LP 13: Loss and Death

Question 1

What types of loss are there?

Answer 1

*Actual
*Perceived

Question 2

What is Actual Loss?

Answer 2

It can be recognized by others

Question 3

What is Perceived Loss?

Answer 3

It is experienced by one person but cannot be verified by others.

Question 4

What are the different sources of loss?

Answer 4

*Some aspect of self (Loss of ability to do what you like due to injury, amputation, etc).

*External objects (Pets, special objects, etc).

*Familiar environment (Nursing home residents, new school, new neighborhood).

*Loved ones (Family and friends)

Question 5

What is Grief?

Answer 5

The response to a loss

Question 6

What are the responses to a loss?

Answer 6

*Anticipatory
*Disenfranchised
*Complicated grief

Question 7

What is Anticipatory Loss?

Answer 7

Being aware that it will happen before it actually occurs.

Question 8

What is Disenfranchised Loss?

Answer 8

Unable to acknowledge loss (Abortion, affair. Dealing with it without saying anything).

Question 9

What is Complicated Grief?

Answer 9

Unhealthy or pathologic process to deal with a loss (Drugs or alcohol).

Question 10

What are the 5 stages of Kubler-Ross’s grieving process?

Answer 10

*Denial
*Anger
*Bargaining
*Depression
*Acceptance

Question 11

What factors influence with Grief responses?

Answer 11

*Age
*Significance of the loss (Something or someone you were very close to).
*Culture (Believing wheather there is a God or not).
*Spiritual beliefs
*Gender
*Socioeconomic status
*Support (Do you have someone to support you or are you alone?).
*Cause of loss or death (How the person died… Overdose, murder, suicide, etc).

Question 12

What are some Interventions for Grieving?

Answer 12

*Identify stage of grief (denial, anger, etc).
*Explore culture, ethnic, and values.
*Listen attentively, silence.
*Clarify, reflect feelings.
*Reinforce supportive relationships ( Encourage people do do normal daily activities).
Promote client autonomy
*Encourage the return to normal activities.
*Engage community resources.

Question 13

What are the responses to Death & Dying?

Answer 13

*Depends on all the factors regarding the loss.
*Tend to cluster in the Stages of Grieving
*Caregivers, both professionals and support people respond to the impending death.

Question 14

What are the Concepts of Death & Dying?

Answer 14

• 5yr old -> Death is sleep
• 9yr old -> Believes unrelated actions caused by death; Believes own death can be avoided.
• 18 yr old -> Fantasizes that death can be defied (Nothing will ever happen to me)
• 18-45 yr old -> Influence by religion/culture
• 45-65 yr old -> Accepts own mortality; death of parents; peaks of death anxiety
• 65+ yr old -> Fears prolonged illness; death of peers; sees death as having multiple meanings

Question 15

What are some Communication Blocks when talking about death? (Avoid these)

Answer 15

*Change the subject
*Offer false reassurance
*Deny what is happening
*Be fatalistic (Everybody dies one day)
*Block discussion
*Be aloof
*Manage client care

Question 16

What is Heart-lung Death?

Answer 16

Cessation of apical pulse, respirations, and blood pressure

Question 17

What are the Legalities of Death?

Answer 17

*Advanced directives
*Autopsy
*Certification of death
*DNR orders
*Inquest
*Organ donation

Question 18

What is a Living Will in WI?

Answer 18

Life sustaining measures when near death or persistant veg. state

Question 19

What is aPower of Attorney for Health Care in WI?

Answer 19

Agent able to make range of health care decisions.

Question 20

What is Inquest?

Answer 20

Legal inquiry into the cuase or manner of death (accidents)

Question 21

What is Preparetion of the (death) Body?

Answer 21

Washing of body by family members

Question 22

What religions/Cultures are opposed to Autopsy?

Answer 22

*Jews
*Jehovah’s Witnessess
*Muslims

Question 23

What religions/cultures are opposed to Organ Donation?

Answer 23

*Jehovah’s Witnessess
*Muslims

Question 24

What religions/cultures are opposed to Cremation?

Answer 24

*Mormon
*Islamic
*Catholic faiths

Question 25

What religions/cultures are opposed to Prolonged Life?

Answer 25

Christian Scientist

Question 26

What is Closed Awereness?

Answer 26

When the dying person is not aware of his/her own death. (Children, elderly)

Question 27

What is Mutual Pretense?

Answer 27

When everyone knows about the death of somebody but they don’t talk about it.

Question 28

What is Open Awereness?

Answer 28

When everyone knows about someone’s death and they talk about it.

Question 29

What are Clinical Signs of dying?

Answer 29

-Loss of muscle tone
-Slowing of circulation (Cynosis)
-Changes in respirations
-Sensory impairment

Question 30

What does Loss of Muscle Tone consists on?

Answer 30

-Relaxation of facial muscles
-Difficulty speaking, swallowing
-Decreased activity of GI tract (nausea, distention)
-Urinary and rectal incontinence
-Diminished body movement

Question 31

What does Slowing of Circulation consists on?

Answer 31

-Dimished sensation (Not feeling when people touch)
-Mottling and cyanosis of the extremities
-Cold skin
-Slower and weaker pulse
-Deceased BP

Question 32

What does Changes in Respirations consists on?

Answer 32

-Rapid, shallow, irregular, or abnormally slow respirations
-Noisy breathing (death rattle)
-Mouth breathing
-Dry oral mucous membranes

Question 33

What does Sensory Impairment consist on?

Answer 33

-Blurred vision
-Impaired senses of taste and smell

->Last sense to leave the dying body is hearing<-

Question 34

What are the Nursing Diagnoses of Death and Dying?

Answer 34

-Anticipatory grieving
-Fear
-Hopelessness
-Powerlessness
-Disuse syndrome

Question 35

What are the Outcomes of Death and Dying?

Answer 35

-Maintain physiological and psychological comfort
-Acheive a dignified and peaceful death

Question 36

What are the Interventions of Death and Dying?

Answer 36

-Helping the client die with dignity
-Hospice and palliative care

Question 37

What is Post Mortem Care?

Answer 37

Care given to the body after death.