Unit 3 Death, Dying and Grief Test 1 Flashcards
What is an infants concept of death?
They have no concept of death.
What is a toddlers’ when it comes to death?
1) Main concern is separation anxiety.
What does death mean to a toddler?
Dean means “less alive.”
What does a middle-age adult focus on when it comes to death?
- Adults focus on physical changes and losses that they begin to experience.
Around what age does a person begin to think about their own mortality?
MIddle-age
How does an older adult deal w/ death?
1) They begin to realize that they will die in the near future and prepare by talking about death and their final wishes and completing their life review.
What may give a purpose to life?
The concept of death
What age group sees death as final and understanding rituals and customs?
Preadolescents
What age group sees death as a distant possibility?
Adolescents.
They think they are invincible and hearty.
What is Loss?
Universal events encountered by all beings who experience emotins.
What are 4 things that are perceived by loss.
1) Separation from loved ones.
2) Giving up of treasured possessions, for whatever reason.
3) The experience of failure, real or perceived.
4) Life events that create changes in a familiar pattern of existence.
Loss can trigger —— associated w/ grief.
Associated
Who recognizes Actual Loss?
Recognized by others as well as the person themselves.
What are some examples of Actual Loss?
1) Loss of a limb
2) Loss of a child
3) Loss of money
4) Loss of a job
Perceived Loss is felt by who?
Felt by the person but is intangible to others.
What are some examples of perceived loss.
1) Loss of youth
2) Financial independence
3) A valued environment
When does Anticipatory Loss occur?
Occurs when a person displays loss and grief behaviors for a loss that has yet to occur.
What are 3 categories of things a person can physically loose?
1) A significant other.
2) Illness or debilitating conditions
3) Developmental and Maturational changes and situations.
What are some categories of Psychological Loss?
1) Loss of aspects of self
2) Environmental loss
3) Loss of significant relationship
How can a person have environmental loss?
Personal possessions that symbolize familiarity and security in a person’s life
How might a person have a loss of aspects of self?
1) Decrease in self-esteem.
2) Loss of hopes and dreams.
What can cause a loss of a significant realtionship?
Result of divorce or separation of any kind.
Define Anticipatory Loss
A person displays loss and grief behaviors before that actual loss
Which loss may tend to intensify as the actual loss becomes imminent?
Anticipatory loss
What are some examples of Secondary Loss?
1) Lost income
2) Loss of home
3) Loss of social network
4) The role the loved one held in the family is gone. It takes time for the family to reorganize.
Along w/ the primary loss of the person, families and loved ones may experience ——.
Secondary losses
When there is a secondary loss it take time for the family to —-.
reorganize
All loss can and will result in —–.
Grief
Define grief.
Grief is the feeling, tone, or outward expression of loss.
Describe denial.
In this stage the individual does not acknowledge that the loss has occurred.
What are Kubler-Ross Stages of Grief?
1) Denial
2) Anger
3) Bargaining
4) Depression
5) Acceptance
Which stage of Kubler-Ross Stages of Grief does Reality set in?
2 Anger
What occurs for a pt to be in the Anger stage of the Kubler-Ross Stages of Grief?
Occurs when individuals internalized the impending loss.
What feelings are associated w/ the anger stage of the Kubler-Ross Stages of Grief?
- Sadness
- Guilt
- Shame
- Helplessness
- Hopelessness
- The anxiety level may be elevated
- One may experience confusion
- Decreased ability to function independently
- Numerous somatic complaints are common
Describe the Bargaining stage of Kubler-Ross stages of Grief.
3 One attempts to strike a bargain w/ God for a second chance, or more time.
Describe the Depression stage of the Kubler-Ross stages of Grief.
4
- One mourns for what has been lost or what will be lost.
- The person is often withdrawn and quiet.,
Should you offer intervention to someone suffering from the depression stage?
Therapeutic intervention should be available, but not imposed.
Describe the acceptance stage of the Kubler-Ross stages of Grief.
5
The individual has worked through the behaviors associated w/ the other stages and accepts or have become resigned to the loss.
What are some variables that influence progression through the grief process?
1) Age
2) Family relationships
3) Socioeconomic positions
4) Culture
5) Religion
What are some variables that influence the progression through the Acceptance stage.
1) Reach acceptance, only to revert back to an earlier stage.
2) May never complete the sequence
3) Never progress beyond the initial stage.
One of the biggest things that influence how a person greaves is their —?
Culture
As a person grieves, they might experience what?
