Loss, Grief, & Dying Flashcards
What are the 5 factors that affect grief?
The significance of the loss
Support system
Unresolved conflict
Previous loss/ timeliness
Spiritual beliefs
Chronic grief, masked grief, and delayed grief are all examples of-
Complicated Grief
Grief that extends into long term with little resolution of feelings =
Chronic Grief
Masked Grief =
Bereaved may drink excessively, argue
Putting grief off till a “better” time to deal with it =
Delayed Grief
Grief that is not socially supported or acknowledged by the usual rites and ceremonies =
Disenfranchised Grief
Experienced before the loss actually occurs (Alzheimer’s) =
Anticipatory Grief
Higher-Brain Death =
No brain activity. Brain stem may still be functional, so both respiratory and cardiac activity can continue even after brain activity stops
Prolonged, deep state of unconsciousness lasting days or even years =
Coma
The person has lost only the higher cerebral functions, continues to have a sleep-wake cycle, may have some spontaneous movements and may open eyes in response to external stimuli =
Persistent Vegetative State
1-3 months prior to death you typically experience:
Begin to withdraw from the world and people.
Sleep increases.
Liquids become preferred.
Poor appetite
1-2 weeks before death, you typically experience:
Reduced BP
Pallor of extremities
Temp. fluctuations
Brief periods of apnea
Congestions increase
Days to hours before death, you typically experience:
A surge of energy
Mental clarity
A desire to eat
Secretions accumulate
Breathing becomes shallow, rapid, or irregular (Cheyne-Strokes)
Sphincters relax
Restlessness + agitation
Moments before death, you typically experience:
Not responding to touch or sound
Can’t be awakened
Short series of long-spaced breaths
What are Kubler Ross’s Psychological Stages of Dying in order?
Denial
Anger
Bargaining
Depression
Acceptance
In regards to Kubler Ross’s Psychological Stages of Dying, do you have to complete one stage to move onto the next? Can you experience 2-3 stages at the same time?
You can experience multiple stages at the same time. You don’t necessarily have to complete one stage to move onto the next
End of life care should be delivered with-
Compassion, sensitivity, and competency
Does end of life care include palliative and hospice care?
Yes
End of life care should include holistic assessment of -
Both the patients and their families
Difference between palliative care and hospice care?
Palliative care can include patients undergoing curative treatments, hospice does not.
In hospice care, quality of life is as important as length of life. This is not the case for palliative care.
May a DNR order be prescribed by a physician?
Yes
When someone else gets appointed by the PT to make decisions for them once they are no longer able to make decisions for themselves =
Durable Power of Attorney
List of instructions given by a PT that states their wishes before they are no longer able to make decisions for themselves anymore =
Advance Directive
Does the ANA prohibit nurses from participation in assisted suicide or euthanasia?
Yes
Lack of action such as withholding meds or food necessary to sustain life =
Passive Euthanasia
Occurs because of a direct action (giving an overdose of meds), can be voluntary (PT consents) or involuntary (PT unable to consent or unaware of it) =
Active Euthanasia
An autopsy requires signed consent from-
Next of kin except in cases of suspicious or unwitnessed death
A PT must be how old for organ donation?
18
Can relatives revoke a person’s organ donation, even after death?
No
A PT expresses trouble trying to find meaning. How would you help them healthfully cope?
Talk them through it
Who’s responsible for deciding what and how much to tell a PT?
The Primary Provider
Dependent parts of corpse appear bluish and mottled-blood stops circulating =
Livor Mortis
Occurs when blood stops circulating =
Algor Mortis
Stiffening of body-contraction of muscles 2-4 hrs after death. Begins in involuntary muscles like the heart =
Rigor Mortis
Can hospice care provide respite care?
Yes
