UNIT 5 - ch. 12 spirituality & ch.13 experiencing loss

Question 1

Define compassion

Answer 1

the force that empowers one to recognize and help someone in need

Question 2

how should a nurses presence feel

Answer 2

calming, healing presence for patients

Question 3

What are some factors during a nurse presence that can impact how the family feels? ( actions or behaviors of the nurse)

Answer 3

Eye contact
body language
calm voice
correct attitude
perceptions
care provided

Question 4

What is compassion fatigue (how is it prevalent in a nurse role)

Answer 4

extreme state of distress associated with being in an environment where there is a constant exposure to high stress environments where therapeutic care by the nurse is constantly needed, can feel burnt out.

Question 5

Define spirituality

Answer 5

the expression of meaning and purpose in life

Question 6

Define spirit

Answer 6

the dimension of ones self

Question 7

Define transcendence

Answer 7

the process of moving beyond ones self

Question 8

define faith

Answer 8

a belief beyond self and what can be seen

Question 9

define hope

Answer 9

confident expression for a better outcome

Question 10

Define religion

Answer 10

a map that outlines beliefs, values and codes of conduct shared by a group of people.

Question 11

Define spiritual distress

Answer 11

the disruption in the belief or value system of a person (situations, people, diagnosis, - anything that cause a dramatic reevaluation of ones life

Question 12

What are some verbal signs someone is in spiritual distress

Answer 12

asking for a religious or spiritual leader (chaplain)
asking for prayer
talks about topics relating to life, purpose, or death.

Question 13

What are some nonverbal signs that someone is in spiritual distress

Answer 13

exhibits neediness
depressed or withdrawn behavior
angry or noncompliant

Question 14

What are some environmental signs that someone is in spiritual distress

Answer 14

has religious books, jewelry or symbols
displays family pictures

Question 15

What are some situational signs that someone is in spiritual distress

Answer 15

• has had a life- threatening diagnosis
• is facing death
• unexpected change

Question 16

when conducting a initial spiritual assessment what 4 patient cues do you need to assess for

Answer 16

• verbal
• nonverbal
• environmental
• situational

Question 17

What does FICA stand for in a focused spiritual assessment?

Answer 17

F: Faith and belief
I: importance of faith
C: Faith community involvement
A: Address spirituality

Question 18

What does SPIRIT stand for in a focused spiritual assessment?

Answer 18

S: spiritual belief system
P: Personal spirituality
I: involvement in a spiritual community
R: Ritualized practices and restrictions
I: implications for medical care
T: terminal- events planning (advance directives)

Question 19

What does HOPE stand for in a focused spiritual assessment?

Answer 19

H: Sources of hope, meaning, comfort, strength, people, love and connection
O: organized religion
P: personal spirituality and practice
E: Effects on medical care and end-of-life issues

Question 20

When doing a focused spiritual assessment what frameworks do you assess for (3)

Answer 20

F.I.C.A
S.P.I.R.I.T
H.O.P.E

know what these stand for

Question 21

List some nursing interventions to promote client spirituality.

Answer 21

• allow time and self disclosure by the patient
• be physically present and actively listen
• support spiritual growth and the clients spiritual requests or needs
• pray, encourage, support
• arrange for a baptism for an at risk infant in emergency

Question 22

What is an Ethical responsibly of a nurse when providing spiritual care to a client

Answer 22

it is the nurses job to provide patient with their needs, this includes spiritual. if nurse refuses to provide spiritual care for patient’s because of bias or fear this represents a violation of the nurse’s commitment to nonmaleficence (inflicting the least harm possible)

Question 23

What are some barriers to providing spiritual care

Answer 23

• lack of awareness or knowledge of needs
• differences between patient or nurse (causes fear or bias)

Question 24

what is algor mortis

Answer 24

the cooling of the body after death

Question 25

what is liver mortis

Answer 25

the settling of blood in the body after death (skin becoming bluish as blood settles)

Question 26

what is rigor mortis

Answer 26

the stiffening of the joints after death

Question 27

define loss

Answer 27

the absence of something valued or important

Question 28

Define greif

Answer 28

the emotional response to loss

Question 29

Define mourning

Answer 29

outward, social expression of loss and greif

Question 30

What are the five stages of grief

Answer 30

1. Denial 2. Anger 3. Bargaining 4. Depression 5. acceptance

Question 31

what are some problems associated with greif (list 4)

Answer 31

- unresolved greif - dysfunctional greif - complicated greif - disenfranchised greif

Question 32

Define unresolved greif (what is another name for this)

Answer 32

disturbances in the regular process of grief to resolution. "complicated grief"

Question 33

Define dysfunctional greif

Answer 33

getting stuck in one or more steps in the grief cycle, being unable to express feelings or move onto acceptance / resolution - for example staying in the depression phase

Question 34

What is another name for Complicated grief ( what 4 types does it include)

Answer 34

"unresolved grief" types: - chronic grief - delayed grief - exaggerated grief - masked grief

Question 35

Define Disenfranchised grief

Answer 35

defined as any loss that is not validated or recognized (job, miscarried, pet)

Question 36

What is complicated loss

Answer 36

a sudden, unexpected loss, or violent / traumatic death - sudden death does not allow the survivor time to prepare for the impending loss - leads to shock, disbelief or a dysfunctional way of processing grief.

Question 37

What are end of life signs in a focused assessment

Answer 37

- decreased breathing - unresponsiveness - fatigue - Discoloration - apnea episodes - changes in bowel or bladder - no response to tactile or verbal stimuli

Question 38

What is the nurses role in end of life assessments

Answer 38

- assess for end of life signs - call family members - respect patient wishes - assess for grieving behavior - providing the needs associated with patient request / religion/ cultural practices - provide empathetic support, therapeutic communication and validating feelings. - collaborate with team or religious leaders

Question 39

Documentation guidelines to postmortem care

Answer 39

- must be objective data - complete / accurate - legible - it should be in time order as they occurred - The last entry to state where and to whom the body was transferred

Question 40

What are the steps to postmortem care in a nurses role

Answer 40

- the body should be cared for as soon as possible after death - respecting cultural preferences and wishes of patient and family members - position patient as naturally as possible and decrease environmental stimuli before family comes in - offer time for family - use dignity and respect even to a dead patient - Do not personalize the situation - remain professional and a support to others - clean / bathe body unless stated otherwise by family cultural preferences - remove all tubes and drains (unless autopsy or crime victim) - apply toe tags, bag tags and tags to belongings. - Document (wishes, events, place and to whom body was transferred)

Question 41

When should you not remove tubes and drains during post mortem care

Answer 41

if an autopsy is going to be done or if the patient was a crime victim, everything can be detached from the wall but not removed from patient.

Question 42

if a postmortem patient has a high drainage wound what is the appropriate action by the nurse. what is the wound was not draining.

Answer 42

remove soiled dressings and apply clean ones if not high drainage, nurse can remove dressings completely.

Question 43

can the nurse state the the Time of death?

Answer 43

depends on facility protocol!!! the majority of the time the doctor has to be called and state the TOD, or two RN's can.

Question 44

Postmortem mouth care...?

Answer 44

- align head in natural position - close eyes - close jaw or tie shut - KEEP DENTURES IN!!!

Question 45

How long after death does rigor mortis start?

Answer 45

2-4 hours after death