Module 11B Flashcards
Chapter43 Sparkle Ppt
Concepts of Loss
Loss occurs when a valued person, object, or situation is
changed or becomes inaccessible such that its value is
diminished or removed.
Actual loss: can be recognized by others
Perceived loss: is felt by person but intangible to others
Physical loss versus psychological loss
Maturational loss: experienced as a result of natural
developmental process
Situational loss: experienced as a result of an unpredictable
event
Anticipatory loss: loss has not yet taken place
Grief:
internal emotional reaction to loss
Bereavement:
state of grieving from loss of a loved one
Mourning:
actions and expressions of grief, including the
symbols and ceremonies that make up outward
expression of grief
Engel’s Six Stages of Grief page 1687
Shock and disbelief Developing awareness Restitution Resolving the loss Idealization Outcome
Definition of Death
Uniform Definition of Death Act: An individual who has
sustained either (1) irreversible cessation of all functions
of circulatory and respiratory functions or (2) irreversible
cessation of all functions of the entire brain, including the
brainstem, is dead.
Medical criteria used to certify a death: cessation of
breathing, no response to deep painful stimuli, and lack
of reflexes (such as the gag or corneal reflex) and
spontaneous movement, flat encephalogram.
Components of a Good Death
Control of symptoms
Preparation for death
Opportunity to have a sense of completion of one’s life
Good relationship with health care professionals
Clinical Signs 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
Kübler-Ross’s Five Stages of Grief page
1687
Denial and isolation Anger Bargaining Depression Acceptance
Advance Directives
Indicate who will make decisions for the patient in case
the patient is unable.
Indicate the kind of medical treatment the patient wants
or doesn’t want.
Indicate how comfortable the patient wants to be.
Indicate how the patient wants to be treated by others.
Indicate what the patient wants loved ones to know.
Special Orders
Allow natural death, do-not-resuscitate, or no-code
orders
Terminal weaning
Voluntary cessation of eating and drinking
Active and passive euthanasia
Palliative sedation
Factors Affecting Grief and Dying
Developmental considerations Family Socioeconomic factors Cultural, gender, and religious influences Cause of death
Needs of Dying Patients
Physiologic needs: physical needs, such as hygiene, pain
control, nutritional needs
Psychological needs: patient needs control over fear of
the unknown, pain, separation, leaving loved ones, loss
of dignity, loss of control, unfinished business, isolation
Needs for intimacy: patient needs ways to be physically
intimate that meets needs of both partners
Spiritual needs: patient needs meaning and purpose, love
and relatedness, forgiveness and hope
Developing a Trusting Nurse–Patient
Relationship
Explain the patient’s condition and treatment.
Teach self-care and promoting self-esteem.
Teach family members to assist in care.
Meet the needs of the dying patient.
Meet family needs.
Providing Postmortem Care
Care of the body Care of the family Discharging legal responsibilities Death certificate issued and signed Labeling body Reviewing organ donation arrangements, if any Care of other patients
