Nursing Exam Death
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Types of Loss Include:
- Material Loss
- Psychological Loss
- Expected Loss
- Unexpected Loss
Terms Related to Grieving Include:
- Anticipatory Grief
The characteristic pattern of psychological and physiological responses a person experiences after the loss of a significant person, object, belief, of relationship.
A state of desolation that occurs as the result of a loss, particularly the death of a significant other.
Encompasses the social prescribed behavior after the death of a significant other.
Define Anticipatory grief.
The characteristic pattern of psychological and physiologica responses a person makes to the impending loss (real or imagined) of a significant person, object belief, or relationship.
Engel's Model of Grief is:
- 1.Shock and disbelief
- 2.Developing awareness
- 3.Restitution (mourning)
- 4.Resolving the loss (focus energy on deceased)
- 5.Idealizaion(neg feeling supressed)
- 6.Outcome (interest in new relationships)
- Last 1 year or longer
Parkes' Model of Grief is:
- 3.Disorganization (severe depression)
- 4.Reorganization 6-9mth post (interest in living)
- 2 years or longer
Grief Cycle Model is:
- 2.Protest 1wk-3mth drops level of function
- 3.Disogranization 3-6mth depression
- 4.reorganization 6-mth - 1yr+ increase level of function
Kubler-Ross' Stages of Dying is:
Hogan's Grief to Personal Growth Model proposes:
- 2 pathways to grief.
- 1.Grief to Growth Pathway
- 2.Mired to Grief Pathway.
Factors Affecting Grieving are:
- Meaning of the loss
- Circumstances of the loss
- Religious beliefs and cultural practices
- Personal resources and stressors
- Sociocultural resources and stressors
Physiological signs of Grieving are:
- Anorexia or GI disturbances
- Lack of Strength
- Physical exhaustion
- Fellings of emptiness and heaviness
Altered Grieving is:
- Dysfunctional Grieving.
- Manifestations of Altered Grieving
What is Dysfunctional Grieving?
Grief that falls outside the normal response range and may manifested as exaggerated grief, prolonged grief, or absence grief.
Subjective Data for Grief Assessment include
- Normal Pattern Identification - personal resources and personal stressors
- Risk Indentifications - Analysis of resources
- Dysfunction Identification - prolonged grief
Objective Data for Grief Assessment include
- Dejected physical appearance
- Slow Motor Function
- Outbursts of anger
- Emotional blunting
- Unkept appearance
- Sleep disturbances
- Appetite disturbances (excessive weight loss or gain)
Nursing Dx Statements for Grieving Includes
- Anticipatory Grieving
- Dysfunctional Grieving
Anticipatory Grieving is
Intellectual and emotional responses and behaviors by which individuals, families, and communities work thru the process of modifying self concept based on the perception of loss
Characteristics of Anticipatory Grieving include:
- Potential loss of significant object
- expression of distress at potential loss
- denial of potential loss
- choked feelings
- changes in eating habits
- alterations in sleep patterns/activity level
- altered libido
- altered communicaiton patterns
Dysfunctional Grieving is:
Extended unsuccessful use of intellectual and emotional responses by which individuals families and communities attempt to work through the process of modifying self-concept based on the perception of loss.
Characteristics of Dysfunctional Grieving include:
- Verbal expression of distress at loss
- denial of loss
- Expression of guilt or expression of unresolved issues
- Sadness or crying
- Difficulty in expressing loss
- Alterations in eating, sleep, dream, activity or libido.
Outcome Identification and Planning
- Moving toward resolution of diverse emotions
- Accepting the reality of the loss
- Reinvesting emotional and physical energy in meaningful people and activities.
- Client teaching
- Working through grief stages
- Encouraging support groups
- Nursing interventions for altered grieving
- Healthcare planning and home community based nursing
- Possible Outcome Criteria
Nursing Dx for the Dying Patient Include
- Deficient Fluid Volume
- Imbalanced Nutrition - Less than body requirements
- Impaired Gas Exchange
- Interruped Family Process
- Ineffective Coping
- Caring for the Deceased
End of Life Care
- Issues related to death and dying
- Concluding phase of and individual's life span
- Focus on physical and psychosocial needs of patient and patient's family
Goals of EOL Care
- Provide Comfort and supportive care during dying process
- Improve quality of remaining life
- Help ensure a dignified death
Physical Manifestations of EOL Care
- Death Occurs when all vital organs and systems cease to function
- Metabolism is decreased
- Body gradually slows down until all function ends
- Respiratory generally ceases first
- Heart stops beating within a few minutes of respiratory shutdown
- Cessation of Heart-lung Function
- Cessation of Whole Brain Function
- Cessation of Higher-Brain Function
The ability to perceive and reason, as well as the ability to communicate understanding of the other person's feelings and their attached meanings, is a core characteristic of a helping relationship.
Define Sympathy -
The fact or power of sharing the feeling of another especially in sorrow or trouble; fellow feeling compassion or commiseration.
To have empathy a nurse must:
- Have enough knowledge and experience to perceive the client's perpective accurately.
- Feel secure enough not to be intimidated if the client experiences a situation differently.
- Feel comfortable enought to be able to imagine what a stiuation might be like for someone else, while remaining outside that situation to maintain objectivity.
- Convey to the client that the nurse perceives the client's feelings, thoughts and experiences accurately.
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