Deck 2 Flashcards
Indirect Visualization Studies
Upper gastrointestinal (UGI)
Small bowel series
Barium enema
Abdominal ultrasound
Magnetic resonance imaging (MRI)
Abdominal CT scan
types of enemas
Cleansing
Retention
-Oil
-Carminative
-Medicated
-Anthelmintic
Large volume
Small volume
anthelminitic enema
destroy intestinal parasites
oil retention enema
lubricate the stool and intestinal mucosa, easing defecation
carminative enema
help expel flatus from the rectum
nutritive enema
administer fluids and nutrition rectally
sigmoidoscopy
visual examination of the distal sigmoid colon, rectum, and anal canal through a flexible or rigid sigmoidoscope
Types of Ostomies
Sigmoid colostomy
Descending colostomy
Transverse colostomy
Ascending colostomy
Ileostomy
Colostomy Diet
low fiber foods first 6-8 weeks
-avoid gas-causing foods
-avoid foods that cause blockage: nuts, corn, popcorn, mushrooms, coconuts, stringy vegetables, foods with skins/casings
-add foods that thicken stool (bananas, cheese, pasta, rice, yogurt, applesauce, potatoes)
-Drink 2.5 quarts of fluids (preferably water)
NG tubes
used to decompress or drain the stomach of unwanted stomach contents
-used to allow GI tract to rest before or after abd surgery to promote healing
-can be inserted to monitor GI bleeding
actual loss
can be recognized by others
tangible and measurable
definite and observable absence of something that was once present.
percieved loss
subjective, felt by the person but not tangible or objectively measurable.
-involves the feeling or belief that something significant has been taken away, even if there is no concrete evidence of the loss
(Ex: the loss of opportunities, or the loss of a valued aspect of one’s life, loss of financial independence)
Physical loss vs. psychological loss
Physical loss is an alteration of our physical self like amputation, removal of an organ, or loss of function
-psychological loss pertains to the emotional and subjective experience of a loss, Loss of self-esteem, loss of a relationship, or loss of a dream or opportunity
maturational loss
experienced as a result of natural development processes
-the emotional distress or sense of grief experienced when individuals go through natural life transitions or developmental milestones, such as aging, retirement, or children leaving home
situational loss
experienced as a result of an unpredictable event
(Ex. job loss, divorce, or a major illness)
anticipatory loss
loss has not yet taken place; a loss that is expected to come
(ex: terminal illness diagnosis or an impending separation)
grief
the internal, emotional response and reaction to the loss of someone or something significant.
-encompasses a range of feelings (sadness, anger, disbelief, and emotional pain.)
bereavement
the overarching term that encompasses both grief and mourning.
-refers to the period of mourning and grief following a significant loss.
-acknowledges the emotional, psychological, and social dimensions of coping with loss.
mourning
the outward expression of grief.
-involves the cultural and social practices, rituals, and behaviors that individuals or communities engage in to express and cope with their grief.
(Ex: funerals, memorial services, or personal rituals that help people navigate the emotional impact of loss.)
dysfunctional grief
prolonged, intense, or impaired grieving process that significantly interferes with a person’s ability to cope and move forward after a loss.
-abnormal or distorted grief that may be either unresolved or inhibited
(Ex: persistent feelings of guilt, an inability to perform daily activities, or the development of unhealthy coping mechanisms)
Engels six stages of grief
Was first to define stage of grief
- Shock and disbelief - denial, “not me”
- Developing awareness - feelings/anger “why me”
- Restitution - involves the rituals surrounding loss (funerals)
- Resolving the loss - dealing with the void left by the loss
- Idealization - the exaggeration of the good qualities of the person or object, followed by acceptance of the loss and a lessened need to focus on it
- Outcome - final resolution of the grief process, includes dealing with loss as a common life occurrence.
uniform definition of death act
An individual who has sustained either..
(1) irreversible cessation of circulatory and respiratory functions
(2) irreversible cessation of all functions of the entire brain, including the brainstem, is dead
Medical criteria used to certify a death
cessation of breathing
no response to deep painful stimuli
lack of reflexes (such as the gag or corneal reflex) and spontaneous movement
flat encephalogram
clinical signs of impending death
Difficulty talking or swallowing
Nausea, flatus, abdominal distention
Urinary and/or bowel incontinence or constipation
Loss of movement, sensation, and reflexes
Decreasing body temperature, with cold or clammy skin
Weak, slow, or irregular pulse
Decreasing blood pressure
Noisy, irregular, or Cheyne-Stokes respirations
Restlessness and/or agitation
Cooling, mottling, and cyanosis of the extremities and dependent areas
Different Special Orders for End of Life
POLST
Allow natural death, DNR, No-Code
Comfort measures only
Terminal Weaning - weaning off ventilator
Voluntary stopping of Eating and Drinking (VSED)
active/passive euthanasia
palliative sedation
Advance directives (living wills and durable power of attorney) indicate:
who will make decisions for the patient if 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.
physiologic needs of dying patients
hygiene
pain control
nutritional needs
psychological needs of dying patients
patient needs control over fear of the unknown, pain, separation, leaving loved ones, loss of dignity, loss of control, unfinished business, isolation
needs for intimacy of dying patient
patient needs ways to be physically intimate that meets needs of both partners
spiritual needs of dying patient
patient needs meaning and purpose, love and relatedness, forgiveness and hope
