Chapter 44: Loss, Grief, and Dying

loss.

The experience of parting with an object, person, belief, or relationship that one values is defined as:

hospice

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?

Cleanse drainage from the skin.

A client at a health care facility has died after a prolonged illness. A nurse is assigned to perform postmortem care for the client. Which intervention should the nurse perform when providing postmortem care?

"I apologize for not responding more quickly and would be glad to help with whatever you need now."

A client that is dying yells at the nurse, "I put my light on a long time ago and you do not even care enough to see what I need!" How should the nurse respond?

bargaining

A client with a terminal illness is overheard by the nurse saying, "If I promise never to smoke another cigarette in my life, please let me recover from this lung cancer." How will the nurse document this stage of grief according to the Kübler-Ross model?

"I will contact the health care provider to extend services since your family member meets the criteria."

A client with end-stage chronic obstructive pulmonary disease (COPD) has reached the end of the 6-month period for hospice services and the family caregiver states, "I don't know what we will do if they cut off our hospice services." What is the best response by the hospice nurse?

durable power of attorney.

A client's son is named to make decisions for his mother in the event she cannot speak for herself. This is an example of a(an):

Call a code and begin resuscitating the client.

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 best action?

Inpatient pain management for hospice clients is covered by Medicare.

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?

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

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?

Inhibited grief

A nurse informs a woman that there is nothing more that can be done medically for her premature infant who is expected to die. The mother suppresses her grief and tells the nurse she is experiencing heart palpitations. What type of grief might the mother be experiencing?

allowing the outer reality of loss to become internally accepted altering the emotional attachment to that which was lost

A nurse is conducting a program for a local community support group about grieving. The nurse would describe grief as fulfilling which function? Select all that apply.

"All efforts will be taken to make sure your loved one is comfortable and out of pain."

The condition of a client with a traumatic brain injury continues to deteriorate despite medical efforts. The decision is made to terminally wean the client from mechanical ventilation. Which statement by the nurse is most significant in educating the family regarding terminal weaning?

"Sometimes a person returns to a previous stage."

The nurse is caring for a client who recently found out he has a terminal illness. The nurse notes that the client is hostile and yelling. Which statement by the nurse shows that she has understanding of the Kübler-Ross emotional responses to impending death?

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

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

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

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.

bargaining

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

A client is unable to return to work after their sibling's death 18 months ago.

Which assessment finding would best support a nursing concern of disordered grieving?

At about age 9, the child perceives death as irreversible.

Which statement regarding perceptions of death by children is accurate?