Aina 🥦

• Grief

  The total response to the emotional experience related to loss, manifested in thoughts, feelings and behaviors associated with overwhelming distress or sorrow
• Bereavement


  The subjective response experienced by the surviving loved ones after the death of a person with whom they have shared a significant relationship
• Mourning


  The behavioral process through which grief is eventually resolved or altered, often influenced by culture, spiritual beliefs and custom
• Factors that influence the loss and grief response

  • Age
  • Significance of the loss
  • Culture
  • Spiritual beliefs and practices
  • Gender
  • Socioeconomic status
  • Support system
  • Cause of loss and death
• Impending death

  The death that will happen, where the length of time between a terminal diagnosis and when death will occur is often unknown
• Clinical signs of impending death

  1. Loss of muscle tone

  2. Slowing of the circulation

  3. Change in respiratory

  4. Sensory impairment
• The signs that death has occurred include no spontaneous breathing, no heartbeat, feces and urine incontinence, no brain activity, eyelids slightly open, pupils enlarged, eyes fixed, no blinking, and jaw relaxed and mouth slightly open
• Changes that occur to the body after death

  1. Algor mortis (gradual reduction of body temperature)

  2. Rigor mortis (body stiffening due to chemical changes in muscles)

  3. Livor mortis (bluish purple discoloration of skin)

  4. Decomposition (tissues become soft and liquefied)
• Various cultural and religious traditions and practices are associated with death, dying and the grieving process
• Nursing management

  1. Assessing (gathering a complete database)

  2. Diagnosing (applying a range of diagnoses)

  3. Planning (maintaining physiologic and psychologic comfort, promoting dignity and quality of life, supporting the family)
• Change

  Often store in cool places to delay this process<|>Embalming prevents the process through injection of chemical into the body to destroy the bacteria
• Death-Related Religious and Cultural Practices

  Various cultural and religious traditions and practices associated with death, dying and the grieving process
• Nursing Management

  1. Assessing

  2. Diagnosing

  3. Planning

  4. Implementing

  5. Evaluating
• Assessing

  • To gather a complete database that allows accurate analysis and identification of appropriate nursing diagnosis
  • Need to recognize the states of awareness manifested by the client and family members
• Diagnosing

  • A range of diagnosis, addressing both physiologic and psychosocial needs, can be applied to the dying client, depending on the assessment data
• Planning

  • Major goals for dying clients are: Maintaining physiologic and psychologic comfort
  • Achieving a dignified and peaceful death
• Implementing

  • The major nursing responsibility for clients who are dying is to assist the client to a peaceful death
  • To minimize loneliness, fear and depression
  • To maintain the client's sense of security, self-confidence, dignity, and self-worth
  • To help the client to accept losses
  • To provide physical comfort
• Meeting the Physiologic Needs of the Dying Client

  • Nurses need to ensure that the client is treated with dignity (honor and respect)
  • Dying clients often feel they have lost control over their lives
• Providing Spiritual Support

  Spiritual support is of great importance in dealing with death<|>The nurse has a responsibility to ensure that the client's spiritual needs are attended
• Supporting the Family

  • The most important aspects of providing support to the family members of a dying client involve using therapeutic communication to facilitate their expression of feelings
  • Family members should be encouraged to participate in the physical care of the dying person
• Evaluation

  • To evaluate the achievement of client goals, the nurse collects data in accordance with the desired outcomes established in the planning phase
  • Listening to the client's reports of feeling in control of the environment surrounding death
  • Observing the client's relationship with significant others
  • Listening to the client's thoughts and feelings related to hopelessness or powerlessness
• Nurses Responsibility In Managing The Client Body After Death

  1. Care of the body

  2. Care of the family

  3. Discharging legal responsibilities
• Care of the body

  • Respect the deceased
  • Ensure the time of death
  • Check for confirmation of death by doctor
  • Perform the procedure fast and quietly
  • Identify type of death (Normal case, Medico – legal, Highly infections case)
  • Tell the family or contact them through phone and let them know
  • Place body in anatomical position, replace dressings, and remove tubes (unless there is an autopsy ordered by doctor)
  • Place identification tags on the body
  • Follow local law if patient died of Medical- Legal or communicable disease
  • The body may be influenced by religious law- check the client's religion and make every attempt to comply
  • Duty handled the deceased belonging
• Care of the family

  • Listen to family's expressions of grief, loss, and helplessness
  • Offer solace and support by being an attentive listener
  • Arrange for family members to view the body
  • In the case of sudden death, provide a private place for family to begin grieving
• Unit Care

  • Clean bed with water and soap then use disinfectant
  • Expose mattress and pillow to sun
  • Disinfectant all the equipment that been use
• Police Case

  Explain to the family the need of postmortem
• POSTMORTEM

  Indication: Police case – an accident, poisoning and suicide<|>Not known the cause of death<|>Consent from family is need<|>Nurse should explain to the family the need of post mortem<|>Carried out according to policy of the hospital or agency
• Last Offices (LO)

  The final preparation of the body after death<|>To prepare the body after death with dignity and respect<|>The present the body for accurate identification<|>To prepare for relatives viewing
• Last Offices Equipment

  • Trolley
  • Bowl, soap and towel
  • Razor, comb and scissors
  • Orange sticks for oral toilet
  • Receiver
  • Identifications labels
  • Tape
  • Mortuary sheet – plastic cadaver bag if appropriate
  • Disposable glove, plastic apron
  • Clean cloth
  • Bandages
  • Disposable bag for waste
• Last Offices Procedure

  1. No preparation of the body may be begun until the physician has officially pronounced the client dead

  2. Provide privacy for relatives to express their grief in whatever manner they choose

  3. Support the relatives if they have lingering questions or concerns that they wish to discuss

  4. Inform appropriate personnel

  5. Don disposable gloves

  6. Place the diseased on his/her back

  7. Close his/her eyelids

  8. Remove pillows

  9. Support the jaw by placing the pillow on the chest underneath the jaw

  10. Remove any mechanical aids, such as foam rings, heel pads

  11. Straighten the limb

  12. Washed diseased, clean the nostril, ear and mouth. Replace any dentures

  13. Remove the dressing and drainage tubes

  14. Re-dress any wound

  15. Label on wrist with an identification label

  16. Wrap the body in a mortuary sheet ensuring that the faced and feet are covered and that all limbs are held securely in position

  17. Tape the second notification of death card to the outside of the sheet

  18. Clean away the equipment used during the procedure

  19. Remove gloves and wash hand

  20. Document the procedure appropriately. Prepare an appropriate forms
• Nurses helps clients deal with all kinds of losses, including loss of body image, loss of a loved one, loss of a sense of well-being, and loss of job
• Knowledge of different stages of grieving and factors that influence the loss reaction can help the nurse understand the responses and needs of clients
• Nurses' attitudes about death and dying directly affect their ability to provide care