Module W: Make-up Work

Question 1

the 3rd stage of grief (in response to death) when person tries to arrange for more times to live to take care of unfinished business; bargains with doctors or God

Answer 1

bargaining

Question 2

respirations stop

Answer 2

apnea

Question 3

the second stage of grief in response to near death, when person express rage and resentment; often upset by smallest things; lashes out at anyone

Answer 3

anger

Question 4

care of the body after death

Answer 4

post mortem care

Question 5

a living will written while resident is mentally competent or by resident’s legal representative which outlines choices about withdrawing or with holding life-sustaining procedures, if terminally ill

Answer 5

advanced directive

Question 6

a description (typically placed in a local newspaper) of a resident’s life, including listing of relatives, birth information, accomplishments/activities, death is immenent

Answer 6

obituary

Question 7

interventions used to restore heart beat or respiratory effort (cardiopulmunary resuscitation or CPR)

Answer 7

extrordinary measures

Question 8

when resident takes several shallow breaths followed by periods of not breathing for 5, 30, or even 60 seconds; does not cause the resident discomfort

Answer 8

cheyne-stokes breathing

Question 9

an order written by a doctor at the request of a resident, which tells the health care team that the resident does not wish and extraordinary measures to be used when resident suffers cardiac or respiratory arrest

Answer 9

DNR

Question 10

the near end of life and near cessation of bodily functions

Answer 10

dying

Question 11

the end of life and cessation of bodily functions

Answer 11

death

Question 12

the first stage of grief ( in response to near death) when a person is told of impending death

Answer 12

denial

Question 13

the fourth stage of grief (in response to near death) when a person begins the process of mourning, cries, withdraws from others

Answer 13

depression

Question 14

support and care provided during the time around death

Answer 14

end of life care

Question 15

stages of grief in response to near death, based on personal, cultural and religious beliefs and experiences, according to Elizabeth Kubler-Ross

Answer 15

Five Stages of Grief

Question 16

health care agency or program for people who are dying (usually less than six months to live) that provides comfort measures and pain management, preserves dignity, respect and choice, and offers empathy and support for the resident and the family

Answer 16

hospice care

Question 17

changes in skin color (pale and bluish) of the hands, arms, feet, and legs when death is near

Answer 17

mottling

Question 18

what are the physical needs of a dying resident

Answer 18

positioning - place resident in most comfortable position for breathing and avoiding pain, maintain body alignment, change resident’s position frequently to avoid pressure ulcers
Cleanliness - providing skin care, including back rubs, bathe and groom resident frequently to promote self-esteem
Mouth and Nose - clean sores or bleeding in mouth following Standard precautions, provide oral care as needed, cover lips with thin layer of petroleum jelly, check for difficulty swallowing or choking, gently clean nose, offer drinking water as often as possible
Nutrition - offer resident’s favorite foods; include liquids or semi-liquids, offer foods frequently and in small amounts, a blanaced diet is not a primary concern
Elimination - keep the resident’s skin and linen clean, provide perineal care as often as necessary

Question 19

do your feelings about death affect the care you give

Answer 19

yes, a caring, kind, and respectful approach helps the resident who is dying and family

Question 20

what are the signs of impending death

Answer 20

psychological and physical withdrawl
decreased level of altertness, with increased periods of sleeping
circulatory slows as heart fails; extremities become cold; pulse becomes rapid and weak
respiratory - irregular, rapid and shallow or slow and heavy
(noisy respiration, apnea, cheyne-stokes breathing)
muscle tone - jaw may sag; body becomes limp; bodily function slow and become involuntary
sensory perception declines; may stare yet not respond, lack of blinking; hearing is believed to be the last sense lost
loss of urinary and bowel control as the muscles in those areas begin to relax
dark-colored urine in very small amounts as a result of decreased blood supply to the kidneys

Question 21

when a dying resident’s religious beliefs are different from yours, what should you do

Answer 21

respect their wishes

Question 22

who writes a living will

Answer 22

mentally competent resident or by resident’s legal representative

Question 23

what is the nurse aide’s role in providing post-mortem care

Answer 23

respect family’s religious restrictions regarding care fo the body
provide privacy and assist roommate to leave area until body is prepared and removed
put body in supine position with one pillow under head to prevent facial discoloration
put in dentures, and if instructed by nurse, remove tubes and dressings
wash body and comb hair
put on gown and cover perineal area with a pad

Question 24

what are the signs that a resident has died

Answer 24

no heartbeat
no respirations
no response when resident is talked to or touched
bowel and bladder incontinence
enlarged pupils that do not respond to changes in light
eyes are fixed on a certain spot
no blinking