Grieving

Signs of impending death

1. Loss of appetite 2. Excessive fatigue and sleep 3. Increased physical weakness 4. Mental confusion or disorientation 5. Labored breathing 6. Social withdrawal 7. Changes in urination 8. Swelling in the feet and ankles 9. Coolness in the tips of fingers and toes 10. Mottled veins

The client on hospice care is receiving palliative treatment. Which is the goal of palliative care for this client? Restore the clients health. Promote the clients recovery. Relieve the clients discomfort. Support the clients significant others.

Relieve the clients discomfort

When will the medical examiner decide whether a postmortem examination needs to be conducted? A death under normal circumstances a client dies more than 48 hours after hospital admission Death within 24 hours of admission to the hospital a client gives a written consent before the death for an autopsy to be performed

That's within 24 hours of admission to the hospital

After a family member is killed, which therapy is most beneficial for the survivors? Grief family psycho analytical psycho educational

Grief grief therapy provides guidance as one completes the tasks a morning. The goal is to prevent unsolved and dysfunctional grief.

Which intervention with the nurse used during the initial interaction with a 76-year-old widower who is terminally ill, very quiet, and unwilling to have visitors? Assess what the client knows about grief and loss related to death in the dying process. Avoid talking about his health condition and isolation unless he initiated the discussion. Encourage him to except phone calls from those who are concerned and wish to visit with him. Explore what he understands about the situation and what the implications mean to him.

Explore what he understands about his situation and what the implications mean to him. A starting point for working with all clients is ascertaining their understanding of their situation and its meaning to them

A terminally ill client is considering allowing natural death rather than the traditional do not resuscitate. Which feeling well the allowed natural death assuage for the client and the family Guilt anger denial sadness

Guilt by framing the death as part of a natural process rather than removing the interventions, the guilt is lessened for the client and for the clients family after the death has occurred.

Which of the statements with the nurse include when counseling a parent about the changes a toddler me exhibit after the death of a family member? Select all that apply the toddler will be resilient over the loss the toddler will understand the cause of the loss the toddler well get disrupted in developing an autonomous sense of self the toddler may experience changes in sleep patterns the toddler may have a bowel or bladder disturbance

The toddler may have a bowel or bladder disturbance the toddler may express changes in sleep patterns

Which question is most therapeutic to ask parents of a three-year-old child who had just died? Do you feel ready to allow us to move your child to the morgue? Would you like to discuss your decision about organ donation? Would you like to talk about how you'll tell other children? Can I be of any help with traditional practices that are important to you?

Can I be of any help with traditional practices that are important to you? The nurse should be sensitive to any cultural or religious beliefs that may help the parents cope with their grief.

Which psychosocial nursing action is the priority when a client die suddenly in the emergency department? notify the family documenting the situation performing postmortem care dealing with personal feelings

Dealing with personal feelings the priority psychosocial nursing action in the situation is deal with personal feelings regarding the sudden death.

Which would the nurse consider to be the center of decision-making when providing client care? Ethics nursing skills analytical skills research-based practice

Ethics

A client has terminal cancer after seven years of chemotherapy and surgeries. The nurse enters the room and find the client crying. Which is the correct intervention by the nurse? Sit down quietly next to the bed and allow him or her to cry. Pull the curtain and leave the room to provide privacy for the client. Explain to the client that has her her feelings are expected and they will pass the time. Observe the length of the time the client cars document his or her difficulty excepting his or her implementing death.

Sit down quietly next to the bed and allow him or her to cry. This demonstrates acceptance of the clients behavior and provides opportunity for the client to verbally expressed feelings if desired.

According to Kubler Ross theory of death and dying, which stage is a terminally ill client displaying by gradually moving towards resolution resolution of feelings about impending death Anger denial bargaining acceptance

Acceptance

Which describes a Living will? A legal document that allows registered nurses to offer special skills to the public An order that directs primary healthcare providers to refrain from reviving clients a written document that directs treatment according to the client wishes in case of terminal illness or condition a legal document that doesn't it's a person or persons chosen by the client to make healthcare decisions on his or her behalf

A written document that directs treatment according to the clients wishes, in case of a terminal illness or condition

Which is the most common cause of death among adolescents? Suicide homicide accidents substance abuse

Accidents accidents are the most common cause of death and adolescence

Which of these is an ethical issue related to the long-term care setting, select all that apply. Guardianship power of attorney advanced directives responsible party designation DNR order adhere to the patient's bill of rights

All apply

A client with untreatable cancer tells the nurse, I think they made a mistake. I don't think I have cancer. I feel too good to be dying. Which stage of grief is the client experiencing Anger denial bargaining acceptance

Denial

An older woman has lived alone since the death of her husband 10 years ago, and she has a long list of vague complaints. Which assessment is the priority for the home health nurse to perform? Assess for feelings of loneliness and isolation. Determine if the client has unresolved grief. Determine if there are safety issues. Ask about availability of support systems.

