Fundamentals of Nursing

Nursing

Quiz 43 :

Loss, Grieving, and Death

Quiz 43 :

Loss, Grieving, and Death

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In working with a dying client, the nurse demonstrate assisting the client to die with dignity when performing which action 1)?Allows the client to make as many decisions about care as is possible 2) Shares with the client the nurse's own views about life after death 3) Avoids talking about dying and focuses on the present 4) Relieves the client of as much responsibility for self care as possible
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Loss leads to grief and everyone experiences this, at least once in a lifetime. It might be failure of a relationship, divorce or death. People change after the grieving period is over, some for better some for worse.
It is the nurses' duty to help out any client who may have had a loss, not affect his clinical condition. It is essential for the nurse to understand the importance of loss and grief. She has to assist the client go through that period.
Sharing her own view about life and death is not at all appropriate as the person is about to die. Avoidance about the death talk might also make the patient worried and scared, and not help him in facing the reality. It can be done only if the client wants it to be.
Hence, the options 2, 3 and 4 are incorrect.
The best the nurse can do in this situation is to allow the patient to make as many changes he likes to with his own care. It will make him feel wanted because these decisions can be taken by him.
Hence, the correct answer is option
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Govinda, 75, was admitted to the hospital after repeated episodes of pneumonia. Despite aggressive antibiotic therapy, her condition rapidly deteriorated and she died unexpectedly 1 week after being admitted to the hospital. Mrs. Govinda's oldest son who Rived nearby and frequently cared for his mother, arranged for the funeral and visited with relatives. He misses his mother and cries occasionally but managed to return to work the following week. The youngest son had difficulty attending the funeral, has been unable to sleep or eat cannot concentrate at work, and cannot believe that his mother Is dead. The middle son did not weep at the funeral and had title to say to his brothers or other relatives. He returned home to another state but has remained distant. He is back to work but feels very fatigued and apathetic. With the diagnosis of pneumonia, a respiratory infection, what physiological (palliative) needs might she have had?
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Palliative care is the approach to improve the quality of the life of client and his family facing the threat of life-threatening illness. The means to achieve this could be physical, psychological and spiritual.
It provides relief from the pain as well as other discomforting symptoms affirms death as normal process; neither intends to hasten or postpone life, integrate the psychological and spiritual aspects as well as offer a support system to client to live positively till death.
The physiological needs to be filled during the palliative care are as follows:
Body processes become slower and homeostatic balance is disturbed. Some of the interventions are controlling pain, providing personal hygiene, relieving respiratory difficulties, nutrition, hydration, elimination as well as providing measures that are related to the sensory changes.
Some of the specific symptoms of pneumonia are chest pain, fever, fatigue, cough and shaking chills. Depending on the pathogen, other symptoms can be swelling of lymph nodes, joints and diarrhea.
Therefore, apart from general interventions, certain specific interventions would be required in the case of chronic pneumonia. Controlling pain and other discomforting symptoms can be done by medications. Antibiotics, analgesics and fluids would be part of the intervention in such cases. Chest physiotherapy might be useful too.

