Term
•Stages of Death and Dying |
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Definition
–Denial
–Anger
–Bargaining
–Depression
–Acceptance |
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Term
| NURSES-PROVIDING TERMINAL CARE |
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Definition
•Hydration- adequate fluid volume
•Nourishment- little interest in eating -may choose a tube feeding or total parenteral nutrition
•Elimination- incontinent of urine/stool or may have retention of urine and constipation
•Skin care very important-potential for skin breakdown R/T incontinence
•Hygiene-keep dying clients clean, well groomed, free of unpleasant odors-frequent mouth care
•Positioning- lateral position helps prevent choking or aspiration-Change & reposition every 2 hours or more if possible |
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Term
| Approaching Death: MULTIPLE ORGAN FAILURE |
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Definition
•Two or more organ systems gradually cease to function
•Oxygen begins to fall below levels required to sustain life, cells, followed by tissues and organs ----begin to deteriorate
- Heart
- Skin
- Liver
- Lungs
- Kidneys
- Brain
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Term
| Approaching Death: Family Notification |
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Definition
•NOTIFY physician first
–Nurse informs family that death is approaching
–If death has occurred already--- physician is responsible for notifying family
–Meeting family/relatives
–Nurse or other support person- meets family and informs them
–Private room if possible or client’s bedside
•Be aware that people show their grief in different ways |
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Term
|
Definition
•Process of feeling acute sorrow over a loss |
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Term
•Psychological reactions – Stages of Grief |
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Definition
–Shock and disbelief
– Developing awareness
– Restitution period
– Idealization
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Term
Physical symptoms
of grief |
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Definition
| anorexia, difficulty breathing & sleeping, tightness in throat & chest, lack of strength |
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Term
•Pathologic or Dysfunctional Grief |
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Definition
Cannot accept someone’s death
- Manifest bizarre or morbid behaviors |
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Term
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Definition
| No standard length of time for “normal” grieving |
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Term
•Signs of resolving grief: |
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Definition
Able to talk about the deceased without becoming too emotional
- Describing the deceased's good and bad qualities
•Important to accept and support all in whatever stage they are in
–try not to direct progress
Nurses- need to be available for comfort |
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Term
| Nursing Interventions with Grieving Clients |
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Definition
Attentive listening
- Silence
- Open and closed questioning
- Paraphrasing
- Clarifying and reflecting feelings
- Summarizing
- Use communication relevant to client’s stage of grief |
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Term
| Nursing Process to use in the case of grief |
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Definition
•Interventions
•Supportive care—Be there for client-family
- Assist with ADLs
- Turn & reposition at least q 2 hours
- Monitor VS, skin, I & O
- Assess cognitive status, depression, anxiety
- Administer pain meds-monitor effectiveness & side effects
-Provide nutrition & fluids
- Allow client/family to express fears
-Provide education & information |
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Term
Legal Definitions
•Advanced Health Care Directives
•Living Will
•Health Care Proxy
•DO-NOT-Resuscitate (DNR)
•DNI – Do Not Intubate
DHN - do not hospitalise |
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Definition
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