Determine if there are safety issues. Safety is a priority, and the client has several risk factors. She is older and lives alone, and has many bad complaints.

Which information with the nurse provided to a client regarding a do not resuscitate order, select all that apply. Do not resuscitate orders would be reviewed routinely by the primary healthcare provider. A primary healthcare provider would make every effort to revive a client if I do not resuscitate order exists legally competent adults may issue a do not resuscitate order verbally or in writing after receiving a proper information about it primary healthcare providers would check for a DNR order before deciding to perform cardio pulmonary resuscitation a DNR order may be attached to a clients medical records without any legal proof of consultation regarding the order

Do not resuscitate orders would be reviewed routinely by the primary healthcare provider legally competent adult may issue a do not resuscitate order verbally or in writing after receiving proper information about it primary healthcare providers would check for a do not resuscitate order before deciding to perform cardio pulmonary resuscitation

Which factor is most important in predicting a persons reaction to imminent loss and grief? Family interactions social support system emotional relationships earlier experiences with grief

Earlier experiences with grief. How a person has handled grief in the past provides clues to show how he or she will cope with grief in the present.

A client who has admitted to the hospital and requires a colon resection states, I want to be a do not resuscitate. The nurse questions the client understanding of a DNR order. Which response by the client best and the kids to the nurse and understanding of a DNR order? My doctor will know what to do my family can make the decision for me if something happens to me I do not want to be cardio pulmonary resuscitated if I have a heart attack, I do not want any medication

If something happens to me, I do not want cardio pulmonary resuscitation

Which parent is expressing anticipatory grief? My daughter died four years ago and I'm still crying and walking around like I'm in a dream My four-year-old was diagnosed with diabetes Molite us, but I'm sure she'll grow out of it. My son's treatments are painful. I'm so angry. Most days I just want to take them home and run away. My son was diagnosed with terminal cancer two months ago and they can't stop my son from dying

My son was diagnosed with terminal cancer two months ago and they can't stop him from dying. Anticipatory grief is intellectual and emotional response to an event that will happen in the future

The student nurses describing palliative care to a clients family. Which statement made by the student nurse indicates a need for correction by the registered nurse? Palliative care is the same as hospice care. Palliative care focuses on the care of the client. Palliative care includes symptom management and the client. Palliative care is an inter-professional approach to the delivery of care.

Palliative care is the same as hospice care. Palliative care can be provided to any client at the time of diagnosis of a serious disease, whereas hospice care is provided to clients only at the very end of life

According to research, which factor increases the probability that the surviving spouse will have a pathological and morbid grief response? The couple had an ambivalent relationship. The cause of this spouses death was suicide. The relationship between the spouses was satisfying. There was an anticipatory grief before the spouse death

The cause of the spouses death was suicide The survivors of suicide feel more guilt and bitterness and go through a longer grieving process

5 stages of grief

denial, anger, bargaining, depression, acceptance

A client who recently was told by her primary healthcare provider that she has extensive terminal 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's not going to die. Which stage of death and dying is the client experiencing? Anger Denial Bargaining Acceptance

Denial

A client in need of a long transplant tells the nurse, I will not take the organ up any person belonging to a different religion. The nurse initiates the process for resolving the ethical dilemma by collaborating with other healthcare team members. Which would the team do after agreeing to a statement of the problem? Interview the family members of the client initiate negotiations for the appropriate course of action assess whether the client is satisfied with the course of action taken determine all possible courses of action based on available information

Determine all the possible courses of action based on the available information When resolving an ethical dilemma the healthcare team to determine all possible courses of action after agreeing to a statement of the problem. At this stage, the members of the team where all possible options to address the situation.

Which information with a registered nurse provided when educating a nursing student about living 's? Select all that apply. Healthcare worker should always follow the direction of a clients living will Clinically specific instructions are provided that help in dealing with unforeseen circumstances. Clients use Living will's to declare any medical procedures they want or do not want when terminally ill living wells are written documents to direct the clients treatments of an event of terminal illness or condition authorized individuals are given authority to make medical decisions on behalf of the client if he or she is unable to do so

Healthcare workers should always follow the directions of a clients Living will clients use living wealth to declare any medical procedures they want or do not want when terminally ill Living wills are written documents that direct a clients treatment in the event of a terminal illness or condition

Which healthcare system focuses solely on palliative care? Hospice rehab assisted-living extended care facilities

Hospice

A client dies during surgery, and the family members asked that the hospital do not conduct an autopsy examination. Which religion might the nurse expect this family to practice? Islam Hinduism Buddhism Christianity

Islam

A client in the intensive care unit tells the nurse, no matter how much you try, I will not be able to recover. No one can change my destiny. Which religion but the nurse expect this client to practice? Islam Judaism Buddhism Christianity

Islam the client may be Muslim because Muslims believe that the time of death is fixed and cannot be changed.

