Study Guide #28 Loss/grief Process

Front 1

Anticipatory grief

Back 1

the process of disengaging on "letting go" that occurs before an actual loss/death has occurred

Front 2

maturational loss

Back 2

includes any change in the devolopmental process that is normally expected druing a lifetime

Front 3

situational loss

Back 3

includes any sudden, upredictable external event

Front 4

bereavement

Back 4

includes grief and mourning---the inner feelings and outward reactions of the survivor

Front 5

grief

Back 5

the emotional response to a loss

Front 6

What is Kubler-Ross's five stages of dying?

Back 6

Denial
Anger
Bargaining
Depression
Acceptance

Front 7

What is Bowlby's four phases of mourning?

Back 7

Numbing
Yearning/searching
Disorganization/despair
Reorganization

Front 8

What is Worden's four tasks of mourning?

Back 8

-Accepting the reality of loss
-Working through the pain of grief
-Adjusting to the environment w/out the deceased
-Emotionally relocating the deceased & moving on w/life

Front 9

What are the symptoms of normal grief?

Back 9

-feelings
-physical sensations
-congnitions (thought patterns)
-behaviors

Front 10

What are examples of feelings (symptoms of normal grief)?

Back 10

sadness, anger, guilt or self-reproach, anxitey, loneliness, helplessness, fatigue, shock/numbness (lack of feeling), yearning, emancipation/relief

Front 11

What are examples of physical sensations (symptoms of normal grief)?

Back 11

hollowness int he stomach, tightness int he chest, tightness int eh throat, oversensitivity to noies, sense of depresonalization ("nothing seems real"), feeling short of breath, muscle weakness, lack of energy, dry mouth

Front 12

What are examples of cognitions-thought patterns- (symptoms of normal grief)?

Back 12

disbelief, confusion, preoocupation about the deceased, sense of the presence of the deceased, hallucinations, hoplessness (I'll never be OK again")

Front 13

What are examples of behaviors (symptoms of normal grief)?

Back 13

sleep disturbance, appetite disturbances, absentiminded behavior, dreams of the deceased, sighing, crying, carrying objects that belonged to the deceased

Front 14

Affective dimension

Back 14

show empathic understanding of the client's strengths. reinforce expression of courage, positive thinking, and realisitic goal setting. encourage expression of both positive and negative feelings

Front 15

Cognitive dimension

Back 15

offer information about the illness and correct any misunderstanding or misinformation. clarify or modify the client's perceptions

Front 16

Behavioral dimension

Back 16

assist the client in using personal resources and making use of external supports to balance need for independence with healthy interdependence and dependence

Front 17

Affiliative dimension

Back 17

encourage clients to foster suportive relationships with others

Front 18

temperoral dimension

Back 18

focus on short-term goals as life expectancy diminishes

Front 19

contextual dimension

Back 19

encourage development of achievable goals. reminisce about achievements or positive moments in time so client can derive menaing from suffering

Front 20

palliative care

Back 20

the prevention, relief, reduction, or soothing of symptoms of disease or disorders w/out effecting a cure

Front 21

hospice care

Back 21

an alternative care delivery model for the terminally ill

Front 22

when caring for clients who have experienced a loss, what should the nurse do?

Back 22

facillitate the grief process by assisting survivors in feeling the loss, expressing the loss, and moving through the tasks of the grief process

Front 23

loss comes in many forms based on?

Back 23

the values and priorities learned w/in a person's sphere of influence, including family, friends, society, and culture.

Front 24

The type of loss and the perception of the loss influence:

Back 24

the degree of grief a person experiences

Front 25

Death is difficult for?

Back 25

the dying person, as well as for the person's family, friends and caregivers

Front 26

Survivors go through a bereavement period that is not linear; rather:

Back 26

an individual will move back and forth through a series of stages and/or tasks many times, possibley extending over a period of several years.

Front 27

a nurse's knowledge of the types of grief allows for:

Back 27

the implementation of appropriate bereavement interventions

Front 28

the was an individual perceives & responds to loss is influenced by:

Back 28

one's development, psychosocial perspectives, socioeconomic status, personal relaiotnships, nature of loss, culture and spiritual beliefs.

Front 29

nursing interventions involve :

Back 29

reinforcement of clients' successful coping mechanisms and introduciton of new comping approaches such as the promotion of hope.

Front 30

When assessing clients in grief, the nurse:

Back 30

does not assume how or if clients experience grief or that a particular behavior indicates grief; rather the nurse allow clients to share what is happening in their own way.

