Coping & stress: grief and loss

Myths about grief & loss

- don't feel sad - Burt your feelings - the loss can be replaced - grieve alone " big boys don't cry" - grievers burden others - " time heals all wounds" - time alone did not heal all, it is what you do with the time that heals

Grief identified via stages

- even though researchers attempt to categorize grief into stages , remember everyone grieves differently and grief is not linear , but is dynamic and ever changing - variety of physical and emotional reactions that wax and wane over time - stages help others make sense of the grieving persons experience y

Physical loss versus psychological loss

- ex. Loss my leg

Rights of the grieving

- experience own unique grief - talk about feelings and grief - feel multitude of emotions - be tolerant of your own physical and emotional limitations - experience " grief attacks" - make use of routine / rituals

Situational loss

- experienced as a result of an unpredictable event

maturational loss

- experienced as a result of natural developmental process -ex . Child growing up

Emotions of loss

- fear - anxiety - anger - sadness - depression - loneliness - resentment

Alarm reaction

- fight or flight - sympathetic nervous system - not long lasting - initial reaction - person perceives stressor , defense mechanisms activated - hormone levels rise , body prepares to react - shock and counter shock phases

Kubler-Ross ⭐️⭐️⭐️

- five stages of grieving process obv situational 1) denial- " No, not me " 2) Anger - " why me ?" 3) bargaining - " yes me , but" 4)depression - " yes me?" 5) acceptance - " I'm ok with it."

Thought about grief and loss

- grief, loss and death is each persons own experience - one does not have to grieve or die alone, but it must be done their own way - there is no " best" way to grieve . Do not judge or imitate others . Follow your own intuition and heart - death, though painful , helps us become fully human and teaches us to not take life for granted

GAS

- how our bodies go through stress - biochemical model of stress ( Hand Selye) - alarm reaction - stage of resistance - stage of exhaustion

Coping mechanisms

- crying , laughing, sleeping, cursing - physical activity / exercise - smoking / drinking - social withdrawal/ limiting relationships to those with similar values and interests

defense mechanisms

- denial - displacement - introjection - projection - rationalization - reaction formation - regression - repression - sublimation - undoing

Factors that affect grief and dying

- developmental considerations - family - socioeconomic factors - cultural, gender, and religious influences - cause of death - the nurse as roll model -

Cognitive appraisal

- Richard s. Lazarus - personal interpretation of a situation - how an individual views a situation

Dysfunctional grieving ⭐️⭐️⭐️

- abnormal or distorted - unresolved ( unable to express feeling, denial, prolonged bereavement, everything makes me angry , not able to move on ) - inhibited ( suppression, somaticizing, don't allow ourselves to feel grief )

Psychosocial stressors

- accidents/ survivors - stressful or traumatic experiences of family members and friends - horrors of history - fear of aggression or mutation - rapid changes in the world - trauma - mind things

Types of loss

- actual loss - perceived loss - physical loss versus psychological loss - maturation loss - situational loss - anticipatory loss ⭐️⭐️

What is grief

- an experience that is part of life - changes reality and perception - normal and natural - an emotional process - people given the opportunity to confront grief will deal/ cope with is better than those who don't or can't

stage of exhaustion

- body shuts down - - results when adaptive mechanisms are exhausted - body either rests and mobilized its defenses to return to normal or dies

Stage of resistance

- body trying to resist the crash that is inevitable ( ex. Crystal meth) - parasympathetic response - body attempts to adapt to stressor - vital signs, hormone levels, and energy production return to normal - body regains homeostasis or adaptive mechanisms fail

Family stressors

- changes in family structure and roles ( ex. New baby, aging, care giver role strain) - anger and feelings of helplessness and guilt - loss of control over normal routines (ex. Mother in law coming for the holidays) - concern for future financial stability ( do I have to pay for kids college)

Physiologic stressors

- chemical agents - physical agents - infectious agents - nutritional imbalances - hypoxia - genetic or immune disorders - disease related - things that happen to our body - physical things

