final exam: chapter 44 (loss, grief, and dying) Flashcards
spirituality is an essential part of __ (holistic/hospice/perioperative) care
holistic
daily living habits | general frame of reference (thinking about oneself and world) | health and illness | relationships | required and prohibited behaviors are all __ and __ of a person’s life in spirituality
beliefs; practices
how has dying in america changed over the years?
a. better management of acute illness (tech, med, process and settings)
b. complex decisions - life sustaining treatment
c. cost of care at end of life
d. family involvement
a-d
the 4 selected recommendations for dying in the us are: __ (hint: cdpp)
clinician-pt communication and advanced care planning | delivery of care | professional education and development | public education and engagement
the types of loss are: __ (hint: aampps)
actual | anticipatory | maturational | physical vs. psychological | perceived | situational
match the types of loss with their appropriate definition:
a. actual
b. anticipatory
c. maturational
d. perceived
e. situational
1. experienced bc of an unpredictable event
2. experienced as a result of natural development process
3. recognized by others
4. loss has not yet taken place
5. less obvious to others; individual experience
a. 3
b. 4
c. 2
d. 5
e. 1
grief is:
a. the state of grieving
b. the internal emotional reaction to loss
c. actions and expressions of grief - outward expressions
b. the internal emotional reaction to loss
mourning is:
a. the state of grieving
b. the internal emotional reaction to loss
c. actions and expressions of grief - outward expressions
c. actions and expressions of grief - outward expressions
bereavement is:
a. the state of grieving
b. the internal emotional reaction to loss
c. actions and expressions of grief - outward expressions
a. the state of grieving
dysfunctional grief is an abnormal response. true or false?
true (there is unresolved and inhibited grief)
unresolved grief is:
a. trouble expressing feelings or loss
b. suppressed feelings that can lead to somatic symptoms (e.g. abdominal pain)
a. trouble expressing feelings or loss
inhibited grief is:
a. trouble expressing feelings or loss
b. suppressed feelings that can lead to somatic symptoms (e.g. abdominal pain)
b. suppressed feelings that can lead to somatic symptoms (e.g. abdominal pain)
death can be defined by an individual who has either irreversible cessation of ALL (1) __ or (2) __
circulatory and respiratory function; brain function (including brain stem)
a person is “dead” based on these 3 criteria:
- cessation of breathing
- no response to deep, painful stimuli
- lack of reflexes (e.g. gag, corneal)
clinical signs of death include: __ (hint: cdddlnnruw)
clotting, mottling, and cyanosis of extremities & dependent areas | decreasing bp | decreasing body temp w/cold or clammy skin | difficulty talking or swallowing | loss of movement, sensation, & reflexes |nausea, flatus, abdominal distention | noisy, irregular, or cheyne-stokes respirations | restlessness and/or agitation | urinary and/or bowel incontinence or constipation | weak, slow, or irregular pulse
the 5 stages of grief are: __ (hint: dabda)
denial and isolation | anger | bargaining | depression | acceptance
true or false. terminal illness can be defined as an illness w/expected death w/in a limited space of time
true
mark the correct options about terminal illness:
a. physician is responsible for this decision
b. pt knows what to do
c. most pts want to know their prognosis and what to do
d. culture influences how much info and who is involved
a, c, d
in terms of the pt view for terminal illness, most pts __ about their condition while competent pts have the right to __ and __ treatment, even life-sustaining ones
know; consent; refuse
in terms of the family view of terminal illness, the family of a pt should be __ to participate in planning pt’s care plan, and needs to be able to __ the pt’s status w/health care providers. the nurse can provide __ and __ as the family begins the grieving process.
encouraged; discuss; support; care
what is the difference between palliative and hospice care?
palliative care enhances the quality of life for a pt, while hospice care focuses on “care” rather than “cure”
which of the following are NOT true about palliative care:
a. enhances quality of life
b. requires life expectancy
c. expenses covered by philanthropy, fee-for-service, and direct hospital support
d. ideally begins at diagnosis of terminal illness
e. peds pts are covered by the mandates from the Affordable Care Act
b. requires like expectancy (does NOT require life expectancy)
d. ideally beings at diagnosis of terminal illness (ideally begins at diagnosis of a serious illness)
which of the following are NOT true about hospice care:
a. pts have 6+ to live
b. expenses are paid by Medicaid, Medicare, and most private health insurers
c. pt/family chooses not to receive aggressive, curative care
a. pts have 6+ to live
