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28 Cards in this Set
- Front
- Back
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Advanced Directives
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legal documents that direct end-of-life issues
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Living Wills
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Directive documents for medical treatment per PT's wishes
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Durable POwer of Attorney
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Document that appoints an individual to make medical decisions when a client is no longer able to do so on own behalf
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Necessary Loss
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Part of life cycle, anticipated but may still be intensely felt
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Actual loss
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Any loss of a valued person or item
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Perceived Loss
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Any loss defined by a PT that is not obvious to others
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Actual loss
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any loss of a valued person or item
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Maturational Loss
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Losess normally expected due to developmental processing of life
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Situational Loss
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Unanticipated loss caused by an external event
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5 stages of grief
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Denial, anger, bargaining, depression, acceptance
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Denial
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Difficulty believing terminal diagnosis or loss
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Bargaining
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Negotiates for more time or a cure
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Depression
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Saddened over inability to change situation
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Acceptance
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Accepts what is happening and plans for future
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Four Tasks of morning
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Accepting loss, using coping mechanisms to experience emotional pain of loss,changing environment to accommodate absence of the deceased, readjusting emotional ties to new individuals, and moving thoughts about the deceased to a less prominent place in everyday thoughts
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Factors influencing loss, grief, coping ability
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current stage of development
interpersonal relationships and social support network culture and ethinicity spiritual and religious beliefs and practices prior experience w/loss socioeconomic status |
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Dysfunctional grieving risks
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-Being dependent upon deceased
-Unexpected death at young age, thru violence, or by socially unacceptable manner -Inadequate coping/lack of support -Pre-existing mental health illness - like depression or substance abuse |
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Normal Grief
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Uncomplicated
emotions may be negative loss, such as anger, resentment, withdrawal, hopelessness, and guilt but should change to acceptance w/time Some acceptance should be evident by 6 mos somatic complaints - chest pain, palps, headaches, nausea, changes in sleep pattern, fatigue |
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Anticipatory Grief
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Implies the "letting go" of an object or person before the loss, as in the case of a terminal illness
Have opportunity to grieve before actual loss |
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dysfunctional Grief
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-Involves difficult progression thru the expected stages of the grieving process
-Usually the work of grief is prolonged, symptoms are more severe, and they may result in depression or exacerbation of a pre-existing disorder PT may develop suicidal ideation, intense feelings of guilt, and lowered self-esteem Somatic complaints persist for an extended period of time |
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Disenfranchised Grief
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Entails an experienced loss that cannot be publicly shared or is not socially acceptable - loss of loved one thru suicide
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Palliative Care can be provided by team of:
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Physicians, nurses, social works, massage therapists, OT, music/art therapists, touch/energy therapists
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S/S of approaching death
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-decreased LOC
-Muscle relaxation -Labored breathing -Mucus collection in lg airways incontinence mottling w/poor circulation nonreactive pupils weak pulse + dropping bp cool extremities perspiration decreased urine output inability to swallow |
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Physical Care
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Give priority to the control of symptoms
Admin meds that manage pain, air hunger, and ancxiety -Ongoing assessments |
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Prevention of abandonment and isolation
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-prevent fear of dying alone by...
-make presence known by answering call lights in a timely manner and making frequent contact -Keep PT informed of procedure/assessment times -Allow fam members to spend the night -Determine where the PT is most comy, such as in a room close to nurse's station |
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Deceased w/newborn
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-Swaddling the infant's body in a clean blanket
-Transporting the cradled infant in the nurse's arms or in a special infant carrier -Offering mementos of the infant (identification bracelets, footprints, cord clamp, lock of hair, photos) |
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Post Viewings of body (Stuff to do)
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-Apply identification tags according to the facility's policy
-Complete documentation -Remain aware of visitor and staff sensibilities during transport |
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Law about autopsies
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May require one if death due to homicide, an accident, or if death occurs w/in 24 hr of hospital admission
-Most facilities require that equiptment used during medical intervention - such as tubes, remain in place if an autopsy is planned |
