| what does coping mechanisms determine | a persons ability to face and accept loss |
| life is a series of | losses and gains |
| what is another way to look at loss | classify it as maturational, situational, or both |
| example of maturational loss | loss of childhood dreams, loss when adolescence romance fails, menopause, loss of hair or teeth |
| example of situational loss | loss of job can lead to loss of self-esteem, |
| what does situational loss promote | emotional growth and the development of coping skills; used later in life to cope with even more significant losses |
| how can earlier experience with loss prepare an individual | to deal with loss throughout the life cycle |
| define grief | the subjective response to actual or anticipated loss; a natural, normal and universal part of human experience |
| morning patterns include | funerals, wakes, memorials, black dress, and defined time of social withdrawal |
| greif involves | thoughts, feelings, and behaviors |
| when is morbidity often seen | after significant losses; divorce, loss of a child or parent |
| grief can go on forever or | can lead to resolution of the hurt and the reestablishment of ones life |
| many years after a loss you can be reminded of the loss with things as simple as | smells, places, foods, dates, holidays, clothing, or other people |
| unresolved grief can result if | the tasks are not completed and can lead to incomplete relationships and health problems |
| out-of-sequence death | the sudden death of someone who is not "supposed to die"; also the most difficult grief to bear |
| what kind of emotions are felt with out-of-sequence death | powerful and emotions of guilt, denial, anger, sorrow |
| one protective impulse is | to blame someone; perhaps oneself for not being more careful or more loving; possibly blaming the deceased person |
| define sense of presence | individuals who have experienced a loss sometimes have a nonthreatening, comforting perception that the deceased is present |
| the sense of presence is apart of what process | the mourning process that occurs because the bond that continues between the bereaved loved ones and the deceased |
| when does the sense of presence occur | during the grieving process and beyond |
| define grief attacks | involuntary and unexpected reappearance of emotions and behaviors associated with grief |
| what may cause a grief attack | eating at a restaurant, certain foods, a thought of the loved one for no reason at all, hearing about a death or reading a similar death |
| when a loved passes the pain never goes away just gets easier to cope what helps coping | time, generally after some time the sadness is replaced with fond memories of the loved one except during special occasions such as birthdays and holidays |
| kubler-ross's denial stage of dying | Individual acts as though nothing has happened and may refuse to believe or understand loss has occurred |
| kubler-ross's anger stage of dying | individual resist the loss and may strike out at everyone and everything |
| kubler-ross's bargaining stage of dying | individual postpones awareness of reality of the loss and may try to deal in a subtle or overt way as the loss can be prevented |
| kubler-ross's depression stage of dying | individual feels overwhelmingly lonely and withdraws from interpersonal interactions |
| kubler-ross's acceptance stage of dying | Individual accepts the loss and looks forward to the future |
| according to worden's task of mourning what is adjust to environment in which the deceased is missing | doesn't realize full impact for a least 3 months; friends and associates stop calling, and the person is left to prey in loneliness; often the individual must take on roles formerly filled by the deceased |
| what is the nurses role to help a patient that's grieving | assess grieving behavior, recognize the influence of grief on behavior, and provide empathetic support |
| during the stages of grief and dying what is a mistake and possibly harmful | to expect patients to progress in some specific manner over specified time |
| the theories on grief are to help the nurse anticipate | potential needs of the patient and families; plan interventions to help patients understand their grief while trying to deal with it |
| infancy to 5 yr old's influences on the concept of death | does not understand the concept of death |
| 5-9 yr old's influences on the concept of death | understands that death is final |
| 9-12 yr old's influences on the concept of death | understands death as the inevitable end of life |
| 12-18 yr old's influences on the concept of death | fears a lingering death |
| 18-45 yr old's influences on the concept of death | has attitude towards death influenced by religious and cultural beliefs |
| 45-65 yr old's influences on the concept of death | accepts own mortality |
| 65+ influences on the concept of death | fears prolonged illness |
| what are the four types of complicated grief | chronic grief, delayed grief, exaggerated grief, masked grief |
| define chronic grief | active acute mourning characterized by normal grief reactions that do not decrease but persist over long periods of time; verbalized as an inability to "get past" the grief |
| define delayed grief | normal grief reactions that are suppressed or postponed; the survivor consciously or unconsciously avoids the pain of the loss; grieving is held back only to resurface later |
| define exaggerated grief | becoming overwhelmed with grief and can't function; reflected in the forms of phobias or self destruction such as alcoholism, substance abuse, or suicide |
| define masked grief | survivors are not aware that behaviors that interfere with normal functioning are a result of their loss; like a person who lost a pet has changes in sleeping or eating patterns develop |
| if a patient is on hospice what are the visiting hours | open and never has a time limit |
| what is difficult to maintain during the dying process | hope |
| what does the nurses challenge become as the patients condition deteriorates | assisting the patient and family in translating their hope for a cure into realistic hopes that focus on short term achievable goals |
| what are some realist hopes the nurse can help focus on with the family and patient | comfortable and pain-free life, live long enough to participate in important family events such as a child's wedding |
| when hope is relinquished | death follows rapidly |
| passive euthanasia | is permitting the death of a patient by withholding treatment that may extend life; such as medication, life support systems or feeding tubes |
| active euthanasia | assisting in such a death |
| what does it mean when survivors of someone who committed suicide become obsessed with their failure | they feel as the "should have seen the signs) and blames themselves |
| why might families of suicide victims avoid reaching out for help | suicide is sometimes not considered acceptable; many families of suicide victims are not given the same support from the church, community, or workplace as those who have died from other causes |
| survivors of suicide victims is complicated and intense and me be | at an increased risk for suicide themselves & a grief counselor is frequently helpful |
| in 2017 what was the 10th leading cause of death in the US | suicide at an average of 121 per day and for the year 44,193 |
| what are the 3 most crucial needs for a dying patient | love and affection, control of pain, preservation of dignity and self worth |
| what are the changes in vitals when death is near for patient | slow, weak and thready pulse; lowered bp; rapid, shallow, irregular, or abnormal slow respirations |
| define death rattle | mucus collects in the patients throat, noisy respirations are heard |
| how is a patients skin when death is impending | cool and clammy; profuse diaphoresis may occur |
| define coroner | public official, not necessarily a healthcare provider appointed or elected to inquire cause of death |
| define medical examiner | trained health care provider and usually has advanced education in pathology or forensic medicine |
| Jews care of the body after death | they dying person may want to make a deathbed confession or desire prayer |
| what must happen to the jews body after death | must not be left unattended until after the burial; a family member may remain present while the body os prepared by nursing staff, during transport to and in the morgue, and at funeral home |
| if you have a Buddhist pt who is dying who should care for the pt | an ordained monk or nun; after death the body should be covered with a cotton sheet |
| should a Buddhist pt body be touched or manipulated after death | no; the eyes should not be closed |
| what is immediate grief after Buddhist pt dies | no noise, no crying is allowed, and organ donation is an individual choice |
| hoe should you document care on a dying patient | objectively, completely, legibly, and accurately |
| what should be documented as death approaches | make frequent documentation including the signs of impending death as they occur |
| after a patient dies what should the nurse document | who was present at the time of death; and continue until you document your last entry; to whom and where the body was transferred |
| what are the physical care requirements of the dying patient that are primary nursing interventions | adequate nutrition, elimination, hygiene, safety, and comfort |
