Chapter 11: Death and Dying

What are some factors that increase the family's potential for dysfunctional grieving following the death of a child?

lack of support system, inadequate coping skills, association of violence or suicide with death of child, unexpected or sudden death, lack of hope b/c of mental health issues

Nursing interventions

make them comfortable (environment, control pain etc.)

A nurse is teaching a parent about complicated grief. Which of the following statements by the nurse is appropriate? A. "It is considered complicated grief if you are still grieving 6 months after your loss." B. "Personal activities are affected when experiencing complicated grief." C. "Parents will experience complicated grief together." D. "Complicated grief self-resolves in 12 months."

B. "Personal activities are affected when experiencing complicated grief."

What are physical manifestations of death?

-sensation of heat, but body is cold -decreased sensation and movement in lower extremeties -loss of hearing -confusion, decreased appetite and thirst -swallowing difficulties, loss of bowel and bladder -bradycardia, hypotension -cheyne-stokes

A nurse often cares children who are dying. Which of the following is an appropriate action for a nurse to take to maintain their effectiveness? (Select all that apply.) A. Remain in contact with the family after their loss. B. Develop a professional support system. C. Take time off from work. D. Suggest that a hospital representative attend the funeral. E. Demonstrate feelings of sympathy toward the family.

A. Remain in contact with the family after their loss. B. Develop a professional support system. C. Take time off from work.

A nurse is teaching a parent of a preschool child about factors that affect the child's perception of death.Which of the following should be included in the teaching? A. Preschool children have no concept of death. B. Preschool children perceive death as temporary. C. Preschool children often regress to an earlier stage of behavior. D. Preschool children experience fear related to the disease process

B. Preschool children perceive death as temporary.

A nurse is caring for a child. Which of the following are physical manifestations of impending death?(Select all that apply.) A. Heightened sense of hearing B. Tachycardia C. Difficulty swallowing D. Sensation of being cold E. Cheyne-Stokes respiration

C. Difficulty swallowing E. Cheyne-Stokes respiration

A nurse is caring for a child who has a terminal illness and reviews palliative care with an assistive personnel (AP). Which of the following statements by the AP indicates understanding of this review? A. "I'm sure the family is hopeful that the new medication will stop the illness." B. "I'll miss working with this client, now that only nurses will be caring for him." C. "I will get all the client's personal objects out of his room." D. "I will listen and respond as the family talks about their child's life."

D. "I will listen and respond as the family talks about their child's life."

Parental grief

Intense, long-lasting, and complex

How to adolescents perceive death?

adult like concept, have difficulty accepting death because they are still dealing with puberty issues

After death

allow family to stay with body as long as they desire, remove tubes and equipment, (everything we learned already)

Palliative care

control pain, environment etc.

Sibling grief

differs from adult/parental grief

What is a preschoolers perception of death?

egocentric, magical thinking, interpret separation from parents as punishment, view dying as temporary

self-care for nurses

express feelings, maintain health, take time off, support systems, attend funeral and keep contact with family if desired

Complicated grief

extends for more than 1 year following the loss -intense thoughts, distressing yearning, loneliness, distressing emotion and feelings, disturbances in personal activities, such as sleep

What is an infant/toddlers perspective of death?

have little or no concept, egocentric thinkers, mirror parents emotions, react in same response as change in routine, can regress to earlier behavior stages

What is included in the assessment ofo the family?

parent's wishes regarding end of life care, dnr, family coping etc.

How to school-age children view death?

start to respond to logical or factual explanations, concept of death is inevitable (9-12), fear of disease, curious about funeral and what happens to body after death

Anticipatory grief

when death is expected or a possible outcome