Foundations Chapter 42: Loss, Grief, and Dying – Flashcards
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The hospice nurse is visiting the wife of a client who died 10 months ago. The wife states, "My life is meaningless since my husband died." The nurse recognizes that the client is in which stage of grief?
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Disorganization In the disorganization stage of grief, the client may exhibit difficulty making decisions, aimlessness, and loss of interest in people, work, and usual activities. In the protest stage of grief, the client may exhibit preoccupation with thoughts of the deceased, searching for the deceased, dreams/nightmares, hallucinations, and concerns about others' health and safety. In the shock stage, the client may exhibit slowed and disorganized thinking, blocking of thoughts, and wish to join the deceased. In the reorganization stage of grief, the client may exhibit a realistic memory of deceased, be comfortable when remembering the deceased, and return to previous level of ability.
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Which priority intervention should the nurse plan to implement to reduce a client's discomfort during terminal weaning?
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Administer sedation and analgesia Terminal weaning is the gradual withdrawal of mechanical ventilation from a client with a terminal illness. Providing sedation and analgesia are the best way to reduce the client's discomfort during the process. The nurse participates in the process by educating the client and family about the burdens and benefits of continued ventilation and what to expect when terminal weaning is initiated. Supporting the family and having the family remain at the bedside are important roles of the nurse during terminal weaning, but do not directly affect discomfort as much as sedation and analgesia.
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A nurse is providing care to pediatric clients on an oncology floor. The nurse would expect which age group as perceiving death as reversible, avoidable and occurring in degrees?
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Preschoolers Preschoolers perceive death as reversible, avoidable, and occurring in degrees. Infants have no concept of life and death. Toddlers experience a fear of abandonment. Early school-age children perceive death as unnatural, reversible and avoidable, and may also personify death.
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A nurse is taking care of a client who is obviously going through the shock phase of grieving. Which nursing intervention is best for this client?
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Help the client mobilize support systems. During this stage it is important to keep the client safe and to him begin accept the reality of the loss. During the protest phase, nursing interventions should focus on encouraging the client to express emotions. During the disorganization phase, interventions started in the shock phase should be continued and the person may need assistance reorganizing his life. During the reorganization phase, assistance is needed to help the person create new patterns of behavior that are efficacious.
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Which stage of grieving is exhibited by the husband of a victim of sudden death who refuses to accept that she is dead?
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Shock In the shock and disbelief stage, the survivor either refuses to accept the loss or shows intellectual acceptance of the loss but denies the emotional impact.
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A widow develops cancer within 6 months of her husband's death. This may be a result of:
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bereavement. Physical health and psychosocial adjustment are intricately intertwined. The bereaved are known to be at greater risk for mortality and morbidity than are comparable nonbereaved people.
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The client has a new diagnosis that requires high-risk treatment. The client is indecisive about treatment and states, "I don't know what to do." The nurse determines that the most appropriate outcome is that the client will:
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report feelings of peace about the decision regarding treatment. The situation is about the client's inability to make the decision regarding treatment. The option that most addresses this is the client reporting feelings of peace about treatment decision. It is inappropriate for the health care provider to make treatment decisions. Explaining the risks and benefits is helpful, and applying good decision-making skills is important, but these are less important than arriving at a decision that meets the client's needs.
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A client has recently lost his father. The client spent about 6 months deeply mourning his loss and is just now able to function at his pre-loss level. He was helped in this process by his strong social support. This client is most likely a(an):
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adult. Adults tend to grieve more intensely and more continuously, but for a relatively shorter period of time than children. Having a good social network helps with this process, as well as having a stable lifestyle.
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The nurse is documenting care provided following the death of a client with terminal cancer who lived in a long-term care facility. Which statement will the nurse document first?
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"Dr. Shepherd notified at 0940." In a long-term care environment, the nurses should contact the healthcare provider who will pronounce the client dead. In the interim, the nurse documents what is happening. After pronouncement of death, post-mortem care is provided and transport to the morgue can take place.
