Coping With Loss

Question 1

Perceived loss is?

Answer 1

Loss that is defined uniquely by the grieving person → may be less obvious to others

EX., loss of confidence or prestige

Question 2

Actual loss =?

Answer 2

Any loss of a person or object that can no longer be felt her known or experienced

Ex. Loss of a body part, a child, a relationship , or a role at work

Question 3

Maturational loss =?

Answer 3

Change in the development process that is normally expected during a lifetime → parts of normal life transitions, but the feeling of loss may persist → grieving help helps the person cope with change

Ex. Parents feeling of loss as a child goes to school for the first time

Question 4

Situational loss =?

Answer 4

Any sudden unpredictable, external event → often includes multiple losses rather than a single loss

Ex. An automobile accident may leave the driver paralyzed, unable to work and, grieving over the death of a passenger in the accident

Question 5

What is bereavement?

Answer 5

State of having lost a significant other to death resulting in grieving in morning

Question 6

Is the bereavement process linear?

Answer 6

No → not linear and does not proceed through sequential stages that can be precisely predicted

Question 7

What is normal grief?

Answer 7

Feelings, behaviors, thoughts, and reactions to a loss:
resentment,
sorrow,
anger,
crying,
loneliness,
withdrawal from activities

Question 8

What is anticipatory grief?

Answer 8

Face of a loss that could be result of a terminal phase of an illness or death that is an anticipated
Ex. Someone caring for someone with Alzheimer’s → series of losses pre-death → loss of companionship, loss of freedom, loss of social roles… Loss of the person they once knew

Question 9

What is complicated or prolonged grief?

Answer 9

Experiences of intense, prolonged and disabling symptoms of grief

Debilitating feelings of loss that do not improve after a significant amount of time this past

Question 10

What is prolonged grief disorder?

Answer 10

Mental disorder, characterized by distressing, disabling, yearning and difficulties, engaging in life activities that persists for a year or more after the loss

Question 11

What is disenfranchised grief?

Answer 11

Experience of grief that is not openly acknowledged, publicly warned or socially supported

Example → divorce a healthcare provider experience experiences the loss of multiple patients or the loss of a pet

Question 12

Mrs. Long is reporting chest pain and shortness of breath and it’s asking to see her husband who died more than a year ago. What is your priority response in this situation?

A) Reorient Mrs. long time place in person
B) give prn analgesia and reassess symptoms in 1 hour
C) assess Mrs. Long for air entry, apply oxygen as ordered and call for help
D) reassure her that her husband died and cannot return.

Answer 12

C→ assessing airway, providing oxygen if needed and activating for help are the most important steps to stabilize the pt
Need to stabilize and prevent deterioration before addressing psychological concerns

Question 13

A conversation with the family reveals they are uncertain about who is the healthcare proxy for Mrs. Long. The nurse refers to an advanced care plan that was placed on the chart in order to clarify Mrs. Long’s wishes. The nurse reassured the family that: select all that apply.

A) the advanced care plan indicates that her youngest child is her healthcare proxy however, legally, the oldest child would be the person the nurse would call for a final decision if needed

B) Since Mrs. Long’s named healthcare proxy is the youngest child, that
person will be called to make the healthcare decision decisions if Mrs. Long is unable to do so.

C) the next step is to call the hospitals ethicist to meet with the family

D) Since Mrs. Long is becoming more confused each day. The advanced care plan is going to be integrated into her care as much as possible.

Answer 13

B

Question 14

Mrs. Long returns home on palliative care program with the supportive her children. As the community nurse your priorities include: select all that apply.

A) describing to the family not to call 911 if Mrs. Long dies unexpectedly from lung cancer at home but rather to call the palliative home care nurse who is on call

B) Reassuring Mrs. Long and her family that all her needs will be met at home

C) Drawing of vials and morphine for pain and shortness of breath

D) Assessment of the family dynamics and assisting the family to develop a plan to arrange a schedule for caregiving

Answer 14

A and D

Question 15

Jonathan’s father died six months ago in the hospital during Covid and he was unable to visit to say goodbye at the time because of visitor restrictions.

Jonathan states without being able to say goodbye or even have a funeral. I feel as though I’m trapped in a bed every morning. I feel like I’m not allowed to be sad.
What kind of grief is Jonathan experiencing?

A) Anticipatory grief
B) disenfranchised grief
C) Prolonged grief
D) Normal grief

Answer 15

B

Question 16

What is the best response to Jonathan’s expression of grief?
A) I can’t imagine how difficult this must be for you. Can I get you a cup of tea?
B) I think this is a conversation to best be had with your counsellor
C) let me get you some contact information for a grief counsellor
D) Expressing these feelings is important. Do you have any support people in your life?
DD

Answer 16

D

Question 17

Sylvie has advanced dementia and is experiencing complications related to end of life care. She is on palliative care program admitted to your medicine ward to receive confront comfort measures only[no vital signs, no formal head to toe assessments ). Sylvie has her daughter who is her substitute decision-maker and power of attorney at the bedside.

You are assigned to be Sylvie’s primary nurse for the day. Sylvie’s daughter approaches the nurse and is very upset. She yells loudly. My mom is in pain and you guys are doing nothing for her. What would be the most appropriate response to Sylvie’s daughter?

A) I need you to stop yelling please let’s go talk somewhere in private
B) let me give your mother some pain medication
C) if you don’t stop yelling, I will call security
D) let’s go see your mother together and figure out what’s going on

Answer 17

A
D Ø good because they’re already at bedside

Question 18

You enter the room to assess Sylvie and she is visibly in pain. You return a few minutes later with hydromorphone and midazolam to help alleviate her symptoms, but she’s restless and refuses to let you administer the medication’s. What is your next nursing action?

A) administer the medication anyway, because the daughter is telling you to

B) Offer her to bring warm blanket, face cloth, and moist oral sponge instead

C) Leave the patient and come back in a while to see if she has common enough to receive the medication

D) Call the charge nurse and ask for assistance in dealing with Sylvie’s daughter

Answer 18

B

Question 19

 Your patient Sylvia is gradually changing in her breathing patterns with periods of apnea, and her extremities are cool and mottled. You speak with her daughter to explain options for the next few hours. What should you say?
A) Ask Sylvie’s daughter if she would like to step away from the unit and take a coffee break
B) Explain to Sylvie’s daughter that her mother’s death is imminent and ask if anyone else should be called at this point
C) prepare to administer Sylvie’s PRN medication’s because she appears to be in distress
D) Sit Sylvia up in bed to assist with her breathing and apply oxygen for dyspnoea

Answer 19

B

Question 20

A 16 year old patient has been admitted to the critical care unit after suffering a closed head injury. The patient is soon declared brain dead. The intensivist and nurse are preparing to approach the family to consider donation of the patient’s heart and lungs. When working with families in the situation it is important to explain that:

A) the ventilator is being used to prevent brain death
B) The ventilator maintains organ perfusion until time for harvesting
C) Tissues, such as cornea can be harvested only if the patient remains ventilated
D) Organ donation can occur only if the patient has made a request to donate organs in the past

Answer 20

B

Question 21

Following the death of a child who has been a patient on the paediatric unit for many months, several nurses are planning to attend the funeral based on permission from their manager. What should the manager realize about the situation? Select all that apply

A) attending the patient’s funeral may cause even more burn out among the nurses

B) Attending the patient’s funeral expresses support for the family to help them in their own grief process

C) attending the patient’s funeral provides an opportunity for the nurses to express their grief more openly

D) Attending the patient’s funeral takes time away from other patients and is mainly a ritual that is focussed on the family

Answer 21

B and C