Chapter 23 Flashcards

0
Q

behaviors used to incorporate loss into one’s life

A

mourning

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1
Q

individuals response to loss

A

grief

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2
Q

superimposed losses without adequate time for grieving can create crisis known as…

A

bereavement overload

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3
Q

nurse responsibility of dealing with loss

A

help pts family adjust in a healthy manner

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4
Q

active and evolving process as one copes with grief

A

bereavement

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5
Q

life transitions in later life

A
  • significant roles
  • financial security
  • independence
  • physical health
  • mental stability
  • life - death
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6
Q

proposed dual processes model weaving loss and restoration

A

loss-restoration model

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7
Q

includes concentrated thinking about life before loss or with person and circumstances and events surrounding death or loss

A

loss oriented coping

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8
Q

includes death new things, distracting oneself from grief, assuming new roles, transcendence

A

restoration-oriented coping

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9
Q

model of grief

-physical and psychological manifestations

A

beginning

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10
Q

grief model

-day to day functioning may be altered

A

middle

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11
Q

grief model

-individual re emerges refocused and adjusted to the loss

A

end

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12
Q

loss response model

A
  • impact
  • functional disruption
  • informing others
  • engaging emotions
  • reorganizing structures
  • reframing memories
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13
Q

ways to move toward integration of the loss

A
  • inform others
  • each time the story is told it becomes more real
  • movement toward a new steady state
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15
Q

typical grief progression

A
  • chaos
  • make sense out of chaos
  • movement toward integration of loss
  • engagement and expression of emotions
  • role replacement
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16
Q

type of grief:

  • response to real or percieved loss before it occurs
  • may see sudden change in attitude toward the thing or person to be lost
  • selling home or possessions, moving to nursing home
  • preoccupation with the loss, detailed planning
A

anticipatory

17
Q

type of grief:

  • somatic and psychological changes occur
  • often occurs in waves
  • preoccupation with loss
  • self blame or guilt may be present
  • functional disruption
  • simple things seem complex
A

acute grief

18
Q

in what stage of grieving is grief work most effective

A

acute grief

19
Q

type of grief:

  • lingering status
  • can be triggered
  • each deals in different ways
  • may be healthy or a sign of complicated grieving
A

chronic grief

20
Q
  • reestablishment of equilibrium is disrupted
  • guilt, anger, ambivalence
  • insomnia
  • depression
  • cognitive difficulties
  • social withdrawal
  • can be misinterpreted as dementia
A

complicated grief

21
Q
  • relationship is not recognized
  • grief is not sanctioned
  • suicides, hiv/aids, pets, gradual losses caused by chronic conditions
  • situations often distance an individual from the family, making open grief impossible
A

disenfranchised grief

22
Q

disenfranchised grief is often accompanied by…

A

complicated grief

23
Q

what to watch out for with disenfranchised grief

A

self destructive behaviors

24
Q

factors affecting coping with loss

A
  • physical
  • psychological
  • social
  • specific to dying and death
25
Q

characteristics of good coppers

A
  • avoid avoidance
  • confront realities and take appropriate actions
  • focus on solutions
  • redefine problems
  • consider alternatives
  • good communication with others
  • seek and use constructive help
  • accept support
  • keep up their morale
26
Q

pt suspects they are dying, but it is never openly discussed

A

suspected awareness

27
Q

pt does not know they are dying

A

closed awareness

28
Q

there is “let’s pretend’ atmosphere (real feelings are kept hidden)

A

mutual pretense

29
Q

acknowledges the reality of the approaching death

A

open awareness

30
Q

interventions for loss

A
  • gently established rapport
  • be ready to listen
  • offer support and direction
  • encourage the griever to talk and tell story of relationship it had been
31
Q

kubler-ross stages of grief

A
  • denial
  • anger
  • bargaining
  • depression
  • acceptance
32
Q

6 c’s for promoting a good death

A
  • core
  • control
  • composure
  • communication
  • continutioy
33
Q

in paliative care, research basis and plan of care is based on…

A

pain

34
Q

barriers to completing advanced directive

A
  • inaccesible documents
  • level of education
  • income
  • younger age
  • race
35
Q

treatment administered when other palliative treatments are not sufficiently effective , a suffering pt unconscious in the proximity of death

A

terminal sedation

36
Q

signs of impending death

A
  1. coolness
  2. increased sleeping
  3. incontinence
  4. disorientation
  5. restlessnes
  6. decreased urine output
  7. altered breathing pattern
  8. noisy respirations
37
Q

when a nurse encourages the griever to share stories with others after a loss, the nurse is employing which intervention?

A

collaboration