UNIT XX - Grief Management Flashcards

1
Q

Define Loss

A

Is an actual or potential situation in which something that is valued is changed or no longer available.

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2
Q

Define Grief

A

A whole range o feelings, thoughts and behaviors related to loss. It is overwhelming, distress or sorrow.

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3
Q

What is Bereavement?

A

It is the normal grieving period expressed by surviving loved ones.

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4
Q

What is Mourning?

A

Involves the process and rituals through which grief is resolved. It is influenced by culture, beliefs and customs.

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5
Q

Berman Textbook - Chapter 30

What are normal grief reactions?

A

Abbreviated grief and anticipatory grief

see page 871

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6
Q

Define Anticipatory Grief.

A

Grieving before the loss actually occurs.

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7
Q

What is Dysfunctional Grieving?

A

Characterized by an extended period of denial, depression, severe psychological symptoms and suicidal thoughts.

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8
Q

What are the two general types of Loss?

A

Actual and perceived

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9
Q

What is Actual Loss?

A

Recognized by others.

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10
Q

What is Perceived Loss?

A

Experienced by one person but cannot be verified by others.

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11
Q

How is loss viewed?

A

situational loss or developmental loss.

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12
Q

Describe situation loss

A

The loss of a job, the death of a child, or the loss of functional ability because of acute illness or injury.

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13
Q

What is the initial stage of grieving?

A

Denial

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14
Q

What is the last stage of grieving?

A

Acceptance

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18
Q

Berman Textbook - Chapter 30

The nurse helps a 50-year-old diabetic client who is to begin giving insulin injections identify previously successful coping strategies that may be useful in the current situation. Which of the following stressors is closely related to the new stressor?

A. Interviewing for a new job
B. Death of a pet while the person was a teenager
C. The person’s partner filing for a divorce
D. Starting to wear eyeglasses at age 30

A

D. Starting to wear eyeglasses at age 30

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19
Q

Berman Textbook - Chapter 30

A client who was informed of a cancer diagnosis assures the nurse he is fine. Which of the following is the most indicative physical evidence to the nurse of the client’s stress?

A. Constricted pupils
B. Dilated peripheral blood vessels (flush)
C. Hyperventilation
D. Decreased heart rate

A

C. Hyperventilation

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19
Q

Berman Textbook - Chapter 30

A client’s family tells the nurse that their culture does not permit a dead person to be alone before burial. Hospital policy states that after 6:00 pm when mortuaries are closed, bodies are to be stored in the hospital morgue refrigerator until the next day. How would the nurse best manage this situation?

A. Gently explain the policy to the family and then implement it.
B. Inquire of the nursing supervisor how an exception to the policy could be made.
C. Call the client’s primary care provider for advice.
D. Move the decreased to an empty room and assign an aide to stay with the body.

A

B. Inquire of the nursing supervisor how an exception to the policy could be made.

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20
Q

Berman Textbook - Chapter 30

Immediately after the parents of a hospitalized child are informed that the child has leukemia, the father responds by continuing his usual work schedule, rarely visiting, and asking when the child can return to school. Of the following, which is the LEAST likely to be an appropriate nursing diagnosis at this time?

A. Ineffective Denial
B. Caregiver Role Strain
C. Fear
D. Compromised Family Coping

A

B. Caregiver Role Strain

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20
Q

Berman Textbook - Chapter 30

The shift changed while the nursing staff was waiting for the adult children of a deceased client to arrive. The oncoming nurse has never met the family. Which of the following greeting is most appropriate?

A. “I’m very sorry for your loss.”
B. “I’ll take you in to view the body.”
C. “I didn’t know your father but I am sure he was a wonderful person.”
D. “How long will you want to stay with your father?”

A

A. “I’m very sorry for your loss.”

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21
Q

Berman Textbook - Chapter 30

Which of the following may be considered normal or “healthy” types of grief? Select all that apply.

A. Abbreviated grief
B. Anticipated grief
C. Disenfranchised grief
D. Unresolved grief
E. Inhibited grief
A

A. Abbreviated grief
B. Anticipated grief
C. Disenfranchised grief

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21
Q

Berman Textbook - Chapter 30

An 82-year-old man has been told by his primary care provider that it is no longer safe for him to drive a car. Which statement by the client would indicate beginning positive adaption to this loss?

A. “I told the doctor I would stop driving, but I am not going to yet.”
B. “I always knew this day would come, but I hoped it wouldn’t be now.”
C. “What does he know? I’m a better driver than he will ever be.”
D. “Well, at least I have friends and family who can take me places.”

A

D. “Well, at least I have friends and family who can take me places.”

22
Q

Berman Textbook - Chapter 30

The nurse, working on a hospice unit, identifies which of the following clients as being closest to death?

A. The 85-year-old female who is incontinent of urine.
B. The 58-year-old man with diminished sensation in the right lower leg.
C. The 28-year-old client with a slow weak pulse and irregular breathing.
D. The 47-year-old client with absent gag reflex.