Which member of the interprofessional team in palliative care setting serves as the client advocate, evaluating the physical, emotional, and spiritual needs of the client? Nurse pharmacist music therapist primary healthcare provider

Nurse in palliative care setting, the healthcare team would comprise professionals are various disciplines to help achieve care outcomes.

Who has the authority to decide if A postmortem will be conducted if a client dies two hours after being admitted to the hospital surviving spouse nursing manager medical examiner primary healthcare provider

Medical examiner if a client dies within 24 hours of being admitted to the hospital, the medical examiner has the right to decide whether a postmortem will be conducted. If the client stuff does not need to be reviewed by the medical examiner and the client has not requested an autopsy in writing, the surviving spouse may request a postmortem

Which interventions with the nurse perform or caring for actively dying client? Select all that apply admit the client to hospice care. Perform aggressive laboratory test. Provide client and family reassurance. Keep the client undisturbed for a long time. Preform symptom management for the client.

Provide client and family reassurance perform symptom management for the client

A client who is in the late stage of pancreatic cancer until actually understands the terminal nature of the illness. Which behaviors indicate the client is emotionally excepting the impending death? Revising the clients will and planning a visit to a friend alternately crying and talking openly about death getting a second third and fourth medical opinion refusing to follow treatments and stating why they won't help anyway

Revising the client will and planning to visit a friend. This is realistic, productive, and constructive ways of using this time

flight or fight response

The flight-or-fight response is a response that occurs when an organism confronted with a threatening situation prepares to fight or flee. This response is controlled by the sympathetic system. This response includes rising heart and respiration rates, constriction of blood vessels, increase in the levels of glucose in your body, and "goose bumps" on your skin.

The nurse reviews the medical record of a client with terminal cancer in notes the presence of a do not resuscitate order. The order was written with the clients admission orders. The nurse recalls that which factor is relevant to the legal aspects of the DNR order? The policies of the agency establish the status of the DNR orders. The age of the client is a primary factor in the decision not to resuscitate. Decisions regarding resuscitation reside with the clients primary healthcare provider. Once a DNR order is signed, it remains in force for the entire hospitalization

The policies of the agency establish the status of DNR orders

Which is true about the effect of grief and loss and toddlers? Show resilience after a loss express a sense of change and sleeping understand the concepts a performance get disturbed in developing an autonomous sense of self

They express a sense of change and sleeping. Toddlers cannot understand loss or death, but often expressed the sense of absence they feel with changes in eating and sleeping patterns or fussiness

Which describes the focus of hospice care? To ease of pain from illness to provide curative treatment to assist with activities of daily living to adapt to the limitations due to an illness

To ease pain from the illness

Three stages of General Adaptation Syndrome (GAS)

alarm, resistance, exhaustion

A client with chronic renal failure stopped responding to the treatment. On examination, the primary healthcare provider determines that the client is terminally ill. Which is the correct nursing intervention in the situation? Suggest that the family members get a second opinion. Suggest that the family members continue to try different treatments. Encourage the family members to provide palliative care to the client. Inform the family members that the disease is no longer curable and the client will die shortly.

Encourage family members to provide palliative care to the client

Which is the most appropriate nursing intervention when providing care for patients who have experienced a stillbirth? Giving a detailed explanation of what may have caused the stillbirth providing a parent with the opportunity to say goodbye to the newborn explaining that an autopsy is not recommended in the setting of a stillbirth waiting to provide any information about follow up care until the patients have an opportunity to adjust to the grief

Providing the parents the opportunity to say goodbye to their newborn

Which explanation was the nurse gave to the family what an older widow, who is in the terminal stages of lung cancer, exhibits mood changes and anger toward the family? She's attempting to avoid the reality of the situation. She was trying to cope with her impeding death. She wants to reduce the families dependence on her. Shes sad because the family will not take her home to die.

She is trying to cope with her impending death. Anger associated with one of the stages of dying

When assessing a client who is receiving palliative care, which question regarding spiritual healthcare is correct? Are you afraid of death? After hearing about your condition, did you lose faith? What is your source of spiritual strength during hard times? May I ask the chaplain to visit you to help you cope?

What is your source of spiritual strength during hard times?

The nurse reviews the medical record of a client who is eligible to receive hospice care. Which are the criteria for a client to receive this type of care? When the person is nearing death when the expected death of a client is within six months when the client seeks no aggressive disease management when a family member has signed and informed consent form When the client has been issued a do not resuscitate order

When the expected death of the client is within six months when the client six no aggressive disease management when the client has not been issued a do not resuscitate order