Death and Dying Chapter 43
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Questions and Answers

What is primarily emphasized in advance directives regarding patient care?

  • The patient's preferences and decision-making authority (correct)
  • Legal obligations of healthcare institutions
  • The preferences of healthcare providers
  • Standard procedures for all patients
  • Which of the following describes a physiological need of terminally ill patients?

  • Closure with unresolved issues
  • Control over their treatment decisions
  • Pain management and nutritional requirements (correct)
  • Comfort from loved ones
  • What is a potential emotional challenge faced by family members caring for a terminally ill patient?

  • Feeling of isolation due to the patient's illness (correct)
  • Comprehensive understanding of medical procedures
  • Financial support from the healthcare system
  • Increased social interaction with other caregivers
  • End-of-life care includes which of the following preferences regarding patient comfort?

    <p>Facilitating the patient's comfort and dignity</p> Signup and view all the answers

    Which type of order allows a patient to decline resuscitation efforts?

    <p>Do Not Resuscitate (DNR) order</p> Signup and view all the answers

    In preparing a body after death, which step is crucial to prevent postmortem complications?

    <p>Begin preparation before body cooling occurs</p> Signup and view all the answers

    What is one of the goals of palliative care?

    <p>Improving the quality of life for patients with life-threatening illnesses</p> Signup and view all the answers

    When a patient dies, who is typically responsible for declaring the death?

    <p>The attending healthcare provider</p> Signup and view all the answers

    What is a key element in establishing a trusting nurse-patient relationship in end-of-life care?

    <p>Educating the patient and family on self-care</p> Signup and view all the answers

    Which of the following reflects a common issue faced by LGBTQ+ individuals in healthcare?

    <p>Discrimination due to sexual orientation affecting medical decisions</p> Signup and view all the answers

    What are the characteristics of actual loss?

    <p>It can be recognized and acknowledged by others.</p> Signup and view all the answers

    Which of the following describes the process of grieving as per Engel's stages of grief?

    <p>A phase of recognizing and working through the loss.</p> Signup and view all the answers

    In Kübler-Ross's Five Stages of Grief, which stage involves the individual experiencing intense anger?

    <p>Anger</p> Signup and view all the answers

    Which factor does NOT significantly influence grief and death according to the content?

    <p>Personal financial status</p> Signup and view all the answers

    What does the definition of death include based on the medical standards outlined?

    <p>Permanent cessation of circulatory and respiratory functions.</p> Signup and view all the answers

    What is the primary component of good end-of-life care?

    <p>Ensuring that symptoms are controlled.</p> Signup and view all the answers

    What does POLST refer to in advanced care planning?

    <p>Medical orders conveying patients' treatment preferences in emergencies.</p> Signup and view all the answers

    Which of the following is NOT a common sign that death is approaching?

    <p>Increased energy levels.</p> Signup and view all the answers

    In terms of advance directives, which option reflects an individual's instructions prior to losing the ability to make decisions?

    <p>Living will</p> Signup and view all the answers

    What is the significance of the term 'mourn' in the context of grief?

    <p>It encompasses the external expressions and rituals associated with grief.</p> Signup and view all the answers

    What type of loss is experienced personally but may not be recognizable to others?

    <p>Perceived loss</p> Signup and view all the answers

    Which stage in Kübler-Ross's Five Stages of Grief involves the acceptance of the inevitable?

    <p>Acceptance</p> Signup and view all the answers

    Which of the following defines the term 'grief'?

    <p>A personal and emotional reaction to loss</p> Signup and view all the answers

    What is an example of a medical standard used to declare death?

    <p>Lack of brain activity</p> Signup and view all the answers

    Which of the following is NOT considered a component of palliative care?

    <p>Treatment of underlying diseases</p> Signup and view all the answers

    Which factor does play a role in shaping an individual's experience of grief?

    <p>Age and developmental stage</p> Signup and view all the answers

    Which term defines a scenario where a loss is anticipated but not yet realized?

    <p>Anticipatory loss</p> Signup and view all the answers

    What is the meaning of the term 'DNR' in medical directives?

    <p>A do-not-resuscitate order</p> Signup and view all the answers

    Which of the following does NOT accurately represent Engel's stages of grief?

    <p>Indifference</p> Signup and view all the answers

    What typically characterizes perceived loss based on the provided definitions?

    <p>It is uniquely felt by the individual</p> Signup and view all the answers

    What is an important factor that influences a terminally ill patient's psychological needs?

    <p>Need for control over fear of the unknown</p> Signup and view all the answers

    Which of the following needs must be addressed in developing a palliative care plan?

