Grief and Loss Flashcards
grief
refers to the personal feelings
that accompany an anticipated or
actual loss
mourning
refers to individual, family,
group, and cultural expressions of grief
and associated behaviors
bereavment
refers to the period of
time during which mourning for a loss
takes place
kubler ross
Denial
* Anger
* Bargaining
* Depression
* Acceptance
anticipatory grief
unconsciously preparing for what might happen
uncomplicated greif
rnage of emotions experience after a olss moving toward adjustment
breif periods of relapse common
complicated or prolonged grief
intense response after loss where profound emotions persist usually >1yr
disenfranchised grief
grievingperson feels socilety does not acknowledge or support person’s right to greive
unresolved grief
traumatic or unexpected loss
parkinsons’s disease
Progressive
Neurodegenerative
Disease of the basal
ganglia
decreased dopamine
involuntary mvmts while still: pill rolling, shuffling gait, drooling, stooped over, bradykinesia
manifestations of parkinsons
Tremor
* Rigidity
* Bradykinesia
* Postural Instability
added manifestations of parkinsons
Autonomic
Dysphagia
Psychiatric
Cognitive
Hypokinesia
complications of parkinsons
Respiratory infections
* UTI
* Skin breakdown
* Falls
what do antiparkinsons drugs do
Enhance or
release supply
of Dopamine
Decrease
cholinergic
effects
Act on
neurotransmitt
er pathways
levodopa side effects
dyskinesias
on-off
on-off phenomenon
when meds wear off, pt appears worse
when patient takes meds, appears much better
L sided hf
dysfxn of L ventricle
decreased co
pulm congestion from increased pulm vessels
systolic L sided hf
decreased L ventricle contraction dt myocardial stretching
reduced ejection fraction
less blood pumped systemically
diastolic L sided hf
heart muscle is hypertrophied
usually caused by htn
prevents aquedate co
preserved ejection fraction
cant get enoug in
decreased co clinical manifestations
Fatigue/weakness
* Oliguria
* Angina
* Confusion, restlessness
* Dizziness
* Tachycardia, palpitations
* Pallor
* Weak peripheral pulses
* Cool extremities
clinical manifestations pulmonary congestions
Hacking cough
* Dyspnea
* Crackles or wheezes in lung
sounds
* Frothy, pink tinged sputum
* Tachypnea
* S3/S4 heart sounds
R sided hf
Caused by left ventricular
failure, right ventricular
MI, or pulmonary
hypertension
* Right ventricle cannot
completely empty
clincial manifestations r sided hf
Jugular Venous Distension
*Enlarged Liver and Spleen
*Anorexia and nausea
*Dependent edema
*Distended abdomen
*Polyuria at night
*Weight gain
labs for hf
BNP- elevates when fluid is present
CMP
CBC
aces
pril
suppress raas
vasodilation
nagging cough
watch renal labs
arbs
sartan
furosedmide
loop diruectic
ivp acute episodes
monitor hypokalemia
bb
metoprolol
blocks sympathetic comensatory resp
monitor low hr and bp
cant use if they have asthma or copd
nitro
isosorbide
HA-tylenol
vasodilators
decreases preload
decreases o2 demands of heart
can decreased affterload
monitor bp
morphine
reduces preload and afterload
decreases o2 demands of heart
manages anxiety and dyspnea
dig
cardiac glycoside
trats chronic hf
increases contractility
decreases hr
apical hr
dig toxicity-hypokalemia and halos
increasing perfusion
med ed
sodium/fluid resctriction
no salt substitues
strict io
dw
emergency treatment pul edema
diruetics
nitro
vent
morphine
MAWDS
meds
activity
wt
diet
symptoms
cardiac diet
limit sodium 2-3 g
limit fuid 2l
med teaching hf
avoid nsaids
a line
alarm must be on
hold pressure if comes out
continueous bp monitoring
clots common
hourly: color, pulse, temp, cap refill
distal infarct
central venous monitoring
about volume status
sits in r atrium
0-5 normal
in negatives- hypovolemia
over 20- need diuretics
swan ganz
measures both cvp and pulm pressures
parkinsons risk
aspiration
speech therapy post op b4 eating or drinking
side effect of levodopa
tardive dyskinseia
lip smacking
tics
what does 30% ef indicate
pt is in hf
needs pacemaker or icd
