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level: chapter 25

Questions and Answers List

level questions: chapter 25

QuestionAnswer
what does coping mechanisms determinea persons ability to face and accept loss
life is a series oflosses and gains
what is another way to look at lossclassify it as maturational, situational, or both
example of maturational lossloss of childhood dreams, loss when adolescence romance fails, menopause, loss of hair or teeth
example of situational lossloss of job can lead to loss of self-esteem,
what does situational loss promoteemotional 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 individualto deal with loss throughout the life cycle
define griefthe subjective response to actual or anticipated loss; a natural, normal and universal part of human experience
morning patterns includefunerals, wakes, memorials, black dress, and defined time of social withdrawal
greif involvesthoughts, feelings, and behaviors
when is morbidity often seenafter significant losses; divorce, loss of a child or parent
grief can go on forever orcan 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 assmells, places, foods, dates, holidays, clothing, or other people
unresolved grief can result ifthe tasks are not completed and can lead to incomplete relationships and health problems
out-of-sequence deaththe 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 deathpowerful and emotions of guilt, denial, anger, sorrow
one protective impulse isto blame someone; perhaps oneself for not being more careful or more loving; possibly blaming the deceased person
define sense of presenceindividuals who have experienced a loss sometimes have a nonthreatening, comforting perception that the deceased is present
the sense of presence is apart of what processthe mourning process that occurs because the bond that continues between the bereaved loved ones and the deceased
when does the sense of presence occurduring the grieving process and beyond
define grief attacksinvoluntary and unexpected reappearance of emotions and behaviors associated with grief
what may cause a grief attackeating 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 copingtime, 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 dyingIndividual acts as though nothing has happened and may refuse to believe or understand loss has occurred
kubler-ross's anger stage of dyingindividual resist the loss and may strike out at everyone and everything
kubler-ross's bargaining stage of dyingindividual 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 dyingindividual feels overwhelmingly lonely and withdraws from interpersonal interactions
kubler-ross's acceptance stage of dyingIndividual 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 missingdoesn'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 grievingassess 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 harmfulto expect patients to progress in some specific manner over specified time
the theories on grief are to help the nurse anticipatepotential 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 deathdoes not understand the concept of death
5-9 yr old's influences on the concept of deathunderstands that death is final
9-12 yr old's influences on the concept of deathunderstands death as the inevitable end of life
12-18 yr old's influences on the concept of deathfears a lingering death
18-45 yr old's influences on the concept of deathhas attitude towards death influenced by religious and cultural beliefs
45-65 yr old's influences on the concept of deathaccepts own mortality
65+ influences on the concept of deathfears prolonged illness
what are the four types of complicated griefchronic grief, delayed grief, exaggerated grief, masked grief
define chronic griefactive 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 griefnormal 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 griefbecoming 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 griefsurvivors 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 hoursopen and never has a time limit
what is difficult to maintain during the dying processhope
what does the nurses challenge become as the patients condition deterioratesassisting 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 patientcomfortable and pain-free life, live long enough to participate in important family events such as a child's wedding
when hope is relinquisheddeath follows rapidly
passive euthanasiais permitting the death of a patient by withholding treatment that may extend life; such as medication, life support systems or feeding tubes
active euthanasiaassisting in such a death
what does it mean when survivors of someone who committed suicide become obsessed with their failurethey feel as the "should have seen the signs) and blames themselves
why might families of suicide victims avoid reaching out for helpsuicide 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 beat an increased risk for suicide themselves & a grief counselor is frequently helpful
in 2017 what was the 10th leading cause of death in the USsuicide at an average of 121 per day and for the year 44,193
what are the 3 most crucial needs for a dying patientlove and affection, control of pain, preservation of dignity and self worth
what are the changes in vitals when death is near for patientslow, weak and thready pulse; lowered bp; rapid, shallow, irregular, or abnormal slow respirations
define death rattlemucus collects in the patients throat, noisy respirations are heard
how is a patients skin when death is impendingcool and clammy; profuse diaphoresis may occur
define coronerpublic official, not necessarily a healthcare provider appointed or elected to inquire cause of death
define medical examinertrained health care provider and usually has advanced education in pathology or forensic medicine
Jews care of the body after deaththey dying person may want to make a deathbed confession or desire prayer
what must happen to the jews body after deathmust 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 ptan 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 deathno; the eyes should not be closed
what is immediate grief after Buddhist pt diesno noise, no crying is allowed, and organ donation is an individual choice
hoe should you document care on a dying patientobjectively, completely, legibly, and accurately
what should be documented as death approachesmake frequent documentation including the signs of impending death as they occur
after a patient dies what should the nurse documentwho 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 interventionsadequate nutrition, elimination, hygiene, safety, and comfort