grief and loss

A client has responded to the recent diagnosis of lung cancer by making extensive plans for overseas travel with the client's children, despite the fact that the oncologist has informed the client of the extremely poor prognosis. The nurse consequently recognizes that the client is likely in the denial stage of grief. How can the nurse best facilitate adaptive grieving for this client?

Address the client's diagnosis and prognosis at a later time or date

The nurse is assisting parents who have just experienced the death of their twin infants. What would be the most appropriate action for the nurse?

Allow the parents to be present at medical rounds and the resuscitation.

The nurse most effectively explains to a terminally ill client's spouse that the frustration and anger the client is exhibiting is associated with what aspect of dying?

An expression of a universally held need of the dying

A public health nurse is developing a plan to implement strategies to assist in lowering of maternal and infant mortality rates for black women in the United States. Which factors should not be included in the plan?

Black women have adequate obstetrical insurance coverage.

Which of the following would lead the nurse to identify that a client is experiencing a physiologic response to grief?

Choking sensation

A hospice nurse performs a follow-up telephone call to the spouse of a client who died about 1 year ago. The spouse tells the nurse, "I'm always feeling so sad. Life just doesn't feel worth living." Further conversation reveals that the spouse is having trouble sleeping and eating since her husband's death and that the spouse is "drinking more since he died." The nurse identifies which nursing diagnosis as the priority?

Complicated grieving

In assessing a postmastectomy client, the nurse determines that the client is in denial. The nurse can best respond by

accepting the denial.

The nurse is assessing a client who reports feeling hopeless since a divorce. Which would be an appropriate question for the nurse to ask in order to determine mental health status for this client?

"Do you ever use drugs to help feel less emotional pain?"

After the physician has discussed euthanasia with a terminal client and family, the nurse assesses their understanding of the topic. Which statement by the family indicates that learning has occurred?

"It is all right to stop dialysis."

A nurse is caring for a client who is scheduled to have a below the knee amputation. The client is visibly upset and angry and shouts at the nurse. Which of the following responses would be most appropriate?

"It's okay to be angry and upset. Is there anything I can do to help?"

During a home care visit to a client in hospice, the client's spouse reveals to the nurse an understanding that the client's death is inevitable. Recognizing the spouse is exemplifying the Kübler-Ross stage of acceptance, which statement by the nurse is most appropriate?

"Tell me how you plan to react when you first realize that your spouse is breathless and has no pulse."

Which statement, made by the nurse, focuses on the purposeful assessment of a client coping with a terminal diagnosis?

"Who do you want to share information about your prognosis with?"

Friends of two teenagers recently killed in a car accident are discussing their sense of loss. Which comment best indicates that the friends are trying to make sense of the loss cognitively?

"Why did they have to die so young?"

A nurse is conducting a spiritual assessment of a terminally ill client using the four step FICA process and asks the question, "What gives your life meaning?" The nurse is assessing which of the following?

Faith and belief

A nurse who provides care on an acute medical unit has observed that physicians are frequently reluctant to refer clients to hospice care. What are contributing factors that are known to underlie this tendency? Select all that apply.

Financial pressures on health care providers Client reluctance to accept this type of care Advances in "curative" treatment in late-stage illness

Nursing students are reviewing information about grieving and its assessment findings. The students demonstrate an understanding of the information when they identify which of the following as a behavioral indicator?

Forgetfulness

The hospice nurse is educating a client's family on the physical signs of approaching death. The nurse identifies that the education has been effective when the family says they will know that death is imminent when they see which related symptoms? Select all that apply.

Irregular respiratory rate Restlessness Bowel incontinence Cyanosis of dependent areas

A hospice nurse is visiting the home of a client who was recently diagnosed with a terminal illness. The nurse is developing the client's plan of care and is assessing beliefs and preferences about end-of-life care. The nurse would expect to complete this assessment at which time?

Over the course of several visits

A nurse is assessing a client with a terminal illness and finds that the client has cachexia. The nurse interprets this as indicating which of the following?

Profound protein loss

A client reports a new onset of sporadic epigastric pain, yellow skin, nausea, vomiting, weight loss, and fatigue. The health care provider orders a diagnostic workup, which reveals end-stage gallbladder cancer. What nursing intervention should be used to facilitate adaptive coping?

Refer client for professional counseling.

A nurse is caring for a client who is grieving the loss of a loved one. Which factor would the nurse identify as contributing to the possibility of complicated bereavement?

The client has experienced a number of previous losses.

When assessing a patient who is grieving, the nurse identifies several emotional indicators. Which of the following would be consistent with the nurse's findings? Select all that apply.

Social withdrawal Apathy Self-blame

The nurse is caring for a client in a hospice facility and uses healing touch. A family member asks the nurse, "What good is touching going to do with cancer?" What is the best response by the nurse? Select all that apply.

To stimulate wound healing To decrease pain To promote health To support end-of-life

A client has just died following urosepsis that progressed to septic shock. The client's spouse says, "I knew this was coming, but I feel so numb and hollow inside." The nurse should know that these statements are characteristic of what?

Uncomplicated grief and mourning

The nurse is caring for a client who is dying. The nurse overhears the client saying, "God, if you will only let me live to see my daughter get married, I promise I will start going to church again." The nurse understands that the client is in which stage of grief according to Kübler-Ross?

bargaining