End of Life Flashcards
An emotional response to a loss. What’s normal and what’s not?
Grief. Normal is anticipatory, disenfranchised, ambiguous. Complicated is exaggerated, delayed, masked.
What are the stages of grief and loss?
Denial, anger, bargaining, depression, acceptance.
What to assess for with grief and loss?
Prior losses, relationships, spiritual/cultural, end of life choices, common reactions
What are common grief reactions?
Physical, emotional, behavioral, cognitive
What interventions for grief?
Comfort, dignity, quality of life, and support.
Working with loss, grief, and dying triggers the nurse’s own personal experiences with loss.
What types of communication should be used when it comes to patients and their families?
Open-ended questions. Interactions based on the stages of grief and loss. Non-judegmental. Honesty. Make time: gift of presence. Do not try to make it better.
For the caregiver?
Recognize that feelings of grief and loss are normal. Take responsibility for your needs. You do not have to do anything alone. Balance your life. Find peace and serenity from within.
Common discomforts of the dying client?
Pain, dyspnea, anorexia, nausea, vomiting, constipation, fatigue, pressure ulcers, confusion, depression, stress, grief
Common concerns of the family when pt is dying?
Pain and other symptoms, fluid and nutrition, mobility, family providing care, planning for the death
What happens in one to three months prior to death?
Begins to withdraw, sleep increases, appetite decreased, difficulty in digesting food
What happens in one to two weeks prior to death?
Body begins to lose ability to maintain itself, skin color changes, reduced bP, pulse variations, non-productive cough, temp fluctuates, perspiration increases, may have brief periods of apnea
What happens days prior to death?
Possible surge of energy resulting in increased mental clarity, desire to talk, eat. Becomes dehydrated with dyspnea. Tongue and soft tissues sag, gag reflex declines, secretions accumulate. Breathing is shallow and rapid, or irregular. Death rattle. Peripheral circulation decreases.
What are some behavioral symptoms of the dying person?
Out of character requests or statements. Performing repetitive tasks. Restlessness.
Signs of impending death?
Increasing sleeping to being unresponsive. Coolness of extremities. Mottling. Shallow respirations/Cheyne stokes. Slowing pulse. Bowel or bladder incontinence. Oliguria to anuria. Decreased muscle tone. Weakness and extreme fatigue.
Signs that death has occurred.
Absence of breathing and pulse. Pupils become fixed and dilated. Eyes may remain open. Skin is waxen. Temp drops. Muscles and sphincters relax. Urine and stool may be released. Jaw may fall open. Can hear trickling of fluids internally.
