z FALL06 LOSS & GRIEVING Nursing Dee
Terms
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- Grief experienced in advance of the event is?
- Anticipatory Grief
- A subjective response of a person whohas experienced the loss of a significant other through death is called?
- Bereavement
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The state in which an individual or group experiences prolonged or unresolved grief & engages in detrimental activities is called?
still birth &/or fetal demise - Dysfunctional Grief
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Emotional suffering often caused by bereavement?
80% - Grief
- An actual or potential situation in which a valuaed ability, object, or person is inaccessible or changed so that it is perceived as no longer valuable is ?
- Loss
- The process through which grief is eventually resolved or altered?
- Mourning
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Identifying ______of fetal loss assists many families in progressing through the grieving process.
identifying the causitive factor - identifying the causitive factor
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An individuals total response to a loss, including physical symptoms, thoughts, feelings, fuctional limitations, & spiritual reactions is called?
a. grief - grief
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Behaviors such as weeping or visiting a gravesite is known as?
mourning - Behaviors such as weeping or visiting a gravesite is known as?
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A period of adjustment when individuals mourn and grieve over loss is known as?
a. bereavement - bereavement
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The five stages of grieving are?
a. denial, anger, bargaining, depression, acceptance - denial, anger, bargaining, depression, acceptance
- Once fetal demise is established it is important to first ...?
- assess the family members ability to adapt to their loss
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Assessing the family members ability to cope with fetal demise is:
open communication between mother, partner & healthcare team members
discussion of prior experiences with loss & coping abilities at that time
ide - Assessing the family members ability to cope with fetal demise is:
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When death has been determined, who informs the family?
a. Physician
b. RN
c. CNM
d. Chaplain - physician &/or CNM
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Nursing diagnosis that may apply in the event of fetal demise &/or infant death may include:
ANTICIPATORY GRIEVING RT immenent loss of a child
POWERLESSNESS RT lack of control in current situational crisis
INEFFECTIVE -
ANTICIPATORY GRIEVING RT immenent loss of a child
POWERLESSNESS RT lack of control in current situational crisis
INEFFECTIVE DENIAL RT the unexpected death of the fetus
COMPROMISED FAMILY COPING RT the death of a child/unresolved feelings regarding perinatal loss
INTERRUPTED FAMILY PROCESSESS RT fetal demise
HOPLESSNESS RT sudden, unexpected fetal loss
RISK FOR SPIRITUAL DISTRESS RT intense suffering secondary to unexpected fetal loss -
When fetal death has occurred before admission, the entire staff on the unit is informed so they can?
avoid making inappropriate remarks - When fetal death has occurred before admission, the entire staff on the unit is informed so they can?
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Upon arrival to the facility, the couple with a known or suspected fetal demise should?
immediately be placed in a private room - Upon arrival to the facility, the couple with a known or suspected fetal demise should?
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When possible, a woman with a known or suspected fetal demise should be placed in a room that is ?
a. farthest away from other laboring women - farthest away from other laboring women
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When a couple arrives to a facility who have a known or suspected fetal demise, take care to?
not leave them in a waiting room with expecting parents or visitors waiting for news from other women in labor - When a couple arrives to a facility who have a known or suspected fetal demise, take care to?
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It is important to allow a couple facing known or suspected fetal demise to remain together, provide privacy, & maintain a supportive environment and?
give complete information about what to expect & what will happen - give complete information about what to expect & what will happen
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When a couple is facing a known or suspected fetal demise, it is important that the RN?
Stay with the couple so they do not feel alone & isolated
& continuously assess cues that they want to be alone
Provide for the cou - When a couple is facing a known or suspected fetal demise, it is important that the RN?
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When couples are facing fetal demise & are asking questions, the RN should?
Provide clear explanations & straightforward answers
Arrange for other multidisciplinary team members interact with the family
Arrange fo - When couples are facing fetal demise & are asking questions, the RN should?
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In the event of fetal demise the RN should?
Explain the plan of care & allow the family to ask questions
Allow family to make decisions for their labor & birth preferences
Review availability of anesthesia & a -
Explain the plan of care & allow the family to ask questions
Allow family to make decisions for their labor & birth preferences
Review availability of anesthesia & analgesia
Facilitate the participation of the woman & her partner in the labor & birth process -
In the event of fetal demise, it is imperative that?
