death/grief

Question 1

how many adults have chronic illness in the US?

Answer 1

129 million adults have 1 or more chronic illnesses, 42% of adults have 2 or more chronic illnesses

Question 2

how many people die per year in the US?

Answer 2

3 million people die per year in US

Question 3

what are the top three causes of death?

Answer 3

heart disease, cancer, and unintentional injuries

Question 4

what is the expected life expectancy?

Answer 4

77.5 y/o

Question 5

what is hospice care?

Answer 5

6 months to live, terminal illness, provided when treatment will no longer cure, interprofessional, holistic care thats treats the whole person including caregivers and family

Question 6

what is palliative care?

Answer 6

holistic care provided throughput lifespan for clients experiencing illness, goal is to improve quality care, concentrated on lessening client suffering at end of life

Question 7

what is the difference between hospice and palliative care?

Answer 7

palliative care is different from hospice care, as palliative care is provided
while the client is still engaging in curative treatment methods

Question 8

what are some barriers to quality care at the end of life?

Answer 8

-failure to acknowledge the limits of medicine
-workforce that is too small to meet demands
-lack of training for healthcare providers
-hospice/palliative care services are poorly understood
-lack of research
-lack of payment models linked to quality measures
-rules and regulations
-denial of death

Question 9

what are physiological changes?

Answer 9

physiological changes at the end
of life follow a familiar pattern of
signs and symptoms. The terminal
phase of a client’s life is
characteristically referred to as
“actively dying” or “imminent
death”

Question 10

what is the “death rattle?”

Answer 10

retention of secretions in the
respiratory tract

Question 11

dyspnea:

Answer 11

shortness of breath

Question 12

cheyne-stokes respiration’s:

Answer 12

an irregular respiratory rate fluctuating
between several quick breaths and
periods of apnea

Question 13

what happens to body temp when death is coming?

Answer 13

-ability of the nervous system to regulate body temperature diminishes, causing
clients to experience both increased and decreased temperature.
-also caused by infection, cancer, and cancer therapy.
-mottling occurs hours or days before death, with the upper and lower extremities
becoming cool to the touch. Mottling occurs as result of the heart’s inability to pump
blood effectively, leading to decreased blood perfusion throughout the body.

Question 14

what happens to vision and hearing?

Answer 14

clients may experience hallucinations
or report hearing and seeing those
who have already died

Question 15

dignity and death correlation

Answer 15

-dignity is regarded as an everyday necessity, essential to the well-being of
all clients. Most complaints related to nursing care at end of life are
associated with a lack of caring.
-as clients near the end of life, illness contributes to a loss of control, which
lessens their sense of dignity.

Question 16

what is good death?

Answer 16

when a client is actively dying, health care providers, family, and
caregivers are responsible for providing a “good death” for the client, this
generally includes pain management, planning for death, closure at the
end of life, clear decision making, and being able to contribute to others.

Question 17

advance directives indicate:

Answer 17

-who will make decisions for the patient in case the patient is unable.
-the kind of medical treatment the patient wants or doesn’t want.
-how comfortable the patient wants to be
-how the patient wants to be treated by others
-what the patient wants loved ones to know.

Question 18

special orders:

Answer 18

-physician order for life-sustaining treatment form (POLST)
-allow natural death, do-not-resuscitate, or no-code orders
-comfort measures only
-terminal weaning
-voluntary stopping of eating and drinking (VSED)
-active and passive euthanasia
-palliative sedation

Question 19

what does post mortem care include?

Answer 19

physical care of the body after death, includes washing the body,
accounting for the client’s
possessions, removing invasive
devices such as intravenous catheters
and indwelling catheters, and placing
identification tags in at least two areas
(toe, arm, outside of body bag, etc.), documenting the date
and time of death, the name of
anyone notified, location of
belongings, and where the client’s
body is moved (funeral home name)

Question 20

post mortem care for the family:

Answer 20

-listen to family’s expressions of grief, loss, and helplessness.
-offer solace and support by being an attentive listener.
-arrange for family members to view the body.
-in the case of sudden death, provide a private place for family to begin
grieving.
-it is appropriate for the nurse to attend the funeral and make a follow-up
visit to the family.

Question 21

true or false: it is voluntary to be an organ or tissue donor

Answer 21

true

Question 22

can a nurse talk to the family about organ or tissue donations?

Answer 22

no, a nurse is not allowed to begin a
dialogue about organ or tissue donation
with the client or a family member. Only
health care professionals who have
completed a course provided or
endorsed by an organ procurement
organization (OPO) are permitted to
initiate the request of the client or
surrogate, nurses role is to assist families who are dealing with the hard decision

Question 23

grief:

Answer 23

the feelings or reactions an individual has to a loss in one’s life, the loss that an individual endures is not necessarily related to a death, as grief can be experienced from any loss or personal
experiences

Question 24

types of grief:

Answer 24

-normal: Also known as uncomplicated grief, is caused by the loss of
someone very close, through death or the ending of a relationship
-anticipatory: Grief that is experienced before the expected loss of
someone or something
-prolonged grief disorder (PGD): Previously known as complicated grief;
lasts >6 months and can be so significant, it affects the client’s ability to
function
-disenfranchised: Grief related to a relationship that does not coincide with
what is considered by society to be a recognized or justified loss

Question 25

true or false: the grieving process is the same for everyone

Answer 25

false, grief is a normal
response to loss, every person has
their own unique and personal way
of moving through the grieving
process. One’s culture often
provides the guidelines for how
people express their grief
experience, and in turn, serves as
the foundation for their actions

Question 26

what is the kubler-ross five stages of grief

Answer 26

-denial: Client refuses to believe the truth and this helps to lessen the pain
of the loss
-anger: Client is trying to adjust to the loss and is feeling severe emotional
distress, often asking “why me?” and suggesting “it’s not fair”
-bargaining: Usually involves bargaining with a higher power by making a
promise to do something in exchange for a different, better outcome
-depression: Reality sets in, and the loss of the loved one or thing is deeply
felt
-acceptance: Client still feels the pain of the loss but realizes they will be all
right

Question 27

what is the dual process of grief?

Answer 27

-during loss-oriented stressors,
grief is conveyed through intense
thoughts and feelings.
-the restoration grief process
involves coping with other losses
that come with the death of a loved
one (secondary losses) and
rebuilding one’s life without the
loved one

Question 28

what is wordens four tasks of mourning?

Answer 28

-accept the reality of the loss
-experience the pain of grief
-adjust to an environment without
the deceased
-create an enduring connection to
the deceased loved one, while
embarking on a new life

Question 29

common grief reactions:

Answer 29

shock, anger, anxiety, numbness, denial, guilt, sadness, relief (if death is expected), depression, age related considerations

Question 30

what is religious-spiritual?

Answer 30

can help a person who is grieving to deal
with death and the grieving process

Question 31

what is the NURSE technique?

Answer 31

-name: Identify what the client just stated, or the emotion expressed by the client.
-understand: Demonstrate understanding by recognizing the client’s feelings and providing an opportunity for the client to discuss their feelings.
-respect: Voice your respect for the client under these circumstances.
-support: Inform the client that you are available to him or her.
-explore: Ask open-ended questions to extend the conversation and provide a more detailed expression of the client’s feelings and beliefs.

Question 32

nurse reaction:

Answer 32

may experience grief after
a client’s death. Reactions differ
among nurses in expressing grief
and is affected by the clinical
circumstances of the client’s death
as well as personal factors specific
to the nurse. Because reactions
differ, each nurse needs to be
aware of and manage their grief