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Loss, Death, and Grieving

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Presentation on theme: "Loss, Death, and Grieving"— Presentation transcript:

1 Loss, Death, and Grieving
Nursing Fundamentals NURS B20

2 Loss, Death, Grieving Nursing by its nature is involved in all processes of life from birth to death. Nurses interact daily with clients and families experiencing loss and grief.

3 Loss Loss of external objects Loss of known environment
Loss of a significant other Loss of an aspect of self Loss of life

4 Concepts and Theories of the Grieving Process
Engle’s Theory (1964) Shock and Disbelief Developing Awareness Reorganization and Restitution

5 Concepts and Theories of the Grieving Process
Kubler-Ross Stages of Dying (1969) Denial Anger Bargaining Depression Acceptance

6 Concepts and Theories of the Grieving Process
Rando Avoidance Confrontation Accommodation

7 Hope Hope is not a single act but a complex series of thoughts, feelings, and actions that change often. Clients and families facing terminal illness or serious loss experience different dimensions of hope. Generalized hope- “I hope all is well” Particular hope- A particular outcome

8 Assessment of the Grieving Client
Age Toddler Preschooler School-age Young adult Middle age Elderly Nature of relationship Nature of the loss Cultural and spiritual beliefs Gender roles Socioeconomic status/ social support system

9 Nursing Diagnoses Anticipatory Grieving Dysfunctional Grieving

10 Implementation Therapeutic communication Maintenance of self-esteem
Promotion of return-to-life activities

11 The Dying Client When does death occur? Traditionally
Since the 1st transplantation Who can pronounce a person dead?

12 Coroner’s Case Request family member consent and signature for autopsy. Several reasons for a death becoming a case for the coroner: Death by suspicious means or not under a doctor’s care Death resulting from an accident Client has been hospitalized for less than 24 hours

13 Death with Dignity Dying Persons’ Bill of Rights (page
Passive euthanasia California Law (1976)- “Right to Die” bill California Natural Death Act Promotion of comfort

14 Death with Dignity Maintenance of independence
Prevention of loneliness and isolation Promotion of spiritual comfort Support for the grieving family Hospice Care

15 Physical Changes Indicating Approaching Death
Temperature usually elevates to 104+ Pulse= fast, irregular, weak, difficult to find Respirations= rapid, shallow, noisy, Cheyne-Stokes BP= decreased Peripheral circulation

16 Physical Changes Indicating Approaching Death
Thirst= dry mouth Sight fails Aphagia Mental alertness varies Hearing- supposed to be last sense to be lost Relaxation of muscles

17 After Death Physical Changes After Death Pupils- Fixed and dilated
Algor Mortis- Rapid cooling of the body Rigor Mortis- Stiffening of the body, develops 2-4 hours after death Livor Mortis- Purple discoloration of skin in dependent areas

18 Care After Death Certification of death Time of death
Notification nursing and admissions office Client’s belongings Removal of therapies Dentures Raise head of bed

19 Care After Death Clean body Remove valuables Positioning
After the family views the body

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