Types of Grief
Anticipatory Grief
Grieving an object or person before the actual loss
EX: Grieving for a family member with end-stage cancer and coming to terms with the upcoming death.
A nurse is dealing with a patient who is managing a new ostomy. The nurse asks the patient "How do you feel about having to care for your new ostomy?" Which of the teaching methods is the nurse utilizing?
Discussion Method
True or False:
Consistently asking patients "Yes" or "No" questions while trying to perform an assessment is an effective skill of therapeutic communication.
If false explain why and give an example of what would be correct.
False
Asking open-ended questions facilitates spontaneous responses and interactive discussion. Not "Yes" or "No" questions.
EX: "Can you tell me more about the pain?" instead of "Are you in pain?"
What is considered PHI?
- Patient's Identity
- Medical Hx
- Financial Information
- Communication: Phone number & Email
- Any information that can be used to identify the patient
What should a nurse do if a patient refuses their medication?
RN should explain the consequences, inform the provider, and document the refusal.
Uncomplicated Grief
This is the typical or normal response to grief. Emotions can be negative (anger,resentment, guilt, withdrawal, hopelessness) eventually leading to acceptance
EX: Losing a grandparent
Explain when you should use the Question and Answer teaching method and provide an example, and question a nurse can ask.
EX: A nurse in a nutrition session with a patient.
Question: "What foods do you think would help lower your cortisol levels?"
When to use: When trying to gauge a patient's baseline knowledge, assess their learning, and engage them in active thinking.
What are some examples of self-concept stressors: Role Performance?
Name at least 3
- Inability to balance career and family
- Physical, emotional, cognitive defects preventing role assumption
- Loss of job role
- Transition from school
- Promotion/Demotion
- Empty Nest
- Assuming responsibility for Aging Parent
True or False:
Patients have a right to read their medical records.
If false explain why and give an example of what would be correct.
True
How can a nurse reduce the risk of puncture wounds or needlesticks?
Provide at least 3 examples
- Never recap needles
- Always dispose of sharps in the sharps bin
- Maintain a sharps injury log
- Attend educational offerings regarding bloodborne pathogens
- Report all needlesticks and sharp related injury
- Plan safe handling and disposal of needles
Prolonged Grief
Grief that persists for a longer period of time and typically interferes with a person's ability to function in everyday life
EX: A person who lost their spouse and struggles with intense sadness, and had an inability to engage in life for more than a year.
This type of stress may lead to burnout and depression.
Chronic Stress
What are some examples of self-concept stressors: Identity?
Name at least 4
- Job loss
- Change in marital status
- Abuse/Neglect
- Dependency on others
- Sexuality concerns
- Repeated failures
-Societal attitudes
- Conflict with others
When charting all documentation should be:
- Factual
- Accurate and Concise
- Complete and Current
- Organized
What steps should the nurse take if a medication error occurs?
- Report the error
- Document the error
- Monitor the patient
- Reflect and Review
Disenfranchised Grief
Grief that is not openly acknowledged or shared; Grief that is not culturally acceptable
EX: Grieving the death of an ex, abortion, miscarriage, death of a pet, death of an inmate
When should a nurse use the Role Play teaching method?
When preparing patients for a real-life situation.
Especially good with kids
What are the interventions that a nurse should take to facilitate communication?
- Establish a trusting nurse-patient relationship
- Provide empathetic responses and explanations by using observations, giving information, conveying hope, and using humor
- Manipulate the environment to decrease distractions
- Demonstrate an empathetic response
What are the legal guidelines for EHR documentation?
- Begin each entry with the date and time
- Record entries legibly, do NOT leave blank spaces in the nurses' notes
- Sign all documentation
- Documentation should reflect assessments, interventions, and evaluations
What are the 10 rights of medication administration?
1. Right Patient
2. Right Medication
3. Right Dose
4. Right Time
5. Right Route
6. Right Documentation
7. Right to Refuse
8. Right Assessment/Indication
9. Right Evaluation
10. Right Patient Education
Someone who lost their best friend and is experiencing significant impairment in their daily life is most likely experiencing which type of grief?
Prolonged/ Complicated Grief
What is the difference between acute and chronic stress and what are some manifestations?
Name at least 4 manifestations
Acute stress is short-term stress that comes from an immediate or anticipated challenge or demand.
EX: Upcoming Exam, Job Interview, Project Deadline
Chronic stress is long-term stress that persists for long periods of time.
EX: Taking care of a newborn, Financial Struggles, Increases Pressure at Work, Caregiver Responsibilities.
Manifestations:
- Irritability
- HTN
- Diabetes
- Anxiety
- Fatigue
- Sleep Disturbances
- Headaches
- Chest Pain
- Tachycardia
How does maintaining a nonjudgmental attitude promote open and honest communication with clients, families, and significant others?
Maintaining a nonjudgmental attitude fosters an environment of trust and safety, which encourages clients, families, and significant others to communicate openly and honestly. When individuals feel accepted and not judged, they are more likely to express their thoughts, feelings, and concerns without fear of criticism or rejection, leading to better understanding and collaboration in care.
What is the privacy rule and what does it entail?
The privacy rule is a part of HIPAA and it requires that nurses protect all written and verbal communication about patients.
What are four things a nurse can do to minimize medication errors?
2. Avoid/Minimize distractions when preparing medications.
3. Double check high-alert medications
4. Clarify unclear orders