fundamentals- chapter 15 Flashcards
1
Q
nurses’ attitudes toward end-of-life care
A
- Death is a universally shared event with all cultures and religions having beliefs and rituals to explain and cope with death, loss, and grief
- It is still taboo to have discussions about death in mainstream North American cultures
- It is normal for nurses to have difficulty dealing with death and dying even if they provide care to critically ill or dying patients regularly
2
Q
change
A
- loss, grief, and mourning are intrinsically linked with life changes
- these are normal and inevitable life transitions
- 6 stages of dealing with life changes (Virginia Satir):
1. status quo
2. introduction of a foreign element
3. chaos
4. integration
5. practice
6. new status quo
3
Q
loss
A
- to no longer possess or have an object, person, or situation
- can be physical (loss of a limb or body function)
- psychosocial (loss of a loved one)
- only the person experiencing the loss can define the value of the loss
4
Q
grief
A
- the total emotional feeling of pain and distress that a person experiences due to loss
- grieving process occurs over time
- person adapts and moves through pain toward recovery or acceptance
- causes physical and emotional symptoms
5
Q
bereavement
A
the state of having suffered a loss by death
6
Q
anticipatory grieving
A
7
Q
dysfunctional grieving
A
8
Q
prolonged grieving
A
9
Q
symptoms of grief
A
- depression, sadness
- fatigue, apathy, lack of interest
- sleep alterations
- loss of appetite
- change in sexual interest
- anxiety, shortness of breath
- feeling helpless, restless, angry, irritable
10
Q
symptoms of grief
A
- forgetfulness, tendency to make mistakes
- confusion, disorientation
- symptoms of the same illness the deceased suffered
- seeing loved one’s presence, hearing loved one’s voice
11
Q
stages of grief
A
- disbelief, yearning, anger, depression, acceptance
- peak within 6 months after the loss
- nurse should reevaluate and create additional nursing plans for patients who continue to score high in these areas after 6 months
12
Q
death
A
- a physiologic event that is typically defined by the absence of spontaneous breathing and heartbeat
- definition of death is now centered on the concept of brain death, which is defined as the absence of brain activity as evidenced by the absence of EEG waves
- brain death is characterized by three findings: coma, absence of brain stem reflexes, and apnea
13
Q
standards of care for the terminally ill
A
- Opportunities provided to spend final moments with people important to the patient
- Families will have opportunity to discuss the patient’s imminent death with the staff
- Family provided private time with the patient
- Family will be provided time to carry out cultural customs regarding the body after death
14
Q
end-of-life care
A
- Consider the terminally ill patient’s preferences
- Try to maintain functional capacity and relieve discomfort
- Control patient’s pain
- Be aware of advance directives and durable powers of attorney
- Make the patient feel safe and secure
- The patient will have ample opportunity to finish business with loved ones
15
Q
rights of the dying patient
A
- Be treated as a person until death
- Caring human contact
- Have pain controlled
- Cleanliness and comfort
- Maintain a sense of hope
- Participate in his care or the planning of it
- Respectful, caring medical and nursing attention