Grief and loss

- how we integrate that loss experience into our lives - unfinished grief over loss can trigger other losses - dealing with grief can indicate coping skills - cognitive , emotional , spiritual and behavioral - someone or something no longer there - can be perceived as traumatic as death - subjective - provides awareness of survival

Emotional response to stress

- how you think and how you feel plays a role in how you handle life - mild anxiety helps us focus on what we're doing - mind -body- interaction - coping and defense mechanisms

Perceived loss

- is felt by person but intangible to others - ex. Empty nest, loss of youth)

Physiologic homeostatis

- local adaption syndrome ( LAS)- involves only one specific body per - reflex pain response - inflammatory response - localized - physiologic stress and how we adapt - reflex pain

Anticipatory loss ⭐️⭐️

- loss has not yet taken place , may help lessen the effect of the actual loss -ex. Don't grieve my death , it didn't happen yet)

Categories of loss

- loss of a person - loss of part of self - external objects or possessions - developmental loss - family, friend , neighbor - mastectomy - misplaced heirlooms - normal life cycles, stage transition, arrival of siblings, starting/ ending school, midlife, retirement

Anxiety levels

- mild ( normal anxiety, talking in class) - moderate ( a little more anxious , testing) - severe & panic ( so heightened to where you can't focus , downward spiral/ panic attack)

Situational strss

- not predictable, can happen at any time

Developmental stress

- occurs as the person progresses throughout the lifespan in a predictable pattern - ex. Taken care of to becoming independent

Abnormal signs of grief

- panic attacks - lasting physical symptoms - excessive guilt / or anger - persistent and intense emotionalism - assuming last illness symptoms of person who died ( the grieving person may take on the symptoms of the one who passes because of the unbalanced emotions) - apathy

Needs of the Griever

- rituals / routine - expression of emotion - manage unfinished business ( ex . Bills) - discover new objectives - knowledge - permission to be - new social roles - to be taken care of ( sometimes , not always) - all individual , how you perceive it and differs for everyone

Sources of stress

- situational - developmental

Systems of grief

- somatic ( pain, ex. Fiber myalgia, physical response with no physical signs) - guilt -self blame - hostility - loss of appetite - restlessness - preoccupation - disorganization - insomnia - anything else out of synch with normalcy

What grief is NOT

- though compared to an illness , grief is not a disease one recovers from - can't tell yourself how to feel - it is not intellectual - it has not term limit - it is not " moving on " or " forgetting"

Crisis resolution

-( ex. Hurricane , border issues ) - realistic perception of the event - effective coping mechanisms - strong support system

Stressor⭐️

-Anything that causes stress -Anything causing a person to experience stress, change in the balanced state

Physiologic Homeostasis

-General adaption syndrome (GAS)

Actual loss

-can be recognized by others

Physiologic Stressors⭐️

-chemical agents, physical agents, infectious agents, nutritional imbalances, hypoxia, genetic or immune disorders - Have both a specific effect on general effect. The specific effect is an alteration of normal body structure and function

Factors affecting stress & coping

-physiologic factors ( do you have a strong immune system or chronic disease ) - genetics - age - mental and physical health - nutritional status - social factors and support systems

psychological stressors⭐️

-pressure, control, predictability, frustration, conflict -Include both real and perceived threats. The person's responses are continuous and include individualized coping mechanisms for responding to anxiety, guilt, fear, frustration and loss

Stress⭐️

-the process by which we perceive and respond to certain events, called stressors, that we appraise as threatening or challenging -Condition in which the Human system response to change and it's normal balanced state

stages of dying

1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance

Signs of impending death

1. Difficulty talking or swallowing. 2. Nausea, flatus, abdominal distention. 3. Urinary and or bowel incontinence/constipation. 4. Loss of movement, sensation and reflexes. 5. Decreasing body temperature with cold or clammy skin. 6. Weak, slow or irregular pulse. 7. Decreasing BP. 8. Noisy, irregular, Cheyne-Stokes respirations. 9. Restlessness and/or agitation. 10. Cooling, mottling and cyanosis of the extremities and dependent areas.

