EAQ Grief and Loss

A nurse takes into consideration that the key factor in accurately assessing how a client will cope with body image changes is what?

The perception of the body changes

After a client has a spontaneous abortion at 12 weeks' gestation, the nurse notes that she and her partner are visibly upset. The partner has tears in his eyes, and the client is sobbing quietly with her face turned to the wall. At this time, what is the nurse's most therapeutic statement?

"I'll be here if you want to talk."

A woman at 22 weeks gestation is admitted with heavy bleeding and severe abdominal cramping. When told that no fetal heart sounds can be detected, the client says to the nurse, "We wanted this baby so badly." How should the nurse respond?

"It must be difficult to lose this baby that was important to you both."

Which statements are true regarding hospice care? Select all that apply.

*Hospice team members can include clergy and other spiritual leaders. *Hospice team members provide comfort measures, medicines, and therapy to the client. *Hospice care can be regulated by home health agencies and community-based organizations.

A nurse's Muslim client has died. Which nursing actions are acceptable to the family members of the client considering their cultural beliefs? Select all that apply.

*Washing the client's body with gloves on *Positioning the client with his face toward Mecca

On the third postoperative day following a below-the-knee amputation, a client is refusing to eat, talk, or perform any rehabilitative activities. What is the best initial approach that the nurse should take when interacting with this client?

Acknowledge that the client's withdrawal is an expected and necessary part of initial grieving.

Which religious group may refuse autopsy?

Christian Science

The nurse is caring for a client who has a newborn with a neurological impairment. What is the most important nursing action?

Assisting the client with the grieving process

A parent whose daughter is killed in a school bus accident tearfully tells the nurse, "My daughter was just getting over the chickenpox and didn't want to go to school, but I insisted that she go. It's my fault that she's dead." How should the nurse anticipate that perceiving a death as preventable will likely influence the grieving process?

Bereavement may be of greater intensity and duration.

A client who recently was told by her practitioner that she has extensive terminal metastatic carcinoma of the breast tells the nurse that she believes an error has been made. She states that she does not have breast cancer, and she is not going to die. The nurse determines that the client is experiencing which stage of death and dying?

Denial

A client who is 21 weeks pregnant experiences a fetal loss because of an incompetent cervix. Once the client's physical needs have been assessed and met, what is the best way for the nurse to address the client's psychologic needs?

Encouraging the client to see and hold the baby while still possible

After counseling an older widowed client, a nurse concludes that the grieving process has been successfully completed when the client does what?

Is able to plan to start new relationships

A 30-year-old woman is to undergo total abdominal hysterectomy for noninvasive endometrial cancer. The nurse anticipates the client may have difficulty adjusting emotionally to this type of surgery. What is the most common reason for this difficulty?

Loss of femininity

The nurse anticipates that the family of a child with cerebral palsy is at risk for difficult parenting issues. What does the nurse conclude is the probable basis for this difficulty?

Loss of the expected healthy child

After the death of a client, the primary health-care provider asks the family members if they wish to donate the organs of the client, and in accordance with their religion, they agree to it without hesitation. To which religious group does this family belong?

Methodist

A nurse is caring for a client who just had an above-the-knee amputation. What is the key factor in assessing how the client will cope with the body image change?

Personal perception of the change

A client with a terminal disease is admitted to hospice care. The nurse coordinator assigns a primary team. Which member of the hospice team evaluates the client's response to treatment and provides emotional support to the client and his caregiver?

Primary nurse

A client who is at 28 weeks gestation and in active labor is crying. She says, "I just know that this baby is going to die. What's the use of doing all this to save it?" What does the nurse conclude about the client?

She is experiencing anticipatory grief and withdrawing from bonding.

A nurse is aware that a co-worker's mother died 16 months ago. The co-worker cries every time someone says the word "mother" and when the mother's name is mentioned. What does the nurse conclude about this behavior?

The co-worker may need help with grieving.

A mother is seeing her newborn, who has visible birth defects, for the first time. When she sees her baby, she becomes disturbed, pushes away, and tells a nurse, "Oh, take the baby away; I never want to see it again." What does the nurse conclude from this behavior?

The response is a common one in a new mother who is finding it difficult to accept that her newborn is less than perfect.

What is true about the effect of grief and loss in toddlers?

They express a sense of change in sleeping.

A client with a massive head injury was admitted to emergency department. The trauma team leader notifies the family that the client is expected to die and asks the family about donating the client's organs. The family members agree to proceed with the donation. To which religious group does the family belong?

Unitarian Universalist Association

A client with acquired immunodeficiency syndrome (AIDS) comments to the nurse, "There are so many rotten people around. Why couldn't one of them get AIDS instead of me?" What is the nurse's best response?

"It seems unfair that you should be so ill."

A client undergoes dilation and curettage (D&C) after an early miscarriage (spontaneous abortion). The nurse finds her crying later in the day. What is the most appropriate statement by the nurse?

"This must be a very hard experience for you to deal with."

A client with cancer is informed that the chemotherapy is no longer working and that death is inevitable. Arrange in order the nursing interventions associated with each stage of Kubler-Ross's stages of death and dying, beginning with denial.

1.Avoid confronting the client. 2.Redirect negative feelings constructively. 3.Help the client identify realistic versus unrealistic goals. 4.Help the client celebrate the simple pleasures in everyday life. 5.Provide maximal comfort measures.