Adaptation To Loss (Basics In Nursing)

Front 1

(def)

loss felt in response to or in anticipation of an event; can be identified by others

Back 1

actual loss

Front 2

(def)

loss perceived by a person alone, may or may not be able to be identified by another person

Back 2

perceived loss

Front 3

(def)

loss surrounding a specific event, such as a job loss, loss of a child, etc.

Back 3

situational loss

Front 4

(def)

loss that occurs in the process of normal development (children leaving home, retirement, death of a parent)

Back 4

developmental loss

Front 5

What are 6 different sources of loss?

Back 5

- changes in self (burns, scars, aging)
- external environment (natural disasters)
- inanimate objects (theft)
- death (pet, person)
- familiarity (moving, new job, etc.)
- loved one (death, divorce, personality changes due to mental disorders)

Front 6

Is grief normal?

Back 6

Yes, it is a normal social process essential for normal mental health

Front 7

How long can grief take?

Back 7

as long as 3-5 years

Front 8

How long can bereavement last?

Back 8

more than a year

Front 9

What is mourning?

Back 9

the behavioral aspect of grief

Front 10

In the US, over ____% of people die outside of the home.

Back 10

50%

Front 11

(def)

agency that focuses on the care of the dying, assisting the family and client in a holistic manner; available 24/7

Back 11

hospice

Front 12

What is the largest qualifier for hospice care?

Back 12

death must be imminent, occurring in 6 months or less

Front 13

(def)

care that focuses on the symptoms, not curing the disease/disorder

Back 13

palliative care

Front 14

(def)

the total response to loss

Back 14

grief

Front 15

(def)

a normal grief reaction that is brief but genuinely felt

Back 15

abbreviated grief

Front 16

(def)

a normal grief reaction that occurs in advance of a loss

Back 16

anticipatory grief

Front 17

(def)

being unable to acknowledge a loss with another person

Back 17

disenfranchised grief

Front 18

(def)

grief that is extended in length and severity

Back 18

unresolved grief

Front 19

(def)

an unhealthy form of grief that is unresolved or inhibited

Back 19

dysfunctional grief

Front 20

What is "Closed Awareness"?

Back 20

The client and/or family is unaware of impending death; they don't completely understand why they are ill and believe they will recover

Front 21

What is "Mutual Response"?

Back 21

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

Front 22

What is "Open Awareness"?

Back 22

The client and people around know about the impending death and feel comfortable discussing it even though it is difficult

Front 23

What is the greatest benefit of "open awareness"?

Back 23

the client can finalize his/her affairs

Front 24

(def)

a subjective response to death experienced by survivors

Back 24

bereavement

Front 25

(def)

a behavioral process through which grief is resolved or altered

Back 25

mourning

Front 26

What are the 6 stages of grieving?

Back 26

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

Front 27

Which stage of grieving?:

stunned, acceptance but emotional denial

Back 27

shock/disbelief

Front 28

Which stage of grieving?:

reality begins to set in, they may become angry

Back 28

developing awareness

Front 29

Which stage of grieving?:

conducts rituals of mourning

Back 29

restitution

Front 30

Which stage of grieving?:

attempts to deal with the painful void, talks about memories

Back 30

resolving the loss

Front 31

Which stage of grieving?:

represses all negative and hostile feelings toward the deceased; internalized admired qualities

Back 31

idealization

Front 32

Which stage of grieving?:

behavior influenced by importance of the loss, degree of dependence, ambivalence towards the deceased, and the number of losses

Back 32

outcome

Front 33

True/False:

For the grieving process to be complete, a person needs to progress through all 6 stages.

Back 33

False- a person may or may not progress through all stages. Some may be completely bypassed, and at other times, a person may become stagnant in a particular stage.

Front 34

What are the 5 Stages of Loss/Dying?

Back 34

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

Front 35

How should a nurse deal with a client in the denial phase?

Back 35

Verbally support the client.

Front 36

How should a nurse deal with a client in the anger stage of loss/dying?

Back 36

- help the client understand it's a normal response to loss and powerlessness
- allow the client as much control as possible

Front 37

How should a nurse deal with a client in the bargaining stage of loss/dying?

Back 37

- listen and encourage the client to talk

Front 38

How should the nurse deal with a client in the depression stage of loss/dying?

Back 38

- allow the client to express sadness
- communicate nonverbally
- Use therapeutic touch
- be with the client in person

Front 39

How should the nurse deal with a client in the acceptance stage of loss/dying?

Back 39

- encourage the client to participate as much as possible
- help family and friends understand the client's need for short, quiet visits

Front 40

What physical changes do you seen in the muscular system with impending death? (7)

Back 40

- loss of muscle tone
- relaxed facial muscles
- difficulty breathing
- difficulty swallowing/loss of gag reflux
- decreased peristalsis, nausea, flatulence, abdominal distention, retention of feces
- possible urinary and fecal incontinence due to decreased sphincter control
- diminished body movement

Front 41

What physical changes do you see in the circulatory system with impending death? (6)

Back 41

- diminished sensation
- mottling and cyanosis of extremities
- cold skin (begins in feet, later in hands, ears, nose)
- warmth if fever is present
- slower and weaker pulse
- decreased BP

Front 42

What changes in vital signs would you see with impending death? (5)

Back 42

- dyspnea (rapid, shallow, irregular, slow respirations)
- noisy breathing (death rattle due to mucous accumulation in throat)
- mouth breathing
- decreased BP
- slow, weak pulse

Front 43

What is the last sense to go?

Back 43

hearing

Front 44

What types of sensory impairment are expected with impending death? (2)

Back 44

- blurred vision
- impaired senses of taste and smell

Front 45

How quickly does rigor mortis occur after death? How long does it last?

Back 45

occurs in 2-4 horus, lasts about 96 hours

Front 46

What should the nurse do with a person's body after death to ease presentation at the funeral?

Back 46

lay the body supine and cross the palms on the abdomen

Front 47

What is algor mortis?

Back 47

the gradual decrease of body temperature after death

Front 48

How may degrees does the body temp drop every hour after death?

Back 48

1.8 degrees until room temp is reaches

Front 49

What is livor mortis?

Back 49

the breaking down of RBCs after circulation has ceased which discolors the surrounding skin; occurs in the lowermost/dependent area of the body

Front 50

What are 6 nursing responsibilities post-mortem?

Back 50

1. call the doctor
2. consider family/friends
3. body positioning
4. shroud
5. religious considerations
6. cultural considerations