Fear

Of unknown and of personal vulnerability

A nurse is providing postmortem care. Which nursing action violates the standards of caring for the body after patient has been pronounced dead end is not scheduled for an autopsy A. The nurse places the patient in a sittinf position while the family visits B. The nurse places identification tags on both the shroud and the ankle C. The nurse removed soiled dressing and tubes D. The nurse makes sure s death certificate is issues and signed

A . The nurse places the patient in a sitting position while the family visits The body should be placed in a normal anatomic position to void pulling up blood, leaving the body in a sitting position is contra indicated

A home healthcare nurse has been visiting a patient with aids who says I'm no longer afraid of dying I think I've made peace with everyone, and I'm actually ready to MoveOn. This reflects the patient's progress to which stage of death and dying? A. Acceptance B. Anger C. Bargaining D. Denial

A. Acceptance The patient statement reflects the acceptance stage of death and dying to find by Kubler Ross

A nurse midwife is Assistinga patient to deliver a full-term baby. The patient is firmly committed to natural childbirth and has attended each natural childbirth class in preparation for labor and delivery. As c section delivery becomes necessary when her fetus shows signs of distress. Inconsolable, the patient cries and calls her self afailure as a mother. The nurse notes that the patient is experiencing what type of loss? Select all that apply: A. Actual B. Perceived C. Psychological D. Anticipatory E. Physical F. Maturational

A. Actual B.perceived C.psychological The loss experience by the woman is actually received. Actual loss can be recognized by others as well as are the person to stay in the loss, perceived loss experience by the person but as intangible to others, and psychological lost the loss that is felt mentally as opposed to physically. Anticipatory loss occurs when one grieves prior to the actual loss, physical loss is a loss that is tangible and perceived by others, and mature national loss is experience as a result of a natural developmental process

A patient diagnosed with breast cancer who is in the end stage of her illness has been in the medical intensive care unit for three weeks. Her husband tells the nurse caring for the patient that he and his wife often talked about the end of her life and that she was very clear about not wanting aggressive treatment that would prolong her dying. The nurse and husband both agree that this seems to be all that Therapy is now doing for her. The nurse would suggest that the husband speak to his wife physician about which type of order? A. Comfort measures only B. Do not hospitalize C. Do not resuscitate D. Slow code only

A. Comfort measure only Comfort measures only order. The wife would want all aggressive treatment to be stocked at this point and all care to be directed to a comfortable dignified health

A nurse teachers problem-solving to a college student who is in a crisis situation. Which statement best illustrates the students understanding of the process? A. I need to identify the problem first B. Listing alternative is the initial step C. I will list alternatives after I develop the plan D. I do not need to evaluate the outcome of my plan

A. I need to identify the problem first Although Identifying the problem may be difficult, our solution is impossible until the problem is identified

A nurse witnesses a street robbery and is assessing a 26-year-old female patient who is the victim. The patient has minor scrapes and bruises and tells the nurse I've never been so scared in my life. What other symptoms with the nurse expect a phone related to the fight or flight response to stress? Select all that apply A.Increased heart rate B. Decreased muscle strength C. Increased mental alertness D. Increases blood glucose levels E. Decreased cardiac output F. Decreased peristalsis

A. Increased heart rate C.increased mental alertness D.increases blood glucose levels The sympathetic nervous system functions under stress to bring about the fight or flight response by increasing the heart rate, increasing muscle strength, increase in cardiac output, increasing blood glucose levels, and increasing mental alertness. Increase peristalsis is brought on by the parasympathetic nervous system under normal conditions and at rest.

