week13: grief and dying

A client has been diagnosed with a terminal illness and has periods of depression and periods of anger, alternating with periods of acceptance. What teaching is most appropriate for the nurse to include when the client's spouse says that the client seems emotionally unstable?

Movement between stages of grief is normal.

The emergency department (ED) nurse accepts an unconscious client brought in by ambulance. The client's family presents a durable power of attorney for health care for the client. Which action should the nurse take?

Obtain contact information for the person designated to make decisions for the client.

A nurse at the health care facility cares for several clients. Some of the clients may require end-of-life care. Which case may require the service of a coroner?

The client did not have any recent medical consultation

A client in a long-term care facility has signed a form stating that he does not want to be resuscitated. He develops an upper respiratory infection that progresses to pneumonia. His health rapidly deteriorates, and he is no longer competent. The client's family states that they want everything possible done for the client. What should happen in this case?

The client should be treated with antibiotics for pneumonia.

A client with a diagnosis of lung cancer is seen in the clinic for follow-up care. Which nursing interventions are essential to include in this client's plan of care to address grief? Select all that apply.

Assist the client to form a support system. Help the client establish coping strategies. Promote good nutrition and sleep habits. Encourage participation in religious rituals.

A graduate nurse enters a client's room and finds the client unresponsive, not breathing, and without a carotid pulse. The graduate nurse is aware that the client has mentioned that he does not wish to be resuscitated, but there is no DNR order on the client's chart. What is the nurse's bestaction?

Call a code and begin resuscitating the client.

A client diagnosed with terminal cancer is making plans to take a trip to visit an estranged sibling. What stage of death and dying, according to Kübler-Ross, is best illustrated in this description?

bargaining

What is Kübler-Ross's third stage of grief?

bargaining

A widow develops cancer within 6 months of her husband's death. This may be a result of:

bereavement.

Upon admission, the nurse should give priority to addressing which need of a client who is displaying symptoms of dysfunctional grief?

coping strategies

The wife of a client who has been diagnosed with a terminal illness asks the nurse about the differences between palliative care and hospice care. Which information would the nurse most likely include in the response?

Hospice care is provided for clients who have 6 months or less to live; palliative care is provided at any time during illness.

hen reviewing a client's chart, the nurse notes that the client is in the disorganization stage of grief. Which assessment finding would support this diagnosis?

"I feel like I have absolutely no idea what to do next."

When a client with end-stage renal failure states, "I am not ready to die," what is the appropriate nursing response?

"This must be very difficult for you."

What is the most important goal of care for the dying client who is receiving comfort care?

providing a comfortable, dignified death

A client has been receiving dialysis for years and now states, "I have been thinking about this for a long time. I no longer wish to continue dialysis. I just want to die." What is the most appropriate statement by the nurse?

"Can you tell me about why you've made this decision?"

A nurse completing admission paperwork asks the client about having an advanced directive. The client states, "I do not know, what is an advanced directive?" What is the nurse's best response?

"It is a written document that identifies a person's preferences regarding which medical interventions to use in the event of a terminal condition."

The nurse is trying to help the client cope with the dying process. Which nursing statement is mostappropriate?

"It must be very difficult for you."

"My father has been dead for over a year and my mother still can't talk about him without crying. Is that normal?" What is the best response by the nurse?

"The inability to talk about your dad without crying, even after a year, is still considered normal."

A nurse is conducting an in-service program for a group of hospice nurses. When describing the grief response in adults and older adults as compared to children, which would the nurse most likely include? Select all that apply.

Adults and older adults grieve more continuously. Children need to go through the same grief reactions as adults do Adults and older adults do not seek an immediate replacement for the lost loved one.

A client states, "My children still need me. Why did I get cancer? I am only 30." This client is exhibiting which stage, according to Kübler-Ross?

Anger

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?

Disorganization

The husband of a client with terminal cancer is afraid of hurting his wife during sexual intercourse. Which action by the nurse is likely to be most helpful in reducing this client's fears?

Encourage discussion between the husband and wife regarding their intimacy needs

The nurse is preparing a presentation on preparing children for death. What information should the nurse include? Select all that apply.

Encourage expression of feelings. Provide for stability and safety. Talk openly about death and the feelings associated with it.

The nurse is receiving a change of shift report on a client who has a terminal illness and has exhibited a slow and progressive decline in the health status over the past several days. Which data supports the client's impending death? Select all that apply.

Gurgling sounds emanating from the client's throat with each breath Distended abdomen with last bowel movement documented 7 days ago Cyanotic nail beds in hands and feet bilaterally

A home hospice client who has Medicare is experiencing extreme pain at home and is refusing to receive inpatient care due to concerns over the cost of inpatient care. What teaching will the nurse include in the plan of care?

Inpatient pain management for hospice patients is covered by Medicare.

When preparing for palliative care with the dying client, the nurse should provide the family with which explanation?

The goal of palliative care is to give clients the best quality of life by the aggressive management of symptoms."

A client is being discharged from the hospital with terminal brain cancer and a life expectancy of 1 month. When planning this client's discharge, it is most important for the nurse to include a referral to which agency?

hospice

The nurse anticipates a dying client to exhibit which signs of impending death? Select all that apply.

incontinence restlessness loss of sensation Cheyne-Stokes respirations

The nurse is giving palliative care to a client with a diagnosis of COPD. What is the goal of palliative care?

to improve the client's and family's quality of life

Following surgery, the surgeon informed the client's spouse that invasive cancer was found during the procedure and the client may only have days to live. The client's spouse has told the physician and the nurse that they do not want the client to know the severity of the diagnosis. How will the nurse respond?

understanding that this directive would violate the client's rights