The couple & family have all wishes & preferences respected - The couple & family have all wishes & preferences respected
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In the event of fetal demise, the RN may assist the couple in making decisions about who is present & what rituals will occur during & following birth such as?
music, lighting & other environmental preferences
laboring o - In the event of fetal demise, the RN may assist the couple in making decisions about who is present & what rituals will occur during & following birth such as?
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Advocates of seeing the stillborn infant believe that viewing assists in?
dispelling denial
enables the couple to progress to the next step in the grieving process - Advocates of seeing the stillborn infant believe that viewing assists in?
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If couple chooses to see their stillborn infant, prepare them for what they will see by saying?
Examples:
"she is going to feel cold"
"he is going to be blue"
"her face is bruised" - If couple chooses to see their stillborn infant, prepare them for what they will see by saying?
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A common practice when presenting the stillborn infant to parents is to?
wrap the infant in a blanket
apply a hat to cover birth defects
this allows time for parents to adjust to the appearance at their own pace - A common practice when presenting the stillborn infant to parents is to?
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In the even of fetal demise, discharge should include?
Information on the grief process
Prepare couple by stressing that others may not know what to say
Stress that even loved ones may make inappropriate comments - In the even of fetal demise, discharge should include?
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It is important to have collegues & family members available for counceling & support for the RN caring for a couple in the event of fetal demise because?
the nurse experiences many of the same grief reactions as the parents of a still - It is important to have collegues & family members available for counceling & support for the RN caring for a couple in the event of fetal demise because?
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In old age, the individual experiences many losses such as changes in physical & mental capabilities. How does a loss of an aspect of oneself affect the elderly?
a The older persons self image is vulnerable
b. It is anticipated - The older persons self image is vulnerable
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A client whose child died in a MVA states " I know I should grieve but I just don't have the time. My other children need me & I can't be crying." The nurse's most therapeutic response is:
a. You are right, you should be grieving - It must be hard on you & your children. Sounds like you are trying very hard to hide your grief, however, working through your grief is important for you to remain healthy.
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Which of the following exemplify contributory factors of unresolved grief after a death?
a. an individual grieved in advance of an amputation of a limb.
b. An individual survives after a fire killed all of the family members.
< - An individual survives after a fire killed all of the family members.
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Which of the following characterizes the beliefs & attitudes about death of an adolescent?
a. Associates death with violence & aggression
b. Begins to understand own mortality expressed as fear or death
c. May fan - May fantasize that death can be defied & acting out through reckless behaviors.
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The spouse of a client has persistently refused to believe that the illness is terminal & that nothing can be done to prevent death. In what way can the nurse be helpful to the client's spouse?
a. Examine own behavior to ensure not sharing - Examine own behavior to ensure not sharing the denial
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In assessing a client who will be undergoing a lung resection, the nurse understands the significance of losing a body part. Which of the following questions is most appropriate to ask during the assessment?
a. What changes do you think theis - What changes do you think this surgery will cause in your life?
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A client thinks that death can be prevented by going to the faith healer in a foreign land but believes it might be too late & too expensive. What is the most appropriate nursing diagnosis for this client?
a. Powerlessness
b. Ho - Powerlessness
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The client, family, & health care personel know that the prognosis is terminal & are in mutual pretense. What effect does this have on the dying person?
a. It permits some degree of privacy but also becomes a burden as there is no one - It permits some degree of privacy but also becomes a burden as there is no one in whom to confide
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What is a therapeutic strategy to communicate with a client who is dying?
a. Encourage client to be as silent as possible to save energy
b. Stay with client & talk about pleasant events
c. Acknowledge the clients disc - Acknowledge the clients discomfort or struggle
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What is the best route for administering pain medication to a dying patient?
a. Intravenous infusion
b. Oral
c. Subcutaneous
d. Intramuscular - Intravenous infusion
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Associating death with violence & aggression is characteristic of?
a. 3-7 years of age
b. 5-9 years of age
c. 9-12 years of age
d. 12-15 years of age - 5-9 years of age
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Beginning to understand ones own mortality expressed as a fear of death is characteristic of?
a. 3-7 years of age
b. 5-9 years of age
c. 9-12 years of age
d. 12-15 years of age - 9-12 years of age
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Fantasizing that death can be defied & acting out through reckless behaviors is characteristic of?
a. preschoolers
b. adolescents
c. Young adults
d. Middle aged adults - adolescents
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Experiencing peaks of death anxiety is characteristic of?
a. adolescents
b. Young adults
c. Middle aged adults
d. Older adults - Middle aged adults