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When asked to sign the permission form for surgical removal of a large but noncancerous lesion on her face, the client begins to cry. Which of the following is the most appropriate response? 1) "Tell me what it means to you to have this surgery." 2) "You must be very glad to be having this lesion removed." 3) "I cry when I am happy or relieved sometimes, too." 4) "Isn't it wonderful that the lesion is not cancer?"
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Loss leads to grief and everyone experiences this, at least once in a lifetime. It might be failure of a relationship, divorce or death. People change after the grieving period is over, some for better some for worse.
Telling the patient that she must be glad to remove the lesion, when she is crying is not the best reply. Citing your own example, is also not appropriate, as the patient, is not in a very sensible state of mind. Saying that the lesion is not cancerous, when the patient is crying about it will not ease her pain.
Hence, the options 2, 3 and 4 are incorrect.
The best reply would be to ask the patient, as to why she was having that surgery. Asking the patient for the purpose of her surgery will bring back sense into the client. She will realize that she intended to go for the operation to get rid of the lesion and would stop crying.
Hence, the correct answer is option
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Which of the following may be considered normal or "healthy" types of grief? Select all that apply. 1) Abbreviated grief 2) Anticipatory grief 3) Disenfranchised grief 4) Complicated grief 5) Unresolved grief 6) Inhibited grief
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Govinda, 75, was admitted to the hospital after repeated episodes of pneumonia. Despite aggressive antibiotic therapy, her condition rapidly deteriorated and she died unexpectedly 1 week after being admitted to the hospital. Mrs. Govinda's oldest son who Rived nearby and frequently cared for his mother, arranged for the funeral and visited with relatives. He misses his mother and cries occasionally but managed to return to work the following week. The youngest son had difficulty attending the funeral, has been unable to sleep or eat cannot concentrate at work, and cannot believe that his mother Is dead. The middle son did not weep at the funeral and had title to say to his brothers or other relatives. He returned home to another state but has remained distant. He is back to work but feels very fatigued and apathetic. From the data provided, describe the phase of bereavement being experienced by each of the three surviving sons.
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The nurse is caring for a family in a shelter 2 days after the loss of their home due to a fire. The fire caused minor burns to several members of the family but no life-threatening conditions. Which of the following is the most important assessment data for the nurse to gather at this time? 1) Availability of insurance coverage for rebuilding the house 2) Family members' understanding of the extent of their physical injuries 3) Psychological support resources available from friends or other sources 4) Family members' grief responses and coping behaviours
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Govinda, 75, was admitted to the hospital after repeated episodes of pneumonia. Despite aggressive antibiotic therapy, her condition rapidly deteriorated and she died unexpectedly 1 week after being admitted to the hospital. Mrs. Govinda's oldest son who Rived nearby and frequently cared for his mother, arranged for the funeral and visited with relatives. He misses his mother and cries occasionally but managed to return to work the following week. The youngest son had difficulty attending the funeral, has been unable to sleep or eat cannot concentrate at work, and cannot believe that his mother Is dead. The middle son did not weep at the funeral and had title to say to his brothers or other relatives. He returned home to another state but has remained distant. He is back to work but feels very fatigued and apathetic. How might your own feelings about death affect the care you provide to the dying client?
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The client has been close to death for some time and the family asks how the nurse will know when the client has actually died. Which of the following would be the most accurate response from the nurse? 1) When the blood pressure can no longer be measured 2) When the gag reflex is no longer present 3) When there is no apical pulse 4) When the extremities are cool and dark in color
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A nursing care plan includes the desired outcome of "quality of life" for a client with a chronic degenerative illness who is likely to live for many more years. Which of the following is one example that would indicate the outcome has been met? 1) The client demonstrates having adequate financial resources to pay for health care for many more years. 2) The client spends the majority of his or her time in spiritual reflection. 3) The client has no signs or symptoms of preventive complications of the illness. 4) The client verbalizes satisfaction with current relationships with other people.
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An 82-year-old man has been told by his primary care provider that it is no longer safe for him to drive a car. Which statement by the client would indicate beginning positive adaptation to this loss? 1) "I told the doctor I would stop driving, but I am not going to yet." 2) "I always knew this day would come, but I hoped it wouldn't be now." 3) "What does he know? I'm a better driver than he will ever be." 4) "Well, at least I have friends and family who can take me places."
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The shift changed while the nursing staff was waiting for the adult children of a deceased client to arrive. The oncoming nurse has never met the family. Which of the following initial greetings is most appropriate? 1) "I'm very sorry for your loss." 2) "I'll take you in to view the body." 3) "I didn't know your father but I am sure he was a wonderful person." 4) "How long will you want to stay with your father?"
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At which age does a child begin to accept that he or she will someday die? 1) Less than 5 years old 2) 5-9 years old 3) 9-12 years old 4) 12-18 years old
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A client's family tells the nurse that their culture does not permit a dead person to be left alone before burial. Hospital policy states that after 6:00 pm when mortuaries are closed, bodies are to be stored in the hospital morgue refrigerator until the next day. How would the nurse best manage this situation? 1) Gently explain the policy to the family and then implement it. 2) Inquire of the nursing supervisor how an exception to the policy could be made. 3) Call the client's primary care provider for advice. 4) Move the deceased to an empty room and assign an aide to stay with the body.
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Govinda, 75, was admitted to the hospital after repeated episodes of pneumonia. Despite aggressive antibiotic therapy, her condition rapidly deteriorated and she died unexpectedly 1 week after being admitted to the hospital. Mrs. Govinda's oldest son who Rived nearby and frequently cared for his mother, arranged for the funeral and visited with relatives. He misses his mother and cries occasionally but managed to return to work the following week. The youngest son had difficulty attending the funeral, has been unable to sleep or eat cannot concentrate at work, and cannot believe that his mother Is dead. The middle son did not weep at the funeral and had title to say to his brothers or other relatives. He returned home to another state but has remained distant. He is back to work but feels very fatigued and apathetic. What factors may have affected how each of the sons reart the death of their mother?
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Govinda, 75, was admitted to the hospital after repeated episodes of pneumonia. Despite aggressive antibiotic therapy, her condition rapidly deteriorated and she died unexpectedly 1 week after being admitted to the hospital. Mrs. Govinda's oldest son who Rived nearby and frequently cared for his mother, arranged for the funeral and visited with relatives. He misses his mother and cries occasionally but managed to return to work the following week. The youngest son had difficulty attending the funeral, has been unable to sleep or eat cannot concentrate at work, and cannot believe that his mother Is dead. The middle son did not weep at the funeral and had title to say to his brothers or other relatives. He returned home to another state but has remained distant. He is back to work but feels very fatigued and apathetic. What cues, other than physical signs, might have indicated that Mrs. Govinda was dying, even though her death was unexpected?
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