Spirituality and End of life

Question 1

Actual Loss

Answer 1

• can be recognized by others as well as the person sustaining the loss
• ex: loss of a limb, child, valued object, or job

Question 2

Perceived loss

Answer 2

• is felt by the person but intangible to everyone else
• ex: loss of youth, financial independence, valued environment

Question 3

Maturational loss

Answer 3

• experienced as a result of natural developmental process
• ex: first child may experience a loss of status when a sibling is born

Question 4

Situational loss

Answer 4

• experienced as a result of an unpredictable event
• ex: traumatic injury, disease, death, natural disaster

Question 5

Anticipatory loss

Answer 5

• a person displays loss and grief behaviors for a loss that has not taken place yet
• often seen in families of patients with serious and life-threatening illnesses
• may lessen the effect of the actual loss

Question 6

Bereavement

Answer 6

state of grieving due to the loss of a loved one

Question 7

Grief

Answer 7

internal emotional response to loss

Question 8

Dysfunctional grief

Answer 8

• abnormal or distorted, may be either unresolved or inhibited
• person may have trouble expressing feelings of loss or may deny them

Question 9

Engel’s 6 stages of grief

Answer 9

1. shock and disbelief
2. developing awareness
3. restitution
4. resolving the loss
5. idealization
6. outcome

Question 10

Clinical signs of impending death

Answer 10

• difficulty talking or swallowing
• nausea/abd distention
• incontinence or constipation
• loss of movement/sensation/reflexes
• decreasing body temp
• weak, slow, irregular pulse
• decreasing BP
• restlessness or agitation
• noisy, irregular respirations

Question 11

Care to facilitate a “good death”

Answer 11

• providing control
• independence and dignity are central issues
• palliative care
• focus on relief of symptoms
• guided by values and preferences of the individual patient

Question 12

Kubler Ross 5 stages of grief

Answer 12

1. denial and isolation
2. anger
3. bargaining
4. depression
5. acceptance

Question 13

Advance Directives

Answer 13

• living will or durable power or attorney for healthcare
• can minimize difficulties by allowing people to state in advance what their choices would be for healthcare that should be provided or foregone in particular situations

Question 14

Living will

Answer 14

provide specific instructions about the kinds of health care that should be provided or foregone in specific situations

Question 15

Power of attorney for healthcare

Answer 15

appoints an agent the person trusts to make decisions in the event of subsequent incapacity

Question 16

Comfort measures only order

Answer 16

indicates that the goal of treatment is a comfortable, dignified death and that further life -sustaining measures are no longer indicated

Question 17

Terminal weaning

Answer 17

the gradual withdrawal of mechanical ventilation from a patient with a terminal illness or an irreversible condition with a poor prognosis

Question 18

Palliative Sedation

Answer 18

the lowering of patient consciousness using medication for the express purpose of limiting patient awareness of suffering that is intractable and intolerable

Question 19

Factors affecting grief and dying

Answer 19

• developmental considerations
• family
• socioeconomic factors
• culture, sex assigned at birth, religious influence
• cause of death

Question 20

Suicide Prevention: action plan

Answer 20

A: assess for risk of suicide or harm
L: listen nonjudgementally
G: give reassurance and information
E: encourage appropriate professional help
E: encourage self help and other support strategies

Question 21

Developing a trusting nurse - patient relationship

Answer 21

• explain patients condition and treatment
• teach self care and promote self esteem
• teach family members to assist in care
• meet the needs of the dying patient
• meet family needs

Question 22

Postmortem care

Answer 22

• prepare body for discharge
• place in anatomical position, replace dressings, remove tubes
• ## place ID tags on the body

Question 23

Postmortem care of the family

Answer 23

• listen to family’s expression of grief, loss, helplessness
• offer solace and support by being an attentive listener
• arrange for family members to view the body
• in the case of sudden death, provide a private place for family to grieve
• it is appropriate for the nurse to attend the funeral and make a follow up visit to the family

Question 24

Universal spiritual needs

Answer 24

1. need for meaning and purpose
2. need for love and relatedness
3. need for forgiveness

Question 25

Spirituality

Answer 25

anything that pertains to a person’s relationship with a nonmaterial life force or higher power

Question 26

Faith

Answer 26

generally refers to a confident belief in something for which there is no proof or material evidence

Question 27

Agnostic

Answer 27

one who holds that nothing can be known about the existence of a higher power

Question 28

Religion

Answer 28

an organized system of beliefs about a higher power that often includes set forms of worship, spiritual practices, and codes of conduct

Question 29

Spiritual Health

Answer 29

the condition that exists when the person’s universal spiritual needs for meaning and purpose, love and belonging, and forgiveness are met

Question 30

Hope

Answer 30

ingredient in life required for a positive outlook

Question 31

Love

Answer 31

connectedness with others

Question 32

Factors affecting spirituality

Answer 32

• developmental considerations
• family
• ethnic background
• formal religion
• life events