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Questions and Answers
Which of the following is NOT a risk factor for complicated grief?
Which of the following is NOT a risk factor for complicated grief?
What is a key component of the treatment for complicated grief?
What is a key component of the treatment for complicated grief?
In assessing coping after death, which dimension includes observing what the person is thinking?
In assessing coping after death, which dimension includes observing what the person is thinking?
Which of the following statements about the grieving process is accurate?
Which of the following statements about the grieving process is accurate?
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Which factor is likely to contribute to prolonged or complicated grief?
Which factor is likely to contribute to prolonged or complicated grief?
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When assessing a grieving client, which of the following dimensions is related to the client's values and beliefs?
When assessing a grieving client, which of the following dimensions is related to the client's values and beliefs?
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Which of the following is NOT a focus during the management of complicated grief?
Which of the following is NOT a focus during the management of complicated grief?
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Which statement best reflects the individuality of the grief process?
Which statement best reflects the individuality of the grief process?
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What is the first phase in the stages of escalation?
What is the first phase in the stages of escalation?
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Which action step is NOT suggested to manage disruptive behaviors?
Which action step is NOT suggested to manage disruptive behaviors?
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Which intervention is recommended during the triggering phase?
Which intervention is recommended during the triggering phase?
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What does zero tolerance for unacceptable behaviors entail?
What does zero tolerance for unacceptable behaviors entail?
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What technique can be used to help clients express their anger verbally?
What technique can be used to help clients express their anger verbally?
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What is a likely outcome of the crisis phase?
What is a likely outcome of the crisis phase?
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In the recovery phase, what is a recommended action for nurses once the client's anger subsides?
In the recovery phase, what is a recommended action for nurses once the client's anger subsides?
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What is essential for preventing physically aggressive behavior?
What is essential for preventing physically aggressive behavior?
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What is one benefit of having a written agreement in treatment plans?
What is one benefit of having a written agreement in treatment plans?
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Why might nurses hesitate to report a colleague's suspected substance abuse?
Why might nurses hesitate to report a colleague's suspected substance abuse?
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What is a significant consequence of not reporting a colleague suspected of substance abuse?
What is a significant consequence of not reporting a colleague suspected of substance abuse?
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Which behavior is NOT a common warning sign of substance abuse in colleagues?
Which behavior is NOT a common warning sign of substance abuse in colleagues?
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What must staff ensure regarding treatment plans to prevent manipulation by clients?
What must staff ensure regarding treatment plans to prevent manipulation by clients?
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In scenarios of suspected substance abuse, how should a nurse ideally respond?
In scenarios of suspected substance abuse, how should a nurse ideally respond?
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Which of these statements about ethical reporting of impaired colleagues is correct?
Which of these statements about ethical reporting of impaired colleagues is correct?
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What is the consequence of handling a colleague's suspected substance abuse informally?
What is the consequence of handling a colleague's suspected substance abuse informally?
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What is the typical timeframe for alcohol withdrawal to peak and resolve?
What is the typical timeframe for alcohol withdrawal to peak and resolve?
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What is a key sign that indicates severe alcohol withdrawal according to the CIWA Scale?
What is a key sign that indicates severe alcohol withdrawal according to the CIWA Scale?
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What medication is commonly used to manage alcohol withdrawal symptoms?
What medication is commonly used to manage alcohol withdrawal symptoms?
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Which statement correctly describes the difference between fixed-schedule dosing and symptom-triggered dosing?
Which statement correctly describes the difference between fixed-schedule dosing and symptom-triggered dosing?
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Which of the following is NOT an expected symptom of alcohol withdrawal?
Which of the following is NOT an expected symptom of alcohol withdrawal?
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What clinical assessment tool is commonly used to guide the management of alcohol withdrawal?
What clinical assessment tool is commonly used to guide the management of alcohol withdrawal?
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What precaution is advised for individuals experiencing seizures during alcohol withdrawal?
What precaution is advised for individuals experiencing seizures during alcohol withdrawal?
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What is a potential risk associated with alcohol withdrawal that necessitates medical supervision during detoxification?
What is a potential risk associated with alcohol withdrawal that necessitates medical supervision during detoxification?
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What is the typical timeline for the onset of withdrawal symptoms after cessation of alcohol intake?
What is the typical timeline for the onset of withdrawal symptoms after cessation of alcohol intake?
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Which of the following symptoms is NOT typically associated with alcohol withdrawal?
Which of the following symptoms is NOT typically associated with alcohol withdrawal?
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What condition may severe alcohol withdrawal progress to if untreated?
What condition may severe alcohol withdrawal progress to if untreated?
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In which scenario might detoxification from alcohol be accomplished safely at home?
In which scenario might detoxification from alcohol be accomplished safely at home?
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What medication is commonly used to suppress withdrawal symptoms during alcohol detoxification?
What medication is commonly used to suppress withdrawal symptoms during alcohol detoxification?