A

C. The 28-year-old client with a slow weak pulse and irregular breathing.

23
Q

Berman Textbook - Chapter 30

The nurse is caring for a terminally ill client who anticipates dying while hospitalized. During routine care the client often laments not being able to say good-bye to his dog but recognizes that hospital regulations prevent animals from visiting. A priority nursing action is to:

A. Find alternate means for the client to say good-bye to his dog such as talking to the dog over the phone via a picture.
B. Encourage the family to sneak the dog into the client’s room and assure them the nurses will look the other way.
C. Obtain permission from the physician to place the client onto a stretcher and wheel him outside where his family can be waiting with his dog.
D. Tell the client, “I am so sorry you can’t see your dog. That must be very difficult for you. Would you like me to put pictures of your dog on the wall so you can at least see him?”

A

C. Obtain permission from the physician to place the client onto a stretcher and wheel him outside where his family can be waiting with his dog.

24
Q

What is closed awareness?

A

The client is not ware of impending death.

25
Q

What is mutual pretense?

A

The client, family, and health personnel know that the prognosis is terminal but do not talk about it and make an effort not to raise the subject.

26
Q

What is open awareness?

A

The client and others know about the impending death and feel comfortable discussing it, even though it is difficult.

27
Q

Berman Workbook - Chapter 30

Why is it important for nurses to understand the significance of loss?

A. Because they will also suffer a loss in their lives.
B. To develop the ability to assist clients working through the grieving process
C. Because they need to be all things to all people
D. To be able to provide supportive care

A

B. To develop the ability to assist clients working through the grieving process

28
Q

Berman Workbook - Chapter 30

What is the most upsetting phase for the grieving person facing the loss?

A. Bargaining
B. Anger
C. Confrontation
D. Accommodation

A

C. Confrontation

29
Q

Berman Workbook - Chapter 30

What religion prefers cremation?

A. Catholics
B. Muslims
C. Hindus
D. Mormons

A

C. Hindus

30
Q

Berman Workbook - Chapter 30

What is the last sense that is considered to be lost?

A. Smelling
B. Seeing
C. Tasting
D. Hearing

A

D. Hearing

31
Q

MyNursingLab Submodule 2.16 - Death and Dying

The nurse is attempting to understand a client’s comment by applying Kubler-Ross’s theory of death and dying. The client asks, “Why me?” This client is expressing:

A. Depression
B. Anger
C. Denial
D. Bargaining

A

B. Anger

32
Q

MyNursingLab Submodule 2.16 - Death and Dying

The client who states, “I only wish I can live long enough to see my grandchildren,” is at which stage of Kubler-Ross’s theory?

A. Denial
B. Anger
C. Acceptance
D. Bargaining

A

D. Bargaining

33
Q

MyNursingLab Submodule 2.16 - Death and Dying

A terminally ill client states, “I think I’m dying.” Which response by the nurse is best?

A. “Why do you think that?”
B. “You think your are dying…”
C. “You have to trust your doctor.”
D. “We won’t let you die.”

A

B. “You think your are dying…”

34
Q

MyNursingLab Submodule 2.16 - Death and Dying

Which behavior would indicate to the evaluating nurse that the client may be experiencing dysfunctional grief?

A. Sad and crying two days after death of husband
B. Crying after breakup of engagement
C. Crying inconsolably in ER after sudden death of sister
D. Leaving child’s room intact three years after a child’s death

A

D. Leaving child’s room intact three years after a child’s death

35
Q

MyNursingLab Submodule 2.16 - Death and Dying

The nurse acknowledges that many terminally clients express a concern that they:

A. Will become a burden
B. Want to die slowly
C. Cannot live forever
D. Have their favorite music playing while they are dying

A

A. Will become a burden

36
Q

MyNursingLab Submodule 2.16 - Death and Dying

One of the main functions of the hospice bereavement program is to:

A. Help the family adjust
B. Help the dying person adjust
C. Request permission for transplant
D. Encourage lifesaving medical treatments

A

A. Help the family adjust

37
Q

MyNursingLab Submodule 2.16 - Death and Dying

The LPN is responsible for which action related to postmortem care?

A. Pronounce the time of death
B. Notify the family of death
C. Identify the body prior to its removal to the morgue
D. Recommend a funeral home

A

C. Identify the body prior to its removal to the morgue

38
Q

MyNursingLab Submodule 2.16 - Death and Dying

The nurse teaches the nursing assistant to concentrate on meeting which of these client needs in the terminal phase of dying?

