as hygiene, pain control, nutritional needs |
| psychological needs | patient needs control over fear of the unknown, pain, separation, leaving loved ones, loss of dignity, loss of control, unfinished business, isolation |
| needs for intimacy | patient needs ways to be physically intimate that meets needs of both partners |
| spiritual needs | patient needs meaning and purpose, love and relatedness, forgiveness and hope |
| Developing a Trusting Nurse–Patient Relationship | Explain the patient’s condition and treatment Teach self-care and promoting self-esteem Teach family members to assist in care Meet the needs of the dying patient Meet family needs |
| Providing Postmortem Care to who? | Care of the body Care of the family Care of other patients Caring for oneself |
| Postmortem Care of the Body | Prepare the body for discharge Place the body in anatomic position, replace dressings, and remove tubes Place identification tags on the body Follow local law if patient died of communicable disease |
| when you should you not remove tubes, replace dressings, and place pt in anatomical position | if there is an autopsy scheduled |
| Postmortem Care of the Family | Be an attentive listener Arrange for family members to view the body In the case of sudden death, provide a private place for family to begin grieving |
| is it appropriate for the nurse to attend the funeral and make a follow-up visit to the family? | yes |
| takeaways from the slideshow | Be respectful to patient and family Always show the patient dignity Follow hospital policy for post-mortem care Discuss your feelings |
Created by:
leh195