Loss Grief and Dying Flashcards
Plan of care (written or oral) stating the client’s wishes regarding how he/she receives healthcare services in the event they become incapacitated or unable to make decisions.
Advance Directives
Two type of advance directives
Living will
Durable Power of attorney
specific instructions the client wishes related to healthcare delivery
living will
designated person to make healthcare wishes in the event a client is unable to make those decisions.
Durable Power of Attorney
Components of Spirituality
Faith, hope, love
An evolving pattern of believing that guides and grounds us and helps us make sense of the world and confront the challenges.
faith
A positive expectation and desire for future things to happen. Includes our basic human need to achieve, create, and to shape something of our life that will endure
hope
Kubler- Ross Stages of Grief
Denial Anger Bargaining Depression Acceptance
Engel Stages of Grief
Shock and disbelief
Developing awareness of the loss
Restitution and Recovery
Worden Stages of Grief
Accepting the reality of the loss
Working through the pain and grief
Adjusting to the environment in which the deceased is missing
Emotionally relocating the deceased and moving on with life
Taking care of the whole person mind, body, spirit, heart, and soul.
Focuses on quality of life
Appropriate for many illnesses and settings.
Palliative Care
A form of palliative care for patients with a short life expectancy
Focus is on the need of the dying
Care may be at home
Hospice Care
Culture should be considered
Remember an individual’s culture can influence decision making regarding end of life care.
Culturally Competent Care
Clinical Manifestations of Impending Death
Difficulty talking or swallowing
Nausea, flatus, abdominal distention
Urinary and/or bowel incontinence or constipation
Loss of movement, sensation, and reflexes
Decreasing body temperature, with cold or clammy skin
Weak, slow, or irregular pulse
Decreasing blood pressure
Noisy, irregular, or Cheyne-Stokes respirations
Restlessness and/or agitation
Cooling, mottling, and cyanosis of the extremities and dependent areas
must be ordered by the provider, after conferring with patient and/or family.
Do Not Resuscitate (Allow Natural Death)
requires signed permission from the next of kin except if required by law (suspicious or unwitnessed deaths).
Autopsy
Call _______ for every death
KODA
Why is it important to position the body with a pillow under the head and shoulders soon after death?
To prevent discoloration from blood settling in these areas, which would be upsetting to the family.
Why is it important to close the eyes and mouth of the deceased and position the body within at least 2 to 4 hours after death?
Rigor mortis occurs about 2 to 4 hours after death. It does not disappear until about 96 hours after death. You would not be able to do these things after the body becomes rigid.
is the natural response to the loss of a person or object. The bereaved person experiences the expected feelings, behaviors, and cognitions. Emotions are intense but gradually diminish over time (several months to several years). Some emotions will always be present, but the intensity will change.
Uncomplicated Grief (normal grief)
is characterized by intensity of emotions and length of time. The person’s responses are maladaptive, dysfunctional, unusually prolonged, or overwhelming. For example, the bereaved may become severely depressed, violent, or suicidal; become a “workaholic”; become socially isolated; or demonstrate addictive behavior. After several years the person may still be experiencing as much pain and disruption as in the first months after the loss.
Complicated Grief, also known as prolonged acute grief,
A nurse is caring for a client recently diagnosed with advanced cancer. Which client statement reflects the Kübler-Ross stage of denial in the grief process? Select all that apply.
- _____ “Why did this have to happen to me now?”
- _____ “How could this happen when I quit smoking cigarettes?”
- _____ “Maybe they mixed up my records with someone else’s records.”
- _____ “I probably will not live long enough to see my children married.”
- _____ “What’s the point in doing anything? They tell me I am going to die soon anyway.”
- This statement characterizes the denial stage of the grieving process. When in denial, a client may identify reasons why the diagnosis is not possible.
