Loss and Grieving

  1. necessary loss
    part of life (house, job change)
  2. perceived loss
    loss is felt by the person, but not evident to others (self-esteem)
  3. maturational loss
    loss which occurs through normal development
  4. situational loss
    loss related circumstances or events (natural disasters)
  5. loss
    a situation, either acutal or potential, in which a valued object is changed, no longer available or gone.
  6. examples of loss
    • known environment
    • significant other
    • aspect of self (limb)
    • life (independence)
  7. grief
    emotional response to loss manifested in thoughts, feelings and behaviors
  8. functions of grief
    accep what has happened, moved on
  9. bereavement
    response to loss, after death of person
  10. mourning
    social way that society says we go through grief
  11. physical symptoms of grief
    crying, fatigue, seeks medical help, loss of weight
  12. abbreviated grief
    people go through grieving process quickly (because it's anticipated, or losing a pet)
  13. anticipated grief
    knew it was going to happen
  14. unresolved grief
    extended or prolonged denial
  15. disenfranchised grief
    unable to acknowledge or share grief
  16. complicated/dysfunctional grief
    fail to grieve or haven't gotten to in years
  17. stages of the grieving process
    • denial
    • protest/anger
    • bargaining
    • disorganization/depression
    • acceptance/healing
  18. factors influencing reaction to loss
    • nature of loss
    • personal relationship
    • cause of death
  19. personal resources/stressors
    • health
    • coping skills
    • spiritual beliefs
    • socioeconomic status
  20. assessment of the grieving process
    • nursing history (support, culture)
    • emotional status (recent loss, normal coping)
    • physical exam (cardiac, respiratory)
  21. desired outcomes for end-of-life-care
    • identification of patients needs
    • control of symptoms of distress
    • meaningful interactions between pt and family
    • peaceful death
  22. advanced directives
    written document prepared by a competent individual specifying what, if any, extraordinary actions the person would want
  23. DPOA
    legal document assigning decision-making power to another person
  24. living will
    legal document that instructs physicians and family members about life-sustaining treatment
  25. palliative care
    focus on care is symptom control and compassion
  26. hospice care
    • life expectancy of 6 mo
    • dignity and peaceful death
    • improve quality of life
  27. physical/ clinical manifestations
    • coolness of extremitites
    • increased sleep
    • fluid and food decrease
    • incontinence
    • congestion and gurgling (death rattle)
  28. providing end of life care
    • pain management
    • pain is the symptom that dying pt fears most
    • pain management should be scheduled to prevent any pain
    • consider alternative route for med prn
  29. dyspnea management-pharmacological
    • opiods
    • anticholinergics
    • bronchodilators
    • sedatives
    • patches
    • rectally
    • sublingually
    • o2 therapy
    • diuretic
    • antibiotics
  30. dyspnea management/non-pharmalogical
    • cool air
    • wet cloths to pt face
    • positioning pt to facilitat chest expansion
    • rest periods
    • imagery and deep breathing
  31. nausea and vomiting management
    • aniemetic agents
    • something cool
    • remove any odors
    • comfortable room temp
    • dietary changes
    • assess for and treat constipation
  32. restless and agitation management
    • assess for pain, urinary retention, constipation
    • treat underlying cause
  33. weakness management
    • aspiration precautions
    • mouth care and moisture for lips
    • altered routs for meds
  34. symptoms at end of life
    • weakness
    • anorexia
    • foods increase discomfort
    • changes in cardio (weak pulses, cyanosis, apnea)
    • changes in breathing
    • changes in gastrointestinal function
  35. rigor mortis
    the stiffening of the body that occurs 2-4 hours after death, muscles stif

    body: supine, flat, put dentures in
  36. algor mortis
    gradual decrease of body temp after death
  37. livor mortis
    • discoloration in depend areas of the body
    • (looks bruised on the back)
  38. cheyne-stokes respirations
    apnea alternating with periods of rapid breathing
Card Set
Loss and Grieving
grief and loss