Last Office

Question 1

4 types of loss

Answer 1

Actual, perceived, situational, developmental

Question 2

What is grief?

Answer 2

Total responses to the emotional experience related to loss

Question 3

Bereavement definition

Answer 3

Subjective response experienced by the surviving loved ones after the death of the person with significant relationship

Question 4

Mourning definition

Answer 4

behavioural process through which grief is eventually resolved/ altered
affected by culture, spiritual beliefs, and custom

Question 5

What are kubler-ross’ stages of grieving?

Answer 5

Denial -> Anger -> Bargain -> Depression -> Acceptance

Question 6

What are signs of impending clinical death

Answer 6

Changes in respiration
Loss of muscle tone
Slowing of circulation
Sensory impairment

Question 7

how to obtain certification of death?

Answer 7

autopsy performed by a physician,
to reveal discrepancies between the diagnosis and the actual cause of death

Question 8

Latest definition & sign of heart-lung death

Answer 8

Total lack of response to external stimuli
No muscular movement, especially breathing, no reflexes, flat encephalogram

Question 9

Pronouncement of death (3 steps)

Answer 9

1. legally dead
2. official declarification by a qualified person (physician)
3. death certificate: date, time, place of pronouncement

Question 10

4 physiological changes after death

Answer 10

Rigor mortis
Algor mortis
Livor mortis
Softening & liquefying of body tissue by bacterial fermentation

Question 11

Rigor mortis definition & intervention

Answer 11

Stiffness of body developed 2-4hrs after death (lack of ATP, muscle contracts and joint immobilized)

Position body in norma anatomical alignment, close eyelids & mouth, insert dentures

Question 12

Algor mortis definition & intervention

Answer 12

Reduction in body temp with loss of skin elasticity

Remove tape & dressings gently to avoid tissue breakdown: avoid pulling on skin/ body parts

Question 13

Livor mortis definition & intervention

Answer 13

purple discolouration of skin (RBC breakdown & release hemoglobin, appears in lowermost/ dependent areas)

Elevate head to prevent facial discolouration w/ pillow

Question 14

Intervention for softening & liquefying of body tissues

Answer 14

perform last office about 1 hr after death is certified; store body in cool place

Question 15

3 categorizations of dead body

Answer 15

1 (blue): standard precaution
2 (yellow): Bagging MUST, embalming not allowed, hygienic prep in parlor only allowed with disposable gloves, gown & mask
3 (red): Bagging MUST, everything else not allowed

Question 16

give examples for each risk category

Answer 16

cat 1: other than those mentioned in cat 2 & 3
cat 2: HIV, Hep C, Creutzfeldt-Jacob disease without necropsy, SARS, Avian influenza, MERS
cat 3: Anthrax, Plague, Rabies, viral haemorrhagic fevers, Creutzfelt-Jacob disease with necropsy