A 70-year-old female patient who has had a number refuses further life-sustaining nutrition, including artificial nutrition and hydration. She is competent, understands that this consequences of her actions, not depressed, and purses and refusing treatment. Her doctor is adamant that she cannot be allowed to die this way, and her daughter agrees. And ethics council has been initiated. who would be the appropriate decision maker? A. Patient B. Daughter C. Doctor D. Ethics consult team

A. Patient Because this patient is competent, she has the right to refuse therapy that she finds to be disportionately Burdensome, even if this heat since her death. Neither her daughter nor her doctor has authority to assume her decision-making responsibility so much she asked them to do so. The ethics consult team is not a decision making body, I can make recommendations but has no authority to order anything

A nurse who cared for a dying patient and his family documents of the family is experiencing a period Of morning. Which behaviors would the nurse expect to see at this stage? Select all that apply A.The family arranges for a funeral for their loved one B.The family ranges for memorial scholarship for their loved one C.The coroner pronounces the patient's death D.The family ranges for hospice for their loved one E.The patient is diagnosed with terminal cancer F.The patient's daughter writes a poem expressing her sorrow

A. The family ranges for a funeral for their loved one B. The family arranges for memorial scholarship for their loved one F. The patient starter write a poem expressing her sorrow Morning is defined as the period of acceptance of loss and grief, during which the person learns to deal with the loss. It is the actions and expressions of that grief, including the symbols and ceremonies example a funeral or final celebration of life that make up at weird expression of grief. People who were bereaved are in a state of grieving from loss of a loved one

A college student visits the schools health center with the vague complaints of anxiety and fatigue. Student tells the nurse, exams or read run the corner and all I feel like doing is sleeping. The students vital signs are within normal parameters. What would be an appropriate question to ask in response to these complaints? A.Are you worried about feeling your exams? B.Have you been staying up late studying? C.Are you using any recreational drugs? D.Do you have trouble managing your time?

A.Are you worried about feeling your exams Mild anxiety is often handled without conscious thought through the use of coping mechanisms, such as sleeping, which are behaviors are used to decrease stress and anxiety. Based on the complaints and normal vital signs, it would be best to explore the patient's level of stress in physiologic response to the stress

A nurse is assessing a 49-year-old male patient who complains of migraines that have come unbearable. The patient tells the nurse I just got laid off from my job last week and I have two kids in college, I don't know how I'm going to pay for it all. Which physiologic effects of stress would be expected findings in this patient? Select all that apply A.Changes in appetite B.Changes in elimination patterns C. Decreased pulse and respiration's D. Use of ineffective coping mechanisms E. Withdrawal F. Attention seeking behaviors

A.Changes in appetite B.Changes in illumination patterns Physiologic affects of stress include changes in appetite and illumination pattern as well as increased pulse and respirations. Using an effective coping mechanisms, becoming withdrawn and isolated, and exhibiting attention seeking behaviors are psychological effects of stress

A nurse is caring for an older male patient in a long-term facility with a spinal cord injury affecting his neurologic reflects arc.Based on this patient data, what would be a priority intervention for this patient? A.Monitoring food and drink temperatures to prevent burns B.Providing adequate pain relief measures to reduce stress C.Monitoring for depression related to social isolation D.Providing meals high in carbohydrates to promote healing

A.Monitoring food and drink temperatures to prevent burns A patient with the damage neurologic reflex arc would have a diminished pain reflex response, which would put the patient at risk for burns as the sensors in the skin would not to detect the heat of the food or liquids. Patient should be provided adequate pain relief, but this is not the priority intervention in this patient. Monitoring for depression would be an intervention for this patient but not his but not related to the damage neurologic reflex arc. A patient who is in Mobile should eat a balanced diet based on the choose my plate dietary guidelines

A nurse is preparing a family for terminal weaning of a loved ones.Which nursing action would facilitate this process? Select all that apply: A. Participate in the decision making process by offering the family information about the advantages and disadvantage is of continued ventilatory support B. Explain to the family what will happen at each phase of the weaning and offer support C.Check the orders for sedation and analgesia , Making sure that the anticipated death is comfortable and dignified D.Tell the family that just book her almost immediately after the patient is removed from the vent to later E.Tell the family that the decision for terminal weaning of a patient must be made by the primary care provider F.Set up mandatory counseling sessions for the patient and family to assist them in making this end-of-life decisions

A.Participate in the decision making process by offering the family information about the advantage and disadvantage of continued ventilatory support B.Explain to the family what will happen at each phase of the weaning and offer support C. Check the orders for sedation and Analgesia , making sure that they anticipated death is from one dignified

