Chapter 15 LECTURE 14 PART I Flashcards
Planning For The End of Life
DEATH AS PART OF THE LIFE CYCLE
-Death is not a normal part of the life cycle (T/F)?
False; Death is a normal part of the life cycle
DEATH AS PART OF THE LIFE CYCLE
-____ people are _____ prepared for the process of dying
-few
-emotionally
DEATH AS PART OF THE LIFE CYCLE
-Is death unique to the aged?
-Can it happen at any time?
-no but most people associate it with the elderly
-yes
DEATH AS PART OF THE LIFE CYCLE
-What is therapeutic presence?
-It can be done by just simply doing what?
-remaining near the patient and family
-holding a hand
DEATH AS PART OF THE LIFE CYCLE
-Therapeutic presence provides ____ while facilitating the expression of ____ & ____
-You don’t want to just what?
-Instead, what should you be? (2)
-strength; emotions and grief
-be in the room
1. Their mind, body, and soul
2. Comforting & let them know you care
THE PROCESS OF DYING
-The process of dying is composed of what two components?
Psychological and physiological death
THE PROCESS OF DYING: Psychological death
-When does this begin?
When a person is told that he or she has a terminal illness
THE PROCESS OF DYING
-What happens first physiological or psychological death?
Psychological death
THE PROCESS OF DYING: Psychological death
-What is your mind doing?
-How long may this take?
-preparing for the process of death
-a while
THE PROCESS OF DYING: Physiological death
-When does it start?
When the body processes decline in function
SIGNS AND SYMPTOMS OF DEATH
-The family should be prepared for what?
-The information should be communicated with _____
-the symptoms that accompany death
-sensitivity
SIGNS AND SYMPTOMS OF DEATH
-Finality of the actual death will come as what to most family members?
as a shock
COMMON SIGNS OF IMPEDING DEATH
1. Increasing ______, ______
2. ____ loss
3. Decreased _____
4. Loss of _____ and ____ control
5. Decreased awareness of _____
6. _____ (____)
7. ____ congestion
8. Altered ____ ____
9. Decreased _____ output
10. Slowed ____
11. _____ and ____ extremities
12. ____ and ____ jaw
- weakness; immobility
- Weight
- appetite
- bowel and bladder
- surroundings
- Diaphoresis (sweating)
- Lung
- breathing patterns
- urine
- pulse
- Cold and mottled
- Relaxed and open
COMMON SIGNS OF IMPEDING DEATH
-With weight loss, sometimes it may be hard to what?
recognize them
COMMON SIGNS OF IMPEDING DEATH
-What can be heard with lung congestion?
-What is this also referred to as?
-loose gurgling sounds
-the death rattle
PSYCHOLOGICAL RESPONSES OF THE DYING PATIENT
-Death and dying is easy to process (T/F)
-False; it is difficult to process
PSYCHOLOGICAL RESPONSES OF THE DYING PATIENT
-Patients may lose what with disability, why?
-Example?
-self-esteem due to increasing dependence on others
-Example: having to get their diaper changed by someone else
PSYCHOLOGICAL RESPONSES OF THE DYING PATIENT
-The grief process should be supported through the efforts of what?
Palliative care and the hospice team
PSYCHOLOGICAL RESPONSES OF THE DYING PATIENT
-What is therapeutic communication?
being understanding of the patient’s emotional outbursts or expression of anger & encouraging venting or verbalization
PSYCHOLOGICAL RESPONSES OF THE DYING PATIENT
-What is one of the key components to therapeutic communication?
Active listening
THERAPEUTIC COMMUNICATION
-Should you say the following?:
“Don’t cry”
No
THERAPEUTIC COMMUNICATION
-Should you say the following?:
“It sounds as if you are dealing with painful memories”
Yes
THERAPEUTIC COMMUNICATION
-Should you say the following?:
“It’s okay to cry”
Yes
THERAPEUTIC COMMUNICATION
-Should you say the following?:
“You will be out of pain soon”
No
THERAPEUTIC COMMUNICATION
-Should you say the following?:
“I’m here if you want to talk”
Yes
THERAPEUTIC COMMUNICATION
-Should you say the following?:
“Tell me how you are feeling”
Yes
THERAPEUTIC COMMUNICATION
-Should you say the following?:
“You need to be strong for you family”
No
THERAPEUTIC COMMUNICATION
-Should you say the following?:
“It is God’s will”
No
KUBLER-ROSS GRIEF CYCLE
-What are the 5 stages of grief?
- Denial
- Anger
- Bargaining
- Depression
- Acceptance
KUBLER-ROSS GRIEF CYCLE: Denial
-What may the patient do?
-Will the family believe you?
-they may curse you out and say the diagnosis isn’t right
-No, they may not
KUBLER-ROSS GRIEF CYCLE: Denial
-They may be in what kind of state?
Shock
KUBLER-ROSS GRIEF CYCLE: Anger
-Who may they be mad at?
-Example?
-God, nurse, child, etc.
-Throwing IV pumps at people or at the wall
KUBLER-ROSS GRIEF CYCLE: Anger
-What is this type of anger?
Displaced anger
KUBLER-ROSS GRIEF CYCLE
-During the denial and anger stage, what should the nurse do?
Provide information and communication
KUBLER-ROSS GRIEF CYCLE: Bargaining
-What is this?
Coming up with things to take away what they are going through
KUBLER-ROSS GRIEF CYCLE: Bargaining
-What should the nurse do during this stage?
Provide a lot of emotional support
KUBLER-ROSS GRIEF CYCLE: Depression
-What do they realize?
That bargaining won’t change the outcome, so they become sad and depressed
KUBLER-ROSS GRIEF CYCLE: Depression
-Some people do not make it out of this stage (T/F)
True
KUBLER-ROSS GRIEF CYCLE: Acceptance
-What does the person come to terms with?
-What do they realize?
-The diagnosis
-That they don’t have a lot of time to live
KUBLER-ROSS GRIEF CYCLE
-During the depression and acceptance stages, what should the nurse do?
Provide them with guidance and support, as well as services