- Anger
- Guilt
- Anxiety
- Depression
- Preoccupation w/ thoughts
- Somatic complaints
What reaction might a family and loved ones have to a sudden death?
The grief response following sudden loss is often intensified since there is little to no opportunity to prepare for the loss, say good-bye, finish unfinished business or prepare for a life apart- for closure.
Grief seems to decrease in intensity w/ passage of —?
Time
Sudden death can generate intense grief responses such as what?
- Shock
- Anger
- Guilt
- Sudden depression
- Despair
- Hopelessness.
What are the 3 issues identified as those being delt w/ in prolonged deaths?
1) The experience of illness
2) The extent of suffering
3) The difficulty of making medical decisions that can complicate the grief of survivors.
What is defined as a normal progression through the grief process?
Functional Grieving
What is defined as an abnormal or distorted grief, it may be unresolved or inhibited.
Dysfunctional Grieving.
Which type of grieving is adaptive or healthy?
Functional grief
Which type of grieving is maladaptive?
Dysfunctional
Name 3 facts that describe functional grief.
1) Runs over predictable course of time.
2) Self limiting
3) Results in a healthy resolution.
What is the hoped outcome after grief?
The resumption of normal life.
What are some grief responses to dysfunction grief.
1) Exaggerated, lengthy, unpredictable course.
2) Results in unresolved conflicts.
3) Deny or ignore the need for emotional support.
4) Unresolved inhibited grief one suppresses feelings and my instead exhibit somatic symtoms.
Define a Advanced directive
Legal document that states the person’s wishes for medical treatment in the event that he cannot make these decisions.
Define Living will.
A form of advanced directive that states the wishes of a person regarding life sustaining treatment in case of serious illness.
Define DNR/DNI
On admission to a health care facility, pts are asked if they wish to sign a do not resuscitate order.
What is the DNR for?
This is to prevent the improper use of cardiopulmonary resuscitation.
Define Durable Power of Attorney.
An appointee that makes your wishes known in the event that you cannot.
What are some of the signs of Clinical Manifestations of Impending Death.
1) Withdrawal from what is going on around them.
2) There may be a decrease in senses, hearing is said to remain until death.
3) Some are quiet and still
4) Others restless and agitated
5) Breathing patters change.
6) Irregularity of respiratory rates w/ periods of apnea
7) BP dropping
8) Pulse slows down
9) Bow and bladder control weakens
10) Level of consciousness changes
11) Inability to swallow
12) Pitting swallow
13) Loss of body heat
14) Mottled skin, pallor
15) < gastrointestinal and urinary tract activity.
What are the 2 things listed under irregularity of respiratory rates w/ periods of apena?
1) Cheyne-Strokes respirations
2) Agonal Breathing
With impending death, what happens to the pt’s pulse?
Pulse slows down after an initial rapid, weak pulse.
Define Euthanasia
The deliberate ending of one’s life and the withholding of treatment.
Define assisted suicide.
The pt takes their own life, although another individual may provide the medication w/ which to do so.
Hospice and palliative care both offer —.
Compassionate care to pts w/ life limiting illnesses.
Palliative care is always a component of what?
Hospice care
Who coordinates the care and services provided for palliative care?
The interdisciplinary team
W/ Palliative care, who collaborate and communicate about care needs?
- Pts
- Families
- Palliative health care providers
- Non-palliative health care providers
What are Palliative care’s aims?
To improve quality of life from every different angle.
What are some of the goals of Palliative care?
1) To keep pain to a minimum
2) To treat symptoms and improve health where possible.
3) To assist w/ mobility and safety.
4) To allow meaningful interactions between pts and their friends, family, community.
5) To improve spiritual and emotional well-being
6) To help reduce the sometimes heavy burden or caregivers through training.
7) To allow both pts and caregivers to understand and express their feelings.
8) To ensure pt and caregivers understand what is happening and make informed, well-thought-through choices.
When and how long is hospice care provided?
Provided to pts w/ a life expectancy of six months or less.
Rather than seeking a cure, hospice care aims to make their remaining time w/ us as ___.
Comfortable and as meaningful as possible.
Center for Hospice Care recognizes that loved ones are also — and may benefit from —-.
- On a difficult journey
- Support, expert advice and services that we can provide.
The primary goal of hospice care is a very simple one:
To ensure that every moment counts, in the last six months of life.
What are the Postmortem care responsibilities of the nurse?
1) Caring for the body
2) Caring for the family
3) Legal responsibilities: identification, death certificate, alerting the mortician.
4) Caring for the other pts