A certified nurse midwife is teaching a pregnant woman techniques to reduce the pain of childbirth. Which stress reduction activities would be most effective? Select all that apply A: progressive muscle relaxation B. Meditation C. Anticipatory socialization D. Biofeedback E. Rhythmic breathing F. Guided imagery

A.a progressive muscle relaxation B.meditation E.rhythmic breathing F.guided imagery Relaxation techniques are useful in many situations, including childbirth, and consist of rhythmic breathing and progressive muscle relaxation.Meditation and guided imagery could also be used to district a patient from the pain of childbirth. Anticipatory socialization help to repair people for rules they don't have yet but aspire to, such as period. Bio feedback is a method of getting mental control of that auto gnomic nervous system and dust regulating body responses, such as blood pressure heart rate and headaches

Adaption⭐️

Adjustment of living With other living things in environmental conditions

Which of the following is an example of a perceived loss ? A. A client mourns the loss of his amputated leg B. A client groves the loss of his wife to cancer C. An older client grieves for the loss of his independence D. A client grieves for the loss of his job

C. An older client grieves for the loss of his independence Perceived loss, such as loss of use, or financial independence, and a valuable environment, Is experienced by the person but is intangible to others. Loss of a limb , of a child, of a valued object, and I have a job or examples of a fall last by the first and sustaining the loss

A nurse is performing an assessment on a female patient who is eight months pregnant. Woman states I worry all the time about being able to handle be coming a mother . Which nursing diagnosis would be most appropriate for this patient? A. Ineffective coping related to the new parenting role B. Ineffective denial related to ability to care for a newborn C. Anxiety related to change in role status D. Situational low self esteem related to fear of parenting

C. Anxiety related to change in role status The nursing diagnosis/maturational crisis Or changes in bowel status. Ineffective coping refers to the ability to operate stressors or use available resources. And if I did and I was a conscious or unconscious attempt to do it now analogy or meaning of an event to reduce anxiety, and these lead to detriment of health. Situational low self-esteem diagnosises feelings of worthlessness related to the current situation that person is experiencing, not related to the fear of change

A nurse is interviewing a patient who just received news that he has PT at a cancer. The patient tells the nurse that getting cancer could never happen to him. Which defense mechanism is this patient demonstrating? A. Projection B. Denial C. Displacement D. Repression

B. Denial Denial occurs when a person refuses to acknowledge the presence of a condition that is disturbing

A nurse is teaching you patience for relaxation technique. Which statement demonstrates the need for more teaching? A.I must breathe in and out in rhythm B. I should take my pulse and expect it to be faster C . I can expect my muscles to feel less tense D. I will be more relaxed and less aware

B. I should take my pulse and expect it to be faster No matter what the technique , relaxation involves rhythmic breathing , a slower pulse , reduces muscle tension and an altered state of consciousness

A nurse is visiting a male patient with pancreatic cancer and was dying at home. During the visit, he breaks down and cries and tells the nurse that it is unfair that he should have to die now when he's finally made peace with his family and wants to live. Which response by the nurse would be most appropriate? A. You can't be feeling this way , you know you are going to die B. It does seem unfair . Tell me more about how you are going to die C. You'll be alright , who knows how much time any of us have D. Tell me about your pain , does it keep you awake at night

B. It does seem unfair . Tell me more about how you are going to die Using an open ended question allows the patient to continue talking. False reassurances are not helpful. Also the patients feelings and restless this should be addressed as soon as possible

A nurse is caring for terminally L patients in the hospital setting. Which example describes appropriate end-of-life care? A.To illuminate confusion, taking care not to speed too much when caring for a comatose patient B.Sitting on the side of the bed of a dying patient? What is the patient's hand, and crying with the patient C.Referring to a counselor the daughter of a dying patient who is complaining about the case associated with artificially feeding her father D.Telling a dying patient to sit back and relax and perform patient hygiene for the patient because it is easier than having the patient help

