DEALING WITH DEATH. GRIEF AND DYING Final stage of life is death Ends unexpectedly Must come to...
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Transcript of DEALING WITH DEATH. GRIEF AND DYING Final stage of life is death Ends unexpectedly Must come to...
GRIEF AND DYING
Final stage of life is death
Ends unexpectedly
Must come to grips with terminal illness
THE NURSE AND DYING
https://www.youtube.com/watch?v=4o7w3iOV_WM
GRIEF AND DYING
Physical needs
Kept comfortable
Oral care, fluid intake and skin care
Report changes
GRIEF AND DYING
Emotional and social needs
Provide privacy
With family as much as desired
Listen if needed
Be genuine
GRIEF AND DYING
Spiritual needs
Cooperate with patient’s clergy
Assist in finding a clergy or chaplain
Remember it is their right to believe whatever feels right to them
GRIEF AND DYING
Hospice care philosophy
Death is a natural process
Control pain
Provide for psychological, spiritual, and social needs of the patient and family
Provide legal and financial counseling
GRIEF AND DYING
Hospice care services
Care for patients with 6 months or less to live
Nursing care under supervision of physicians and nurses
Care in hospice facility, long-term care facility or at home
Support patient and family
Provide counseling to family after death
DEATH AND POSTMORTEM CARE
Signs of approaching death
Less responsive Body functions slow down Lose of voluntary and
involuntary muscle control Involuntarily void or defecate Jaw may drop Breathing becomes irregular,
shallow and laborious Circulation slows, extremities
become cold and mottled Pulse becomes rapid then
weaker Skin becomes pale Eyes stare and do not respond
to light
D H S R A P P R O V E D C U R R I C U LU M -U N I T 1 2 18
SIGNS OF APPROACHING DEATHChanges in sensory functions
and ability to speakVisionincreased secretions in corner of eyesblurred visionfailing visionno eye movement/staring
D H S R A P P R O V E D C U R R I C U LU M -U N I T 1 2 19
SIGNS OF APPROACHING DEATHChanges in sensory functions
and ability to speak (continued)
Speechbecomes difficulthard to understandmay be unable to speak
Hearing - last function to be lost
D H S R A P P R O V E D C U R R I C U LU M -U N I T 1 2 20
SIGNS OF APPROACHING DEATH
Changes in circulation and muscle tone
Circulationfailsheat gradually lost from body
SKIN CHANGES
hands and feet cold to touch and mottledface becomes pale or gray and mottledperspiration may increase (diaphoresis)
D H S R A P P R O V E D C U R R I C U LU M -U N I T 1 2 22
SIGNS OF APPROACHING DEATHChanges in circulation and
muscle tone (continued)
Muscle tonebody limpjaw may dropmouth may stay partly open
D H S R A P P R O V E D C U R R I C U LU M -U N I T 1 2 23
SIGNS OF APPROACHING DEATHChanges in Vital SignsRespirationsslowershallowlaboredmay experience dyspnea, apnea, Cheyne-Stokesmucous collects in the throat and bronchial tubes (death rattle)
CHEYNE STOKES RESPIRATIONS
https://www.youtube.com/watch?v=CrKfmfuP9l4&safe=active
D H S R A P P R O V E D C U R R I C U LU M -U N I T 1 2 25
SIGNS OF APPROACHING DEATHChanges in Vital Signs (continued)
Pulserapidweak and irregular
Blood pressure dropsTemperatureelevatedsubnormal
D H S R A P P R O V E D C U R R I C U LU M -U N I T 1 2 26
SIGNS OF APPROACHING DEATH
Urinary and anal incontinence
Decreased peristalsis, abdominal distention
Release of flatus
Decreased pain
Loss of consciousness
DEATH AND POSTMORTEM CARE
Moribund changes
Pupils dilatedNo pulse or respirationHeat lostUrinate, defecate or release flatus
Lowest parts of body turn purple
Rigor mortisOdor