A. Emotional
B. Social
C. Comfort
D. Therapeutic

A

C. Comfort

39
Q

MyNursingLab Submodule 2.16 - Death and Dying

The nurse asks the dying client’s family members to talk about funeral plans outside the client’s room, recognizing that the last sense to be lost is often:

A. Sight
B. Touch
C. Hearing
D. Smell

A

C. Hearing

40
Q

MyNursingLab Submodule 2.16 - Death and Dying

The nurse charts and reports to the physician the observed signs of approaching death, including:

A. Pink warm skin and bradycardia
B. Restlessness
C. Pallor and cool skin
D. Tachycardia and increase in blood pressure

A

C. Pallor and cool skin

41
Q

MyNursingLab Submodule 2.16 - Death and Dying

One of the nurse’s clients just expired. Minutes after he has been pronounced dead, his family arrives on the unit for a visit. The nurse’s best action is to:

A. Allow them time with their loved one
B. Have them return later to pick up his things
C. Tell them the body must be prepared for the morgue
D. Prepare and wrap the body, leaving only the head exposed so that they can see the person.

A

A. Allow them time with their loved one

42
Q

MyNursingLab Submodule 2.16 - Death and Dying

In providing postmortem care, the nurse instructs the nursing assistant to be sure to:

A. Pack the rectum with gauze packing
B. Position the client in a sitting position
C. Keep the client’s eyes open
D. Replace dentures in the mouth

A

D. Replace dentures in the mouth

43
Q

MyNursingLab Submodule 2.16 - Death and Dying

The nurse understands that sign of resolved grief is when:

A. The loss of appetite and lack of interest persist
B. Crying has ended
C. The person only cries when talking about the loss
D. The person remembers the good and the bad times.

A

D. The person remembers the good and the bad times.

44
Q

MyNursingLab Submodule 2.16 - Death and Dying

According to the teachings of Kubler-Roos, the dying client experiences which stage after denial?

A. Bargaining
B. Acceptance
C. Disbelief
D. Anger

A

D. Anger

45
Q

ATI Text Book - Chapter 33 (Coping)

A nurse is caring for a client whose partner passed away 4 months ago and who has been recently diagnosed with diabetes mellitus. He is tearful and states, “How could you possibly understand what I am going through?” Which of the following would be an appropriate response by the nurse?

A. “It takes time to get over the loss of a loved one.”
B. “You are right; I cannot really understand. Perhaps you’d like to tell me more about what you’re feeling.”
C. “Why don’t you try something to take your mind off your troubles, like watching a funny movie.”
D. “I might not share your exact situation, but I do know what people go through when they deal with a loss.”

A

B. “You are right; I cannot really understand. Perhaps you’d like to tell me more about what you’re feeling.”

46
Q

ATI Text Book - Chapter 33 (Coping)

A home health nurse performs a 3-day postpartum visit for a first-time mother. The household includes her husband, her mother, and her father. Which type of family form is represented here?

A. Nuclear
B. Extended
C. Blended
D. Alternative

A

B. Extended

47
Q

ATI Text Book - Chapter 33 (Coping)

Which of the following is the priority nursing intervention for a family with a history of violence?

A. Educating the family about anger management
B. Viewing the family in context
C. refining the family’s communication skills
D. Using the family’s strengths to define them

A

B. Viewing the family in context

Rationale:
The priority intervention is to collect more data to determine which family member(s) is a victim of abuse and needs assistance to be protected. Teaching anger management is a good strategy, but first there must be a family assessment to determine if there are anger safety issues. Refining communication skills and using family strengths are not the priorities if the safety of a family member is in jeopardy.

48
Q

ATI Text Book - Chapter 33 (Coping)

which of the following approaches should the nurse use when working with a family using an open structure for coping with crisis?

A. Prescribing tasks unilaterally
B. Delegating care to one member
C. Speaking to the primary client privately
D. Convening a family meeting

A

D. Convening a family meeting

49
Q

ATI Text Book - Chapter 33 (Coping)

Which of the following is considered a situational role change?

A. A toddler learning to control elimination
B. An adolescent experiencing puberty
C. A young adult getting married for the first time
D. A middle adult experiencing menopause

A

C. A young adult getting married for the first time

50
Q

ATI Text Book - Chapter 36 (Grief, Loss, and Palliative Care)

In which stage of grief, per Kubler-Ross, is a client who is terminally ill displaying when she states that she is going to a clinic for acupuncture?

A. Anger
B. Depression
C. Bargaining
D. Acceptance

A

C. Bargaining

51
Q

ATI Text Book - Chapter 36 (Grief, Loss, and Palliative Care)

A client is diagnosed with terminal cancer. The nurse observes the client’s family assisting with all ADLs. Which of the following rationales for self-care should the nurse communicate to the family?

A. Allowing the client to function independently will strengthen her muscles and promote healing.
B. The client needs to be given privacy at times for self-reflecting and organizing her life.
C. Her sense of loss can be lessened through retaining control of certain areas of her life.
D. Performing ADLs is required prior to discharge from an acute care facility

A

C. Her sense of loss can be lessened through retaining control of certain areas of her life.

52
Q

ATI Text Book - Chapter 36 (Grief, Loss, and Palliative Care)

Which of the following is a sign of impending death?

A. Elevated blood pressure
B. Warm extremities
C. Tense muscles
D. Labored breathing

A

D. Labored breathing