B. Sitting on the side of the bed of a dying patient , holding the patient and and crying with the patient The nurse should not be afraid to show compassion and empathy for the dying person, including crying with the patient if it differs. The sense of hearing is believed to be the lessons to leave the body, many patients retain a sense of hearing almost to the moment of that, therefore nurses should explain to the patient and nursing care being given. The nurse should address caregiver role dreams by actively listening to family members were experiencing. Because it is getting hers done patience to be as active as possible for as long as possible, it is generally not good practice for basic self-care measures the patient can perform simply because it is easier to do it this way

Physiologic Indicators of Stress

Backache Constipation or diarrhea Dilated pupils Dry mouth Headache Increased urination Increased pulse, blood pressure, and respirations Nausea Sleep disturbances Stiff neck Increased perspiration Chest pain Weight gain or loss Decreased sex drive

A patient told the nurse that he has no one he can trust to make healthcare decisions for him should he become incapacitated. What should the nurse suggest he prepare? A. Combination advance medical directive B. Durable power of attorney for health care C. Living will D. Proxy for health care

C, living will The Living will Is a document this process purpose is to allow individuals to afford specific instructions about the type of house. They would like to receive in particular and avoid situations. A durable power of attorney for healthcare points in Asian or proxy the person trust to make decisions in the event of subsequent and capacity. The combination advanced medical directive also appoints a proxy for the patient

All of the following diagnosis may apply to a young couple who gave birth to a premature infant with serious respiratory problems with spend in the neonatal intensive care unit for the last three months. The couple has a 22 month old son at home. Which diagnosis would be most appropriate based on the following assessment data. Report of chronic fatigue and decreased energy,Kill about neglecting sent him home, shortness of temper with one another, and apprehension about continued ability to go on this way? A . Grieving B. Ineffective coping C. Caregiver role strain D. Powerlessness

C. Caregiver role strain. The defining characteristics for the NANDA diagnosis caregiver role strain fit in the set of assessment data provided

A nurse interviews and 82-year-old resident of a long-term care facility who says that she has never gotten over the death of her son 20 years ago. She reports that her life fell apart after that and she never again felt like herself or was able to enjoy life. What type of proof is this woman experiencing? A. Abbreviated B. Anticipatory C. Dysfunctional D.inhibited

C. Dysfunctional Dysfunctional grief extends the morning period for an abnormally long time, characterized by abnormal or disoriented expressions of grief

A nurse is caring for a patient in shock or alarm reaction phase of gas. Which response by the patient would be expected? A. Decreasing pulses B. Increasing sleepiness C. Increasing energy levels D. Decreasing respiration's

C. Increasing energy levels The body perceives a threat and prepares to respond by increasing the activity of the autonomic nervous and endocrine systems. The initial were shocked face is characterized by increased energy levels, oxygen intake, cardiac output, blood pressure, and mental alertness

A nurse is assessing the developmental levels of patients in a pediatric office. Which individual would a nurse document is experience development of stress? A.An infant who learns to turn over B.A school aged child who learns how to add and subtract C.And adolescent who is a loner D.Are young adult who has a variety of friends

C.And Adolescent who is a loner The adolescent who is a loaner is not meeting a major task which is being a part of a peer group for that level of growth and development

A nurse caring for a patient in a hospital setting uses anticipatory guidance to prepare them for painful procedures. Which instruction with the nurse provide in this type of stress management,? A.The nurse teaches patience rhythmic breathing to perform prior to the procedure B.The nurse told patient to focus on a pleasant place, mentally please themselves in it, and breathe slowly in and out C.The nurse teaches patience about the pain involved in the procedure and methods to cope with it. D.The nurse teaches patience to create and focus on a mental image during the procedure to become less responsive to the pain

C.The nurse teachers patient about the pain involved in the procedure and methods to cope with that Anticipatory guidance focuses on psychologically preparing a person for an unfamiliar are painful event. When patients know what to expect, their anxiety is reduced, which occurs when teaching about the pain involved and related pain relief measures. Breathing is a relaxation technique, focusing on a pleasant place and really slowly in and out is a meditation technique, And focusing on a mental image to reduce responses to stimuli is a guided imagery techniques

