Psychological Issues: Death & Dying

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What stressors may affect self concept?
Body image: stroke, colostomy, preg. Self esteem: Job loss, sexuality, repeated failures. Role: lack of definition of role
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What behaviours may indicate altered self concept?
Avoiding eye contact, hesitant speech, overly apologetic or critical, freq crying, slumped posture, difficulty making choices, self harm/eating disorders
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What nursing interventions can be used for those w. altered self concept?
Teach coping strategies, establish therapeutic relationships, identify pt strengths, communicate, health promotion, show empathy & acceptance, set goals for change, encourage responsibility, refer to support groups
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What stressors may affect spirituality?
Acute illness: dealing w. conflict around beliefs, anger. Chronic: threatened independence = fear. Successful adaption may strengthen spirituality. Aging: many losses, altered self image. Advanced illness: hope of remission, review of life & meaning
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What does 'Sexual Health' mean?
State of physical emotional & social wellbeing RT sexuality, includes sense of gender, influenced by values & behaviours, need to establish close relationship w. others
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What is the impact of illness on sexual health?
Heart disease anxious bout sex, Diabetes: erectile, orgasmic dysfunction. Spinal cord injury joint diseases: loss of ROM fatigue, chronic pain, STDs, mental health disorders, impotence.
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What nursing interventions can be used for those w. poor sexual health?
Health promotion (e.g info on STDs), sexual counselling, referrals & social workers, anxiety reduction, treatment for impotence, lifestyle changes
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What are the different types of loss?
Actual: person, sight, hearing, speech, limb. Perceived: dignity, self esteem, role. Maturation/development: child leaves home, Situational: specific events divorce, illness
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What is Grief?
Total response to emotional experience RT loss
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What is Bereavement?
An actual process people go through after loss
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What is Mourning?
A behavioural process required for healing: linked to spirituality & culture. Gradually incorporate mourning into everyday life
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What are some manifestations of the grieving experience?
Physical: hollow stomach, difficulty breathing. Behavioral: withdrawal, crying. Cognitive: preoccupation w. deceased, < motivation. Emotional: anger, guilt, depression. Spiritual: search for meaning, hostility
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What does TEAR stand for?
To accept the reality of loss. Experience the pain of grief. Adjust to the new envi where deceased is missing. Reinvest in life and new relationship based on memory
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What are the situations surrounding death?
Anticipated: come to terms, set affairs in order, min grieving. Sudden: diff to accept, poor adjustment. Suicide: guilt, probs w. guilt resolution, abandonment, anger. Homicide: high risk for post traumatic stress
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What are the 3 process of death?
Social death: gradual withdrawal, drifting away. Psychological death: dependence, grief over losses, meds, illness. Biological death: med criteria
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What can nurses do for dying patients?
recognize & accept emotions, provide support, explain dying process, answer honestly, use support groups, rapport, provide time, listen
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What is Rigor Mortis?
Stiffening of the msucles, 2-4 hours after death
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What is Algor Mortis?
Cooling of the body, 1 degree per hour
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What is Liver Mortis?
Discoloration, mottling and bruising of skin from settling of blood in lower body after death
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What happens after death?
Rigor mortis, algor mortis, liver mortis, tissues soften & liquefy and fermentation starts to take place
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What are the 5 stages of grief? Do All Babes Drive Audis?
1. Denial, 2. Anger, 3. Bargaining, 4. Depression, 5. Acceptance
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What behaviours may indicate altered self concept?

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Avoiding eye contact, hesitant speech, overly apologetic or critical, freq crying, slumped posture, difficulty making choices, self harm/eating disorders

Card 3

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What nursing interventions can be used for those w. altered self concept?

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Card 4

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What stressors may affect spirituality?

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Card 5

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What does 'Sexual Health' mean?

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