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53 Cards in this Set

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Is disenfrancized grieving healthy?
yes it can be, the feelings are felt privatly but not expressed publicly
What is hospice care
end of life care foced on the support and care of the dying person and family. with the goal of a peaceful and dignafied death (usually has doctore certification of death around 6 months
slowing circulation is a clinical sign of impending death. What are the results of the slowing circulation
Diminished sensation; Mottling and cyanosis; Cold skin; Slowed B/P
changes in respriation is a chinical signs of impending death. what are the results of this change in respirations
Rapid, shallow, irregular or abnormally slow respiration;
Noisy breathing called the death rattle caused by collecting of mucus in the throat; Mouth breathing resulting in dry oral mucus membranes
what is palative care
an approach to end of life care that is for improving quality of life of the client with terminal illness (can be any length of time) Can be used in conjunction of therapies that prolong life
What is end of life care
care provided in the final weeks of life; Provides clean, dry and comfort to the client and post morten and family support
What is rigor mortis
Stiffening of the body 2-4 hours after death; Caused by lack of ATP which causes the muscles to contract; It leaves the body at about 96 hours after death
What is algor mortus
The gradual decrease in the body's temperature after death
what is Livor Mortis
The discoloration of tissue after blood circulation has ceased. it appears in lower or dependant areas of the body.
Loss can be...
Situational or developmental a nd either actual or percieved (both of which can be anticipatory
the 2 main nursing goals for dying clients
1. Maintain physiological and psychological comfort
2. achieving a dignified and peaceful death which includes maintaining personal control a nd accepting declining health
What should nurses provide to dying clients to ensure a peaceful and dignified death
1.Open communication
2. Physical help
3. Emotional and spiritual support
4. Maintain a sence of control
What is the major responsibility as a nurse to the dying client
A peaceful and dignafied death; How: minimizing loneliness, fear and depression; maintain clients sense of security and self worth; help client to accept losses a nd provide physical comfort
What is loss
An actual or potential situation in which something that is valued is changed or no longer available
What are the types of loss?(3)
Actual
Perceived
anticipatory
describe acutal loss
Can be recognized by others
Describe Perceived Loss
Experienced by one person, but maybe not by others. Cannot be verified by other; EX: loss of youth
describe anticipatory loss
Experience of loss before it happens
What are some sources of loss?
1.loss of life
2. loss of an aspect of oneself
3. Loss of an object
4.Seperation from accustomed environment
5. Loss of loved or valued person
6. Situational loss
7. developmental loss
what is situational loss
V.S.
Developmental loss
Situational can hapeen at any age EX: accident, job loss
Development occurs at certain age or development of life
What is greif
" The emotional response to loss" the total responce to the emotional experience reatled to loss; Is essential for good mental a nd physical health; is a social process
Describe Bereavement
a subjective responce to death of a person whom you have had a relationship with.
What is anticipatory grief
Grief experienced in advance; therefore when the loss actually happens the reaction will be diniished because the expression of grief has already began
What is mouring
The behavior process through which grief is resolved or altered; it is often enfluencedby culture, spirtiual and customs of the person
What is disenfranchised Grief
you are unable to achnowledge the loss to others or pubicly but privatly the feelings are felt
what is complicated grief
it is unhealthy grief; coping stratigies are maladaptive; can be unresolved or ihibited grief
What are the types of grief (4)
1. anticipatory
2. Abbreviated
3. disenfranchized
4. complicated (can be unresolved or inhibited)
What are forms of unhealthy complicated Grief
1. Unresolveed or chronic grief(extended time and severity)
2. delayed grief(purposefully or subconciously suppressed)
3. inhibited grief
4. Exaggerated Grief(person used dangerous activities to lessen the pain of grieving)
What are the 5 stages of Kubler-Ross's framework of grief
Denial
Anger
Barganing
Depression
Acceptance
5 things that can contribute to unresolved grief
1.Mulitple losses
2. intense feelings toward the person
3. Need to be brave
4. Lack of support
5. extreme value of the person
6. Uncertainty (EX: missing in action, no body found)
why is it improtant that a nurse recognise Kubler-Ross's stages of greiving
So that you realize these are the actual steps and nrmal sequence of a persons actions. The nurse should not deny the steps but verbally re-enforce and not support. Understand that anger needs the right channel for expression
what are the 7 commom factors that can affect loss and grieving responses
1. age 2. culture 3.gender 4.socio-econoic status 5.support system 6.cause of loss of death 7. significance of the loss
how can age affect grieving
The kinds and amount of experiences will influence the perspective of the person.
What are the common clinical symptoms of grief
sleep distrubance; loss of appetite; Difficulty concentration, Fatigue; Lonelyness; Forgetfullness; confusion
what are common symptoms of complicated grief
1. extended time of denial
2. extended time of depression
3. severe physio symptoms
4. Suicidal thoughts
5. severe psychological signs and symptoms
Differentiate normal to complicated grieving
Normal grieving is a normal process whereas complicated grieving is a disorder
what is the overall nursing goals for grieving clients
resolution
what are the beliefs and attitude of ages 0-5 about death (pre-school aged)
they believe it is reversable or temporary- sleeping; they dont really understand or are unaware of what death is
What are the belief or attitudes of 5-9 year olds about death
they understand that death is final; They believe death can be avoided; they may believe that they are responsible; may associated death with aggression or violence
What are the beleifs or attitudes of 9-12 year olds about death
they understand that death is the inevitable end of life. they are begining to understand their own moratlity; they may pertend not to care; they may express an intrest in afterlife or fear of death; They start asking questions
what are the attitudes or beliefs of 12-18 year olds about death
fear of lingering death; Fantasizes that death can be defied; Reaches adult perception but unable to emotionally accept it; "its not going to happen to me but someone else"
what are the beliefs and attitudes of 18-45 year olds about death
Mostly influenced by religous or cultural beliefs
What are the beliefs and attitudes of 45-65 year olds about death
accepts own morality; encounters death of parent and peers; May experience death anxiety that diminishes with well being
What are the beliefs and attitudes of the 65+ aged about death
Fears prolonged illness; Sees death as freedom from pain and a reunion; worries about being a burden
What are some common fears of death
loss of control; What happens next; Pain of dying; Not being able to breath; Being alone; Loss of dignaty; The unknown
what are the 3 types of awareness associated with dying clients
closed awarenes
mutual pretense
Open awareness
Describe open awareness
all know the prognosis and are comfortable (even if hard to do) in discussing it
What is closed awareness
Client is not made aware of terminal prognosis
What is mutual pretense
All involved know the prognosis but dont talk about it. An effort is made not to bring up the subject; This puts a heavy burden on the dying person (they have no one to talk to)
What are the nurses asesment priorities in caring for dying clients and their families
1. it depends on the awareness
2. must be aware of physical signs of death
3. According to awareness prepare client and family(education)
4. if appropriate famil can start to thin about surrounding events (funeral ect)
what ae the clinical signs of impending or imminent death
1. loss of muscle tone
2. Slowing of circulation
3. changes in respirations
4. sensory impairment
What is the last sense to be loss prior to death
hearing
What are the nursing measures for care of the body after death
Religion and culturewill influence; Pillow under head; eyelids closed; dentures in; natural and comfortable look; not bath but clean; jewlery-policy but wedding ring may be taped on; Proper ID; remove soiled linen; Get rid of suction devices