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What does a Clinical Institute Withdrawal Assessment score of 7 signify?
What does a Clinical Institute Withdrawal Assessment score of 7 signify?
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Which withdrawal management approach adapts medication based on the severity of symptoms?
Which withdrawal management approach adapts medication based on the severity of symptoms?
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For what duration do withdrawal symptoms typically peak after cessation of alcohol intake?
For what duration do withdrawal symptoms typically peak after cessation of alcohol intake?
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Study Notes
Grief and Loss
- Grief can lead to major depression in individuals with a history of the disorder.
- Changes in treatment settings, routines, environments, or staff can also trigger a sense of loss and grief.
- Risk factors for complicated grief include the death of a spouse, child, or parent, particularly in early childhood or adolescence.
- Sudden, unexpected, and untimely deaths, multiple deaths, deaths by suicide or murder are also associated with increased risk of complicated grief.
Treating Complicated Grief
- Focuses on understanding the grief process, managing painful emotions, thinking about the future, strengthening relationships, telling the story of the death, learning to live with reminders, and remembering the person who died.
Assessment of Coping after Death
- Involves observing all dimensions of human response: cognitive, emotional, spiritual, behavioral, and physiologic.
- Effective communication during assessment helps clients understand their experience.
- Assessment facilitates the client's grief process.
- The grieving response is individual, with no one right way to grieve.
- Grief is a dynamic process, not a linear progression through stages.
Critical Components of Assessment
- Adequate perception of the loss.
- Ability to process the loss in a healthy way.
- Functional adaptation to life after loss.
Dealing with Disruptive Behavior in Organizations
- Leaders must create and implement processes for managing disruptive and inappropriate behaviors.
- Seven action steps are suggested:
- A code of conduct outlining acceptable and unacceptable behavior.
- A process for managers to handle disruptive behavior.
- Education for all team members on expected professional behavior.
- Zero tolerance for unacceptable behaviors, holding all individuals accountable.
Stages of Escalation
- Triggering phase: Initiates an aggressive response.
- Escalation phase: Behavior escalates toward the crisis phase.
- Crisis phase: Client loses the ability to perceive events accurately, solve problems, express feelings, or control behavior.
- May lead to physical aggression.
- Recovery phase.
- Post-crisis phase.
De-escalation Techniques
- Approach the client in a nonthreatening, calm manner.
- Convey empathy for the client's anger or frustration.
- Encourage the client to express angry feelings verbally.
- Use clear, simple, short statements.
- Allow the client time to express themselves.
- Suggest a quiet area or assistance to minimize stimulation.
- Offer medications (PRN) if ordered.
- Help the client use relaxation techniques and address the problem or conflict.
Professional Response to Impaired Colleague
- Addressing suspected substance abuse in colleagues is a sensitive and challenging issue.
- Nurses may hesitate to report concerns due to difficulty believing a health professional could be impaired, guilt, fear of falsely accusing someone, or avoiding conflict.
- Reporting suspected substance abuse is an ethical and, in some states, legal responsibility.
- General warning signs include:
- Poor work performance.
- Frequent absenteeism.
- Unusual behavior.
- Slurred speech.
- Isolation from peers.
Specific Signs of Substance Abuse
- Incorrect drug counts.
- Excessive controlled substances listed as wasted or contaminated.
- Tachycardia (over 100).
- Hypertension.
- Fever.
- Anxiety and agitation.
- Confused restlessness.
- Seizures.
Alcohol Withdrawal
- Symptoms usually begin 4-12 hours after cessation or reduced alcohol intake.
- Coarse hand tremors, sweating, elevated pulse, blood pressure, insomnia, anxiety, nausea, vomiting.
- Severe withdrawal can lead to hallucinations, seizures, or delirium tremens.
- Withdrawal peaks on the second day and lasts about 5 days (but can vary).
- Medical supervision is required for withdrawal.
- If symptoms are mild, home treatment is possible.
- For severe withdrawal or those unable to abstain, a 3-5 day admission to a hospital or psychiatric unit is common.
- Safe withdrawal typically involves benzodiazepines, like lorazepam, chlordiazepoxide, or diazepam.
- Dosage is determined by tapering based on a fixed schedule or symptom-triggered dosing, using the CIWA scale to assess severity.
Opioid Withdrawal
- Symptoms include:
- Muscle aches.
- Runny nose.
- Yawning.
- Nausea.
- Restlessness.
- Vomiting.
- Diarrhea.
- Insomnia.
- Cramps.
- Anxiety.
- Sweating.
- Withdrawal can be managed medically with medications like buprenorphine (Subutex) or methadone.
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Description
This quiz explores the complexities of grief and loss, focusing on how grief can impact mental health and lead to complications like major depression. It also covers the treatment approaches for complicated grief and assessments that gauge coping mechanisms following the death of a loved one. Understanding these factors is essential for supporting individuals through their grieving process.