Change, Loss, and Grief
A client learns of the death of a family member. Which manifestation of grief should the nurse expect in this client?
Crying, shouting, anger, unbelief
Death is defined as what?
The absence of brain activity pulse and respirations
cessation of life
Focuses on symptoms that cause the person distress and adequately treating those symptoms
Comfort care
What is palliative care?
- Goals?
Care that is focus on the relief of physical manifestation such as pain. It addresses spiritual, emotional , and psychosocial aspects of the clients life.
Goal is to learn to live fully with an incurable condition
What is a psychological response to grief?
Anger
Denial
Depression
Bargaining
Name three rights of the dying patient
EX.
• Have pain controlled
•treated as a living human being until I die
•I have the right to not be deceived
What does a truly compassionate nurse do?
Studies and learns about pain management and applies those principles in daily practice
listens to patient and family
displays empathy and compassion
What are the characteristics of discomfort?
Pain, Anxiety, Restlessness, Dyspnea, N/V, Dehydration, Diarrhea, Constipation, and Inability to perform ADLs.
What is grief?
subjective response to actual or anticipated loss
Arrange Elisabeth Kübler-Ross's stages of coping with death in the correct sequence.
Denial
Anger
Bargaining
Depression
Acceptance
What is the first step to master the skill of therapeutic communication?
Begin by becoming comfortable with your own beliefs, values, and attitudes about death and dying
What is rigor mortis and what is it caused by?
Stiffness of body after death.
Defined by the person experiencing the loss and is less obvious to other people.
Perceived loss
Being exceptional dependent on the decease
Dysfunctional grieving
When discussing end of life care with a patient, what is most important to remember?
It is ultimately the patient's decision
What types of deaths are reported to the coroner?
Death within 24 hours after admission or during surgery
Death of a person who has not been under a physician’s care
What are specific instructions for healthcare
treatment that a person declares
Advance Directive
Living Will
Durable Power of Attorney
Important difference between palliative care and hospice.
The concept of palliative care is not exclusive to the end-of-life care; it is used in a variety of practice areas when the focus of care needs to switch from the curative focus to the focus on quality of life
Inventions to Prevent this
Abandonment and isolation
- Prevent the fear of dying alone
-Answer all call lights in a timely manner
-keep the client informed of procedure and assessment time
-Allow family to stay overnight
Manifestations of Approaching Death
Assessment finding of a person approaching death
Decrease LOC, Loss of muscle, Labored breathing (cheyne stokes:periodic breathing, gradual hyyperpnea,hypopnea, and apnea)
touch diminished, mucus collecting in large airways, Incontinence, Mottling, Decrease UO, Pupils not reactive to light, pulse slow and weak, BP dropping.