PWB: death & dying (Class 11)

Question 1

religous care

Answer 1

helping patients maintain faithfulness to their belief system and worship practices.

Question 2

spiritual care

Answer 2

helping people identify meaning and purpose in life, look beyond the present, and maintaing personal relations as well as relationship with a higher being or life force.

Question 3

faith

Answer 3

ongoing effort to make sense of our lives and purpose of being. represents a set of beliefs developed over time.

Question 4

faith struggles

Answer 4

common among people who experience illness and loss.

these people may feel anger guild or self judgment, worthless.

Question 5

nursing process

Answer 5

assessment expresses level of care & support.
assessment tools: listening, ask direct questions, FICA (faith, importance, community, address), spiritual well-being scale.

Question 6

assessment: faith/belief

Answer 6

ask about religous source of guidance. understand the patients philosophy of life.

Question 7

assess: life & self responsibility

Answer 7

ask about a patients understanding of illness limitations or threats and how the patient will adjust.

Question 8

assess: connectedness

Answer 8

ask about pts ability to express a sense of relatedness to something greater than self.

Question 9

goals & outcomes

Answer 9

a spiritual care plan includes
realistic & individualized goals.
with relevant outcomes

Question 10

setting priorities

Answer 10

the pt identifies what is most important

Question 11

teamwork & collaboration

Answer 11

in a hospital setting the pastoral care department is valuable resource

Question 12

diagnosis

Answer 12

anxiety, ineffective coping, complicated grieving, hopelessness, powerlessness, readiness for enhacned spiritual well-being, spiritual distress, risk for spiritual distress, risk for impaired reliogiosity

Question 13

hospice

Answer 13

model of care for pts and family when faced with limited life expectancy. based on philosophy of death with comfort & dignity.

Question 14

palliative

Answer 14

care tht is given to improve quality of life when a patient is facing life-threatening illness. the relief of physical, mental, and spiritual distress for people with an incurable illness.

Question 15

sensory changes near death

Answer 15

hearing is usually the sense to disappear. touch decrease in sensation with decrease perception to pain. taste and smell will decrease. blurring of vision, sinking, and gazing of eyes. blink reflex absent. eyelids remain half open.

Question 16

gastrointestinal system changes

Answer 16

slowing of GI tract & possible cessation of function. accumulation of gas. abdominal distention and nausea. loss of sphincter control. bowel movement may occur before imminent death or at time of death

Question 17

musculoskeletal system changes

Answer 17

gradual loss of ability to move, sagging of jaw resulting from loss of muscle tone, difficulty speaking, difficulty maintaining body alignment, loss of gag reflex, jerking or twitching from large doses of opioids.

Question 18

cardiovascular system changes

Answer 18

increased heart rate: later slowing and weakening of pulse. irregular rhythm, decrease in blood pressure, delayed absorption of drugs administered IM or SC

Question 19

respiratory system changes

Answer 19

cheyne-stokes respiration, inability to cough or clear respiratory secretions. grunting, gurgling, or death rattle, irregular breathing, gradually slowing down to terminal gasps, coolness and mottling, absence of respiration.

Question 20

integumentary system changes

Answer 20

mottling of hands, feet, arms, and legs. cold clammy skin, cyanosis on nose, nail beds and knees, waxen color (pallor) as blood settles to dependent areas.

Question 21

urinary system changes

Answer 21

gradual decrease in urinary output, incontinent of urine, unable to urinate

Question 22

phases of death:

one to three months

Answer 22

withdrawal from the world and people. decrease food intake. increase in sleep. going inside self. less communication.

Question 23

phases of death:

one to two weeks

Answer 23

disorientation, agitation, talking with the unseen, confusion, picking at clothes

Question 24

phases of death

days or hours

Answer 24

intensification of 1-2 weeks signs. surge of energy, decrease blood pressure, eye glassy, tearing, half open, irregular breathing, stop/start, restlessness or no activity, purplish knees, feet hands blotchy, pulse weak hard to find, decrease urine output, may be incontinent

Question 25

phases of death:

minutes

Answer 25

fish out of water breathing, cannot be awakened.

Question 26

kublers 5 stages of grief

Answer 26

shock & denial.
anger
depression and detachment.
dialogue and bargaining.
acceptance.

Question 27

3 stages of grief

Answer 27

1. shock & disbelief, 2. developing awareness, 3. restitution and recovery.

Question 28

chronic grief

Answer 28

when intensity does not diminish after the first year

Question 29

conflicted grief

Answer 29

unresolved issues, ambivalent feelings toward deceased

Question 30

absent grief

Answer 30

carrying on as though nothing has happened.

Question 31

maladaptive or dysfunctional grief

Answer 31

delayed or exaggerated, may relate to real or percieved loss. 1. may occur when grief not resolved from prior experience. 2. grief may have been blocked in some way. 3. feelings and behaviors become exaggerated/disruptive to persons lifestyle

Question 32

normal grief

Answer 32

natural response to a loss. expected feelings and behaviors. emotions intense but gradual. several months to several years

Question 33

dysfunctional grief

Answer 33

difference is related to the length of time. intensity of the emotion. maladaptive dysfunction. prolonged and overwhelming.