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Types of Loss Include:
- Material Loss
- Psychological Loss
- Expected Loss
- Unexpected Loss
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Terms Related to Grieving Include:
- Grief
- Bereavement
- Mourning
- Anticipatory Grief
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Define Grief
The characteristic pattern of psychological and physiological responses a person experiences after the loss of a significant person, object, belief, of relationship.
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Define Bereavement:
A state of desolation that occurs as the result of a loss, particularly the death of a significant other.
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Define Mourning:
Encompasses the social prescribed behavior after the death of a significant other.
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Define Anticipatory grief.
The characteristic pattern of psychological and physiologica responses a person makes to the impending loss (real or imagined) of a significant person, object belief, or relationship.
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Engel's Model of Grief is:
- 1.Shock and disbelief
- 2.Developing awareness
- 3.Restitution (mourning)
- 4.Resolving the loss (focus energy on deceased)
- 5.Idealizaion(neg feeling supressed)
- 6.Outcome (interest in new relationships)
- Last 1 year or longer
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Parkes' Model of Grief is:
- 1.Numbness
- 2.Yearning
- 3.Disorganization (severe depression)
- 4.Reorganization 6-9mth post (interest in living)
- 2 years or longer
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Grief Cycle Model is:
- 1.Shock
- 2.Protest 1wk-3mth drops level of function
- 3.Disogranization 3-6mth depression
- 4.reorganization 6-mth - 1yr+ increase level of function
- can
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Kubler-Ross' Stages of Dying is:
- 1.Denial
- 2.Anger
- 3.Bargaining
- 4.Depression
- 5.Acceptance
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Hogan's Grief to Personal Growth Model proposes:
- 2 pathways to grief.
- 1.Grief to Growth Pathway
- 2.Mired to Grief Pathway.
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Factors Affecting Grieving are:
- Meaning of the loss
- Circumstances of the loss
- Religious beliefs and cultural practices
- Personal resources and stressors
- Sociocultural resources and stressors
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Physiological signs of Grieving are:
- Anorexia or GI disturbances
- Insomnia
- Crying
- Lack of Strength
- Physical exhaustion
- Fellings of emptiness and heaviness
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Altered Grieving is:
- Dysfunctional Grieving.
- Manifestations of Altered Grieving
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What is Dysfunctional Grieving?
Grief that falls outside the normal response range and may manifested as exaggerated grief, prolonged grief, or absence grief.
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Subjective Data for Grief Assessment include
- Normal Pattern Identification - personal resources and personal stressors
- Risk Indentifications - Analysis of resources
- Dysfunction Identification - prolonged grief
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Objective Data for Grief Assessment include
- Dejected physical appearance
- Slow Motor Function
- Weeping
- Outbursts of anger
- Emotional blunting
- Unkept appearance
- Sleep disturbances
- Appetite disturbances (excessive weight loss or gain)
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Nursing Dx Statements for Grieving Includes
- Anticipatory Grieving
- Dysfunctional Grieving
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Anticipatory Grieving is
Intellectual and emotional responses and behaviors by which individuals, families, and communities work thru the process of modifying self concept based on the perception of loss
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Characteristics of Anticipatory Grieving include:
- Potential loss of significant object
- expression of distress at potential loss
- denial of potential loss
- guilt
- anger
- sorrow
- choked feelings
- changes in eating habits
- alterations in sleep patterns/activity level
- altered libido
- altered communicaiton patterns
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Dysfunctional Grieving is:
Extended unsuccessful use of intellectual and emotional responses by which individuals families and communities attempt to work through the process of modifying self-concept based on the perception of loss.
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Characteristics of Dysfunctional Grieving include:
- Verbal expression of distress at loss
- denial of loss
- Expression of guilt or expression of unresolved issues
- Anger
- Sadness or crying
- Difficulty in expressing loss
- Alterations in eating, sleep, dream, activity or libido.
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Outcome Identification and Planning
- Moving toward resolution of diverse emotions
- Accepting the reality of the loss
- Reinvesting emotional and physical energy in meaningful people and activities.
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Implementation
- Client teaching
- Working through grief stages
- Encouraging support groups
- Nursing interventions for altered grieving
- Healthcare planning and home community based nursing
- Referral
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Evaluation
- Goal
- Possible Outcome Criteria
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Nursing Dx for the Dying Patient Include
- Pain
- Fatigue
- Deficient Fluid Volume
- Imbalanced Nutrition - Less than body requirements
- Impaired Gas Exchange
- Interruped Family Process
- Ineffective Coping
- Caring for the Deceased
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End of Life Care
- Issues related to death and dying
- Concluding phase of and individual's life span
- Focus on physical and psychosocial needs of patient and patient's family
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Goals of EOL Care
- Provide Comfort and supportive care during dying process
- Improve quality of remaining life
- Help ensure a dignified death
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Physical Manifestations of EOL Care
- Death Occurs when all vital organs and systems cease to function
- Metabolism is decreased
- Body gradually slows down until all function ends
- Respiratory generally ceases first
- Heart stops beating within a few minutes of respiratory shutdown
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Define Death
- Cessation of Heart-lung Function
- Cessation of Whole Brain Function
- Cessation of Higher-Brain Function
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Define Empathy
The ability to perceive and reason, as well as the ability to communicate understanding of the other person's feelings and their attached meanings, is a core characteristic of a helping relationship.
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Define Sympathy -
The fact or power of sharing the feeling of another especially in sorrow or trouble; fellow feeling compassion or commiseration.
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To have empathy a nurse must:
- Have enough knowledge and experience to perceive the client's perpective accurately.
- Feel secure enough not to be intimidated if the client experiences a situation differently.
- Feel comfortable enought to be able to imagine what a stiuation might be like for someone else, while remaining outside that situation to maintain objectivity.
- Convey to the client that the nurse perceives the client's feelings, thoughts and experiences accurately.
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