Chap. 43: grief and loss

A patient with a terminal illness tells the nurse, "I have lived a long life. I am ready to die." What is the nurse's best response? 1. Sit quietly by the bedside 2. Offer the patient a back rub 3. Tell the family about the patient's statement 4. Initiate a discussion of how dying is part of the life cycle

1. Sit quietly by the bedside

A nurse is caring for a client who is dying. The nurse develops the plan of care understanding that which intervention would be inappropriate in the care of the client? 1. Offer to contact the clergy to support the client's spiritual needs. 2. Make referrals to other disciplines based on the client's stated needs. 3. Plan to balance the client's need for assistance with that for independence. 4. Provide extremely thorough answers to each question asked by the client or family.

4. Provide extremely thorough answers to each question asked by the client or family. In planning care for the dying client, the nurse provides information and answers questions to the extent most helpful to the client and family

The nurse is caring for a client who has just expired. Which action will the nurse perform? Provide a complete bath. Allow the client's family to see the client's body before it is discharged. Have the nurse technician place identification tags on the outside of the shroud. Place the client in a semi-Fowler's position.

Allow the client's family to see the client's body before it is discharged.

Which priority intervention should the nurse plan to implement to reduce a client's discomfort during terminal weaning? Administer sedation and analgesia. Have the client's family remain at the bedside. Offer emotional support to the family. Provide an explanation of the process.

Administer sedation and analgesia.

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? Consult with the charge nurse or nurse manager before calling the code. Respect the client's wishes and avoid calling a code. Call a code and begin resuscitating the client. Initiate a slow-code until the physician arrives.

Call a code and begin resuscitating the client.

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? Place a rolled towel under the head. Cleanse drainage from the skin. Apply hairpins and clips. Avoid replacing dentures in the mouth.

Cleanse drainage from the skin.

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. Distended abdomen with last bowel movement documented 7 days ago Systolic blood pressure which rose from 100 to 110 mm Hg A regular apical pulse of 90 beats/minute Cyanotic nail beds in hands and feet bilaterally 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 Gurgling sounds emanating from the client's throat with each breath

The cardiac nurse, who has been caring for a hospitalized, terminally ill client for 3 days, finds that the client has expired. The nurse manager knows that the nurse can legally care for these clients when the nurse makes which statement?

Hospitals are mandated to notify transplant programs of potential donors.The scarcity of organs has resulted in legislation mandating hospitals to notify transplantation programs of potential donors. Consent for autopsy is legally required, usually from the closest surviving family member. It is usually the physician's responsibility to obtain permission for an autopsy. If death is caused by accident, suicide, homicide, or illegal therapeutic practice, or if it occurs within 24 hours of admission to the hospital, the coroner must be notified. Organs can be obtained from brain-dead clients and non-heart-beating cadavers.

The client is a young mother whose spouse died 3 months ago. The client is tearful and unkempt, eats a poor diet, and has lost 50 lb (22.6 kg) since the death of the spouse. The client states, "I can't do this anymore." The nursing diagnosis best supported by these data is: Ineffective coping related to failure of previously used coping mechanisms Decisional conflict related to inability to progress following spouse's death Ineffective denial related to poor grief resolution Death anxiety related to death of spouse

Ineffective coping related to failure of previously used coping mechanisms

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 severely injured in a motor vehicle accident is rushed to the health care facility with severe head injuries and profuse loss of blood. Which sign indicates approaching death? The frequency of urination decreases. The client's breathing becomes noisy. The client is calm and peaceful. The arms and legs are warm to touch.

The client's breathing becomes noisy. Noisy breathing, or death rattle, is common during the final stages of dying because of the accumulation of secretions in the lungs. Reduced urination is not seen during the final stages of dying. Instead, the client develops loss of control over bladder and bowels due to loss of neurological control. The peripheral parts of the client's body such as the arms and the legs are cold to touch (not warm) because the circulation is directed away from the periphery and toward the core of the body. Clients in the last stages of dying are usually not calm and peaceful; they occasionally exhibit sudden restlessness due to hunger for oxygen

Upon admission, the nurse should give priority to addressing which need of a client who is displaying symptoms of dysfunctional grief? self-care activities coping strategies spiritual distress pain management

coping strategies

A terminally ill client is being cared for at home and receiving hospice care. The hospice nurse is helping the family cope with the client's deteriorating condition, educating them on the signs of approaching death. Which sign would the nurse include in this education plan? increased urinary output increased sensory stimulation difficulty swallowing decreased pain

difficulty swallowing

Which stage of grieving is exhibited by the husband of a victim of sudden death who refuses to accept that she is dead? depression shock doubt protest

shock

The experience of parting with an object, person, belief, or relationship that one values is defined as: grief. loss. death. bereavement.

loss.Loss is defined as the experience of parting with an object, person, belief, or relationship that one values;

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