    <p>Holistic needs including spiritual connections</p> Signup and view all the answers

    Which action is essential when preparing the body after death to maintain dignity?

    <p>Positioning the body in an anatomical position</p> Signup and view all the answers

    What must be communicated to family members regarding the patient's end-of-life care preferences?

    <p>The patient's advance directive content</p> Signup and view all the answers

    What is often a major concern for LGBTQ+ individuals in healthcare settings?

    <p>Discriminatory attitudes affecting treatment decisions</p> Signup and view all the answers

    Which statement accurately reflects the focus of hospice care?

    <p>Enhancing life quality in terminal stages</p> Signup and view all the answers

    What documentation is crucial after a patient's death for legal purposes?

    <p>Death certificate</p> Signup and view all the answers

    Which of the following reflects a misconception about palliative care?

    <p>It is synonymous with hospice care.</p> Signup and view all the answers

    What physical need may be overlooked in end-of-life nursing care?

    <p>Nutritional intake</p> Signup and view all the answers

    Which approach is least likely to support a trusting nurse-patient relationship?

    <p>Maintaining a strict professional distance</p> Signup and view all the answers

    Study Notes

    Learning Objectives

    • Identify types of loss, including actual, perceived, and anticipated losses.
    • Describe signs of impending death and their significance in patient care.
    • Understand terminology related to end-of-life care, such as advance directives and palliative care.
    • Determine effective communication strategies for interacting with terminally ill patients and their families.
    • Develop care plans for terminal patients and their loved ones.
    • Recognize discrimination faced by LGBTQ+ families in end-of-life situations.
    • Outline nursing procedures during post-mortem care.

    Types of Loss

    • Actual loss: Recognizable by others.
    • Perceived loss: Felt by the individual but invisible to others.
    • Anticipated loss: Loss that is expected but has not yet occurred.
    • Distinction between physical loss (e.g., bodily function) and psychological loss (e.g., identity changes).

    Definitions

    • Grief: Inner emotional response to loss.
    • Bereavement: The state of mourning following the loss of a loved one.
    • Mourning: The process and expression of grief, involving various symbols and rituals.

    Engel's Stages of Grief

    • Shock and disbelief.
    • Developing awareness.
    • Return to normalcy.
    • Resolution of loss.
    • Idealization of the deceased.
    • Outcome of bereavement.

    Kübler-Ross's Stages of Grief

    • Denial and isolation.
    • Anger.
    • Bargaining.
    • Depression.
    • Acceptance.

    Factors Influencing Grief and Death

    • Developmental considerations (age and maturity).
    • Family dynamics and support systems.
    • Socioeconomic factors (access to healthcare).
    • Cultural, gender, and religious beliefs.
    • Cause of death (unexpected vs. expected).

    Definition of Death

    • According to the Uniform Definition of Death: A person is declared dead if either
      • circulatory and respiratory functions have stopped irreversibly, or
      • there is irreversible cessation of all brain function, including the brainstem.

    Signs of Impending Death

    • Physical indicators, such as changes in breathing patterns (e.g., Cheyne-Stokes respiration).
    • Importance of awareness and observance of these signs for caring professionals.

    Components of a Good Death

    • Symptom management and palliative measures.
    • Preparation for death emotionally and spiritually.
    • Opportunities for life reflection and closure.
    • Positive relationships with healthcare providers.
    • Advance directives: Instructions for care if a person loses decision-making capacity.
    • POLST/MOLST: Medical orders respecting treatment preferences for terminal patients.
    • DNR (Do Not Resuscitate): Order to refrain from CPR in the event of cardiac or respiratory failure.
    • Living will: Document specifying treatment preferences in future medical crises.

    Patient Needs at End-of-Life

    • Physiological: Pain management, hygiene, nutrition.
    • Psychological: Control over fear, separation, and dignity.
    • Intimacy: Need for physical closeness and emotional support.
    • Spiritual: Seeking meaning, and connection, and finding a purpose.

    Developing Trusting Nurse-Patient Relationships

    • Providing clear explanations of diagnosis and treatment.
    • Teaching self-care to empower patients.
    • Supporting family members in caregiving roles.
    • Addressing the needs of both patients and their families.

    LGBTQ+ Rights in Healthcare

    • Importance of non-discrimination policies in healthcare settings.
    • Issues concerning the acceptance of same-sex partners in decision-making.
    • The significance of support systems, including chosen families and spirituality during end-of-life care.