A nurse is responsible for preparing patient for surgery in an ambulatory care center. Which technique for reducing anxiety would be appropriate for these patients? A.Discouraging over verbalizations of fears and anxieties B.Focusing on the outcome as opposed to the details of the surgery C.Providing time alone for reflection on personal strengths and weaknesses D.Mutually determining expected outcomes of the plan of care

D. Mutually determining expected outcomes of the plan of care Nurse is preparing patience for surgery should be mutually determine expected outcomes of the care, as well as encouraging verbalizations and feelings, perceptions, and fears. Explain all procedures including sensations likely to be experience during the procedure, and stay with the patient to promote safety and reduce fear

A visiting nurse is performing a family assessment of a young couple caring for their newborn who was diagnosed with cerebral palsy. The nurse notes that the mothers hair and clothing are unkept and the house is untidy, and the mother states that she is so busy with the baby that I don't have time to do anything else. What would be the priority intervention for the family? A. Arrange to have the infant removed from the home B. Inform other members of the family of the situation C. Increase the number of visits by the visiting nurse D. Notify the care provider and recommend respite care for the mother

D. Notify the care provider and recommend respite care for the mother Reactions of family members to recoup care for long periods of time, called caregiver burden, include chronic fatigue, sleep disorders, and an increase incidence of stress related illnesses, such as hypertension and heart disease. The nurse should address the issue with the primary care provider and recommend a visit from a social worker and or arrange for respite care for the family

A nurse interview the woman who was abused by her partner and is seeing a woman shelter with her three children. She tells the nurse been so worried that my husband will find me and try to make me go back home. Which data would the nurse most appropriately document? A.Patient displays moderate anxiety related to her situation B.He should manifest panic related to feelings of impending doom C.Patient describes severe anxiety related to her situation D.Patient expresses fear of her husband

D. Patient expresses fear of her husband Fear is the response( feeling of dread) to a known threat. Anxiety another hand is vague uneasy feeling of discomfort or dried from an often unknown source. Panic causes a person to lose control and experience drought and tear, which can lead to exhaustion and death, that is not the case in this situation

The family of the patient who is just died asked to be alone with the body and asks for supplies to wash the body. The nurse providing care knows that the mortician usually washes the body. Which response would be most appropriate? A.Inform the family that there is no need for them to wash the body since the mortician typically does this B. Explain that the hospital policy for beds they're being alone with the deceased patient in the hospital supplies are to be used only by hospital personnel C. Give the supplies to the family but maintain a watchful eye to make sure that nothing unusual happens D.Provide the requested supplies checking if this request is linked to their religious or cultural customs and asking if there's anything else you can do to help

D.Provide the requested supplies checking if this request is linked to their religious or cultural customs and asking if there's anything else you can do The family may want to wash the potty for personal religious or cultural reasons and should be allowed to do so

Loneliness and resentment

Due to changed circumstances and of others whose families are in tact

Mental/ physical

Friends , family , support system

Physiologic reserve

Healthy or not

Balance timeline

Homeostasis

Sadness

Inconsolable and pervades life

Depression

Isolated in grief unable to share feeling

Anger

May be directed at self or others

Intensity differs from

Person to person - culture to culture - time to time for the same person

Anxiety

Something worse may happen/ loss of control

Allostsis

The term to describe the process of achieving homeostasis through physiologic or behavioral changes

Homeostasis⭐️

Various physiologic And psychological mechanisms respond to changes in the internal and External environment to maintain balanced state

reflex pain response

automatic response of the central nervous system to the stimulus of pain

defense mechanisms

in psychoanalytic theory, the ego's protective methods of reducing anxiety by unconsciously distorting reality

inflammatory response

localized response of the body to injury or infection; protective mechanism that eliminates invading pathogens and allows for tissue repair to occur

Local Adaptation Syndrome⭐️

localized response of the body to stress, precipitated by trauma or pathology

coping mechanisms

patterns of behavior used to neutralize, deny, or counteract anxiety

sympathetic nervous system

the division of the autonomic nervous system that arouses the body, mobilizing its energy in stressful situations

parasympathetic nervous system

the division of the autonomic nervous system that calms the body, conserving its energy