Front 31

A nurse must assess the terminally ill client's and family's wishes for end-of-life care, including:

Back 31

the preferred place for death, the level of life-sustaining measure to employ and expectations regarding pain dn symptom management

Front 32

The nurse develops a plan of care by:

Back 32

integrating clients' resources such as physical energy and activity tolerance, supportive family members, spirtitual faith, and methods for coping.

Front 33

The nurse establishes a caring presence and:

Back 33

employs therapeutic communication stragegies that enable clients to discuss their loss and find ways to resolve it.

Front 34

Palliative care:

Back 34

allows clients to make more informed choices, achieve better alleviation of syptoms, and hve more opportunity to work on issues of life closure.

Front 35

A nurse can promote a client's self-esteem and dignity by:

Back 35

taking a therapeutic stance that conveys respetct for the client as a whole person

Front 36

Hospice is not a facility but:

Back 36

a concept for family-centered care designed to assist the client in being comfortable and maintaining a satisfactory lifestyle until death.

Front 37

A child is grieving over the loss of a favorite toy. this is an example of:

Back 37

actual loss

Front 38

a middle-age man comes to a community clinic for his annual flu examination. in the discussiion w/the nurse she learns that he still works at a local law firm. however, he has recently lost two important cases & his boss has been applying pressure on him "to turn it around." the client may be experiencing:

Back 38

perceived loss

Front 39

the community health nurse's job is to provide a grief counseling for the community residents where a major flood has occurred. the loss associated with flooding is best described as:

Back 39

situational loss

Front 40

the client has been diagnoses w/terminal brain cancer. when the nurse visits him during rounds, he asks her whether the cancer could ahve been caused by something he ate or perhaps exposure to smoe chemical toxin. the client is likely experiencing:

Back 40

Bowlby's phase of disorganization and despair

Front 41

according to Kubler-Ross's stages of dying, during this phase, the client may feel overwhelmingly lonely and withdraw from interpersonal interaction.

Back 41

Kubler-Ross's stage of depression

Front 42

Since the death of his wife, the client has assumed full responsibiltiy for the care of his children. He has noticed over the last few eeks that friends calling less often. he is most likely in the following phase of mourning:

Back 42

Worden's task III of mourning

Front 43

a factor that uniquely influences an older adult's grief response is:

Back 43

sense of contributions in life

Front 44

"Client will be able to discuss expected course of disease" is an example of a:

Back 44

goal

Front 45

A 16 yo client has been admitted to the ICU after suffering a closed head injury. the physician & nurse are preparing to approach the faimily to consider donation of the heart & lungs. when working w/families in this situation, it is important to explain that:

Back 45

the ventilator and other life support equipment maintains oxygen and organ perfusion until the organs can be removed.

Front 46

this type of care allows clients to make more informed choices, achieve better alleviation of symptoms, and have more opportunity to work on issues of life closure:

Back 46

palliative care

Front 47

Which statement about loss is accurate?
1. loss is only experienced when there is an actual absence of something valued.
2. the more an individual has invested in what is lost, the less the feeling of loss.
3. loss may be maturational, situational, or both.
4. the degree of stress experienced is unrelated to the type of loss.

Back 47

3-loss may be maturational, situational, or both

Front 48

The developmental stage at which the child is first able to understand logical explanations about death is:

Back 48

school age

Front 49

a hospice program emphasizes:
1. curative treatment and alleviation of symptoms.
2. palliative treatment and control of symptoms
3. hospital-based care
4. prolongation of life

Back 49

palliative treatment and control of symptoms

Front 50

Trying questionable and experimental forms of therapy is a behavior that is caracteristic of which stage of dying?
1. anger
2. depression
3. bargaining
4. acceptance

Back 50

acceptance

Front 51

All of the following are crucial needs of the dying client except:
1. control of pain
2. preservation of dignity and self-worth
3. love and belonging
4. freedom from decision making

Back 51

freedom from decision making

Front 52

Doug Brown is a 70yom who comes to the neighborhood health clininc. after an eye examination, his physician explains that he has senile cataracts, which explains his progressive visula loss. Mr Brown's situation could be described as a:

Back 52

Maturational loss

Front 53

A client who exhibits terminal reslessness can best be assessed by:

Back 53

reviewing laboratory values

Front 54

When preparing a body after death, you should not close the eyes of a client who practices which of the folloing religions:

Back 54

Buddhism

Front 55

A priority in palliative care is symptom management. A principle to follow in symptom management is:

Back 55

recognize that the dying client's symptoms are very real