    Post-Mortem Care

    • Notify appropriate providers and complete death certification.
    • Prepare the body for disposition while ensuring privacy for the family.
    • Essential tasks: Positioning the body, closing eyes and mouth, and cleaning the patient.
    • Address family grief needs, providing comfort and privacy.

    Family Post-Mortem Support

    • Facilitate family viewing of the deceased with sensitivity.
    • Create a mindful environment for family members to begin the grieving process.
    • Ensure proper identification and handling of the body before transferring to mortuary care.

    Learning Objectives

    • Identify types of loss, including actual, perceived, and anticipated losses.
    • Describe signs of impending death and their significance in patient care.
    • Understand terminology related to end-of-life care, such as advance directives and palliative care.
    • Determine effective communication strategies for interacting with terminally ill patients and their families.
    • Develop care plans for terminal patients and their loved ones.
    • Recognize discrimination faced by LGBTQ+ families in end-of-life situations.
    • Outline nursing procedures during post-mortem care.

    Types of Loss

    • Actual loss: Recognizable by others.
    • Perceived loss: Felt by the individual but invisible to others.
    • Anticipated loss: Loss that is expected but has not yet occurred.
    • Distinction between physical loss (e.g., bodily function) and psychological loss (e.g., identity changes).

    Definitions

    • Grief: Inner emotional response to loss.
    • Bereavement: The state of mourning following the loss of a loved one.
    • Mourning: The process and expression of grief, involving various symbols and rituals.

    Engel's Stages of Grief

    • Shock and disbelief.
    • Developing awareness.
    • Return to normalcy.
    • Resolution of loss.
    • Idealization of the deceased.
    • Outcome of bereavement.

    Kübler-Ross's Stages of Grief

    • Denial and isolation.
    • Anger.
    • Bargaining.
    • Depression.
    • Acceptance.

    Factors Influencing Grief and Death

    • Developmental considerations (age and maturity).
    • Family dynamics and support systems.
    • Socioeconomic factors (access to healthcare).
    • Cultural, gender, and religious beliefs.
    • Cause of death (unexpected vs. expected).

    Definition of Death

    • According to the Uniform Definition of Death: A person is declared dead if either
      • circulatory and respiratory functions have stopped irreversibly, or
      • there is irreversible cessation of all brain function, including the brainstem.

    Signs of Impending Death

    • Physical indicators, such as changes in breathing patterns (e.g., Cheyne-Stokes respiration).
    • Importance of awareness and observance of these signs for caring professionals.

    Components of a Good Death

    • Symptom management and palliative measures.
    • Preparation for death emotionally and spiritually.
    • Opportunities for life reflection and closure.
    • Positive relationships with healthcare providers.
    • Advance directives: Instructions for care if a person loses decision-making capacity.
    • POLST/MOLST: Medical orders respecting treatment preferences for terminal patients.
    • DNR (Do Not Resuscitate): Order to refrain from CPR in the event of cardiac or respiratory failure.
    • Living will: Document specifying treatment preferences in future medical crises.

    Patient Needs at End-of-Life

    • Physiological: Pain management, hygiene, nutrition.
    • Psychological: Control over fear, separation, and dignity.
    • Intimacy: Need for physical closeness and emotional support.
    • Spiritual: Seeking meaning, and connection, and finding a purpose.

    Developing Trusting Nurse-Patient Relationships

    • Providing clear explanations of diagnosis and treatment.
    • Teaching self-care to empower patients.
    • Supporting family members in caregiving roles.
    • Addressing the needs of both patients and their families.

    LGBTQ+ Rights in Healthcare

    • Importance of non-discrimination policies in healthcare settings.
    • Issues concerning the acceptance of same-sex partners in decision-making.
    • The significance of support systems, including chosen families and spirituality during end-of-life care.

    Post-Mortem Care

    • Notify appropriate providers and complete death certification.
    • Prepare the body for disposition while ensuring privacy for the family.
    • Essential tasks: Positioning the body, closing eyes and mouth, and cleaning the patient.
    • Address family grief needs, providing comfort and privacy.

    Family Post-Mortem Support

    • Facilitate family viewing of the deceased with sensitivity.
    • Create a mindful environment for family members to begin the grieving process.
    • Ensure proper identification and handling of the body before transferring to mortuary care.

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    Description

    This quiz focuses on Chapter 43 of the Fundamentals textbook, which explores various aspects of death and end-of-life care. You will learn about different types of loss, signs of impending death, communication strategies for end-of-life patients, and care planning for terminal illness. The quiz also addresses challenges faced by LGBTQ+ families during this critical time.

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