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fundamentals last section 6 > care of the dying and their families > Flashcards

care of the dying and their families Flashcards

1
Q

things to remember when caring for the dying

A

ensure dignity Is maintained, care for the individual and for the loved ones, routine interventions maintained (hygiene, clean linens, assess for pain/ comfort), call for support services, provide loved ones with comfort

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2
Q

clinical signs of impending death: CV

A

weak, slow, irregular pulse, decreasing BP

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3
Q

clinical signs of impending death: respiratory

A

noisy, irregular, cheyne stokes respirations, apnea

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4
Q

clinical signs of impending death: GI/GU

A

nausea, flatus, abdominal distention, constipation, incontinence, decreased urine output

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5
Q

clinical signs of impending death: neuro

A

difficulty talking or swallowing, loss of voluntary movement, sensation, reflexes; restlessness, decreased level of consciousness, agitation, hallucinations

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6
Q

clinical signs of impending death: skin

A

cold, clammy skin, mottling and cyanosis

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7
Q

legal definition of death: uniform definition of death act (1981)

A

an individual who has sustained either (1) irreversible cessation of all functions of circulatory and respiratory functions (2) irreversible cessation of all functions of the entire brain, including the brainstem is dead

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8
Q

medical criteria used to certify a death has occurred:

A

cessation of breathing, no response to deep painful stimuli, lack of reflexes (gag reflex, corneal reflex), and spontaneous movement

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9
Q

changes of the body after death: primary flaccidity then rigor

A

stiffening

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10
Q

changes of the body after death: algorithms mortis

A

cooling

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11
Q

changes of the body after death: liver mortis

A

discoloration

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12
Q

nursing responsibilities at the time of death

A

notification of: physician, loved ones, spiritual care, organ donation consultant; facilitation of legal requirements, care of the deceased, care of the loved ones

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13
Q

nursing responsibilities at the time of death: physician

A

they pronounce the time of death, legal time of death

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14
Q

nursing responsibilities at the time of death: loved ones

A

next of kin or guardian

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15
Q

nursing responsibilities at the time of death: care of the deceased

A

place a sign on the patients door, relocate room mate, prepare the loved ones to visit

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16
Q

Management of personal belongings

A

remove jewelry, glasses, religious items, personal blanket, distribute the personal items not worn by the patient (medical devices- walkers), document what items went to family, document where items are stored

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17
Q

nurses are responsible for

A

the management of the patients belongings

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18
Q

care of the deceased: loved ones

A

provide conference room for private space, provide access to phones, provide opportunity to meet with chaplain, chairs at side of bed & side rails down

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19
Q

before loved ones leave do what for the deceased

A

offer to call funeral home, determine if there are special religious practices, obtain contact info in case, distribute patients personal belongings

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20
Q

post mortem care

A

bath the body, perform interventions required for organ donation, close eyes, place dentures in mouth, patient supine/ HOB 30 degree/ arm at sides, remove all tubes, change dressings (if corner case, leave all tubes and lines in), obtain morgue pack, patient appropriately identified (wrist band, tag on toe, tag on bag), place abd pads between buttocks, secure chin

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21
Q

transferring the deceased

A

be aware of special handling that is required for communicable diseases, transfer to morgue or funeral home following facility policy, RN signs to release the body to the next location

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22
Q

nursing documentation for deceased patient

A

time of death, persons notified/ time of notification, list & disposition of personal belongings, time deceased was transferred from your care/ destination/ who transported the deceased

23
Q

organ donation

A

at time of death, nurses notify organ donation consultant, nurses provide info to the organ donation consultant regarding the deceased, consent for donation is obtained by the consultant (Ohio offers advanced authorization on drivers license)

24
Q

autopsy

A

medical examination after death (used to determine cause of death), consent must be obtained prior ro completion of an autopsy, coroner can over ride the families decision in some cases

25
Q

code blue

A

when a person experiences cardiac or respiratory arrest

26
Q

full code

A

all attempts will be made to resuscitate

27
Q

DNR (do not resuscitate)

A

no attempts will be made to resuscitate

28
Q

DNR specified

A

determines what type of resuscitate efforts will be made at the time of arrest (compressions only, medications only, do not intubate(DNI))

29
Q

DNR CC (comfort care)

A

only comfort measures will be used, no further diagnostic measures (oxygen administered, medications are administered, routine hygiene and wound care)

30
Q

living will

A

addresses wishes regarding extraordinary measures

31
Q

durable power of attorney for healthcare

A

indicates who the patient wishes to make their healthcare decisions

32
Q

advanced directives are not the same as

A

DNR orders

33
Q

what are advanced directives

A

legal documents that the patient completes to indicate the patients wishes should he or she be unable to make decisions

34
Q

palliative care

A

focus on providing relief for the symptoms and stress of a serious illness, goal is to improve quality of life, a subspecialty of medicine that is helpful for persons of any age, with many different diagnoses

35
Q

hospice care

A

the middle for quality compassionate care for people facing a life limiting illness or injury, focuses on medical management/ pain management/ emotional & spiritual support

36
Q

what is grief

A

characteristic patterns of physiological and psychological response to a loss

37
Q

what is mourning

A

socially prescribed behaviors of one who has experiences a loss (usually a loved one)

38
Q

what is bereavement

A

persons total response to the loss; physical, social, emotional, and cognitive responses

39
Q

disenfranchised grief

A

experience of grieving a loss that is not acknowledged by society

40
Q

engels 6 stages of grief: 1.

A

shock and disbelief

41
Q

engels 6 stages of grief: 2.

A

developing awareness

42
Q

engels 6 stages of grief: 3.

A

restitution

43
Q

engels 6 stages of grief: 4.

A

resolving the loss

44
Q

engels 6 stages of grief: 5.

A

idealization

45
Q

engels 6 stages of grief: 6.

A

outcome

46
Q

kubler- ross 5 stages of grief: 1.

A

denial

47
Q

kubler- ross 5 stages of grief: 2.

A

anger

48
Q

kubler- ross 5 stages of grief: 3.

A

bargaining

49
Q

kubler- ross 5 stages of grief: 4.

A

depression

50
Q

kubler- ross 5 stages of grief: 5.

A

acceptance

51
Q

self care: examine and clarify your own feelings about death and loss. do what

A

take time ti grieve (find supportive listener), it is acceptable to show your emotions to the deceased loved ones

52
Q

the patient asks the nurse to explain a living will. What is the nurses best response?

A

It lists specific instructions for health care

53
Q

a terminally ill patient says to her nurse “my situation is hopeless; I have no control over anything” which of the following interventions does the nurse implement?

A

encourage her to tell you more about how she is feeling, sit in a chair next to her, hold her hand

54
Q

your patient has just returned from a diagnostic test. the results show that he has very advanced cancer. who is responsible for what, when and how the patient is told

A

his physician

fundamentals last section 6 (3 decks)

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