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undefined, object
copy deck
-refers to no longer possessing or having an object, person or situation
Eq of loss
-losing money,
-a job,
-one's health or
What is the most difficult loss to accept?
-one's own death
-the emotional feeling of pain & distress in response to a loss
Grieving process
-a process that occurs over a period of time as a person adapts to and moves through the pain of loss
-State of having suffered a loss by death
Anticipatory grieving
may occur before a loss actually happens
dysfunctional grieving
-when it falls outside the normal responses
Death or dying
-the cessation of all physical & chemical processes that invariably occurs in all living organism; a stage of life
brain death
the permantent stopping of integrated functioning of the person as a whole
-philosophy of care for the dying
-study of death
Kubler-Ross's stages of coping with death

Hope for cure
Hope for treatment
Hope for prolonged life
Hope for peaceful death
-an inner positive life force, a feeling that what is desired is possible
Comfort care
-focused on identifying symptoms that cause the patient distress & adequately treating those symptoms
-relief of symptoms when cure is no longer possible
Nsg diagnosis for the pt who is dying
-activity intolerance
-death anxiety
-anticipatory grieving
-imbalanced nutrition: less than the body requirement
-risk of loniless
-impaired physical mobility
-imparied skin integrity
-deficient knowledge
-self-care deficit
Cheyenne-Stokes respirations
-respirations may gradually become more shallow & are followed by periods of apnea
to say goodbye to those people & things that are important.
it may also be saying i am sorry, forgive me. I forgive you. I love you.
Advance directive
-spells out pt's wishes for health care at that time when they may be unable to indicate their choice
Durable power of attorney for health care
-a legal document that appoints a person chosen by the pt to carry out his wishes as expressed in an advance directive (health care proxy)
DRN means
Do NOT Resuscitate

-act of ending another person's life to end suffering, with (voluntary) or without (involuntary) his consent
*mercy killing*
Passive Euthansia

Give an eg
-when a pt chooses to die by refusing treatment that might prolong life

-witholding atrifical feeding or Parental (IV) fluids, not treating pnuemonia with antibotics
Active Euthansia
-administrating a drug or tx to kill the pt
T or F
Both passive euthanasia and assisted suicide are considered to be a violation of the AMA's Code for Nurses
active euthansia not passive
T or F
Honoring the refusal of life-prolonging treatment of a patient w/ a terminal illness is legally & morally permissble
it is ethically not morally
person w/ legal authority to determine cause of death
an examination of the body, organs and tissues to determine the cause of death
after death, the care of the body
A person's reaction to loss is influenced by what
the importance of what was lost & the culture in which the person is raised
-Life expectancy for white female is highest
-African American females
-White males
-African American
-79.9 yrs
-74.7 yrs
-74.6 yrs
-67.8 yrs
In order to meet the emotional and physical needs of pts and their significant others, nurses must first what?
take the time to look at their own views of death & come to terms with its reality
A loss consist of what aspects
eg amputation of a leg, inablity to speak or walk after a stroke
eg disfiguring surgery
scarring from burns may result in an alter self image and emotional problems

loss of a job
role of a homemaker
familiar environment
independence such as a move to nsg home
T or F
A major loss may result in normal grieving for 1 to 2 yrs
NOTE: There is no actual time frame for grieving.
Visible absence of grieving may be viewed by others as good adjustment, but it often results in what?
psychosomatic illness
How does a ns validate a pt's loss?
reassure the grieving person:
-that the loss was important
-that you understand the loss
Crying may be embarassing for the patient and a simple act of _____________ acknowledges the acceptability of weeping
handing a tissue
What cultures are less likely to want to be told if they have a terminal illness & they feel that the family should make decisions, not the patient, about life-sustaining treatment
Mexican American
Korena American
Palliative care the focus is on what?
-symptom management
-comfort care
Where is hospice care provided
-pt's home
-nursing home
-hospice unit
Who identified the stages of copying with death
-sheet used to wrap body after death
rigor mortis
rigidity of muscles that occurs after death
Identify common fears a pt is likely to experience when dying
-fear of pain
-the unknown
-loss of dignity
-loss of control
T or F
At sometime a pt should be pushed to discuss what he is obviously avoiding
At no time
there are steps for a beginning students and new graduates can do to understand what to say to a dying pt
1st step become comfortable w/ your own beliefs, values, and attitudes about death and dying
2nd step read and learn about the actual dying process and observe exp nurses talking with dying pts and grieving relatives
3rd step be open to the difficult questions of life & death that permit pts to discuss their feelings and needs
Nonchemical approaches to pain relief may include:
-visualization & guided imagery
-relaxation & breathing exericises
-music therapy
-religious healing
use of TEN (transcutaneous electrical nerve stimulation)
-hydrotherapy eg whirlpool
When a pt is no longer taking oral fluids, small amts of concentrated pain medication can be inserted ______________
in the buccal cavity (cheek)
________scheduled pain medication with _____ backup for breakthrough pain is most __________
Pt's w severe pain can recieve _____doses of narcotics without ________depression or tolerance when the dose has been increased in response to increasing pain
Research has shown that ___________ results in less distress and pain and that _______ does not improve comfort
When a dying pt has dyspnea and suctioning is not effective;what is used?
-medication eg scopolamine patch or morphine can decrease secretions
-O2 by nasal may provide comfort
For the dying pt, what contributes to the risk of skin breakdown:
-wt loss
-decreased nutrition
T or F
The dying pt is not going to get stronger or better;he gets weaker and weaker,because he is lying in bed
not because he is lying in bed, but because he is dying

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