Chapter 17 Loss Grieving and Death

Chapter 17 Loss Grieving and Death

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE. Choose the one alternative that best completes the statement or answers the question.1)A client is admitted to the hospital after collapsing at his home and being resuscitated by theemergency medical team. The client has been intubated, placed on a respirator, and isunresponsive. The client has no apparent advance medical directive. A close friend of the clientcomes to the nursing station and tells the nurses that the client has no immediate family and thatthe client had asked him if he would assume the Durable Power of Attorney for Health Care ifanything should happen to him, although no papers were ever signed. What is the mostappropriate action by the nurse at this time?1)A)Suggest that the client get a form for Durable Power of Attorney for Health Care and bring itto the hospital.B)Refer the friend to the facility’s legal department.C)Tell the friend that since there is no written living will or healthcare proxy, all decisions forcare will be made by the physician.D)Document the friend’s comments in the client’s medical record.Answer:BExplanation:A)Advance directives are legal documents that are prepared prior to a personbecoming incapable of making healthcare decisions. The nurse will mostappropriately refer the friend to the legal department and decisions will be madewith the input of the department and the client’s physicians. The nurse could alsorefer the friend to the client’s physician, although telling the friend that alldecisions will be made by the physician since there is no living will or healthcareproxy is incorrect because the physician will be unlikely to make decisionsindependent of the information provided by the friend. Suggesting that the clientget a form for Durable Power of Attorney for Health Care and bring it to thehospital will not accomplish anything. Documenting the friend’s comments in theclient’s medical record suggests that nothing can be done is this situation except todocument what has occurred.ImplementationSafe, Effective Care Environment — Coordinated CareAnalysisB)Advance directives are legal documents that are prepared prior to a personbecoming incapable of making healthcare decisions. The nurse will mostappropriately refer the friend to the legal department and decisions will be madewith the input of the department and the client’s physicians. The nurse could alsorefer the friend to the client’s physician, although telling the friend that alldecisions will be made by the physician since there is no living will or healthcareproxy is incorrect because the physician will be unlikely to make decisionsindependent of the information provided by the friend. Suggesting that the clientget a form for Durable Power of Attorney for Health Care and bring it to thehospital will not accomplish anything. Documenting the friend’s comments in theclient’s medical record suggests that nothing can be done is this situation except todocument what has occurred.ImplementationSafe, Effective Care Environment — Coordinated CareAnalysis1
C)Advance directives are legal documents that are prepared prior to a personbecoming incapable of making healthcare decisions. The nurse will mostappropriately refer the friend to the legal department and decisions will be madewith the input of the department and the client’s physicians. The nurse could alsorefer the friend to the client’s physician, although telling the friend that alldecisions will be made by the physician since there is no living will or healthcareproxy is incorrect because the physician will be unlikely to make decisionsindependent of the information provided by the friend. Suggesting that the clientget a form for Durable Power of Attorney for Health Care and bring it to thehospital will not accomplish anything. Documenting the friend’s comments in theclient’s medical record suggests that nothing can be done is this situation except todocument what has occurred.ImplementationSafe, Effective Care Environment — Coordinated CareAnalysisD)Advance directives are legal documents that are prepared prior to a personbecoming incapable of making healthcare decisions. The nurse will mostappropriately refer the friend to the legal department and decisions will be madewith the input of the department and the client’s physicians. The nurse could alsorefer the friend to the client’s physician, although telling the friend that alldecisions will be made by the physician since there is no living will or healthcareproxy is incorrect because the physician will be unlikely to make decisionsindependent of the information provided by the friend. Suggesting that the clientget a form for Durable Power of Attorney for Health Care and bring it to thehospital will not accomplish anything. Documenting the friend’s comments in theclient’s medical record suggests that nothing can be done is this situation except todocument what has occurred.ImplementationSafe, Effective Care Environment — Coordinated CareAnalysis2)A client is 1-week postadmission for burns incurred during a fire. The client’s sister was admittedto the intensive care unit with burns from the same fire. The client is scheduled to go to physicaltherapy in an hour and has just been told that her sister has died. What are appropriate actions bythe nurse at this time? (Select all that apply.)2)A)Stay with the client until it is time for her to go to physical therapy.B)Ask the client if she would like anything for pain before going to physical therapy.C)Ask the client if she would like to be taken to the intensive care unit to be able to see hersister’s body.D)Remind the client about the importance of physical therapy in her own recovery.E)Express condolences for the client’s loss.F)Provide the client privacy to grieve her loss.Answer:C, E, FExplanation:A)The focus is not on the physical therapy that is scheduled, even though it isimportant in the client’s recovery. The client has just received the news that hersister has died and nursing actions are most appropriately directed towardproviding emotional support. The client should be offered the opportunity to seeand be with her sister one more time before the body is taken from the unit to themorgue.ImplementationPsychosocial IntegrityAnalysis2
B)The focus is not on the physical therapy that is scheduled, even though it isimportant in the client’s recovery. The client has just received the news that hersister has died and nursing actions are most appropriately directed towardproviding emotional support. The client should be offered the opportunity to seeand be with her sister one more time before the body is taken from the unit to themorgue.ImplementationPsychosocial IntegrityAnalysisC)The focus is not on the physical therapy that is scheduled, even though it isimportant in the client’s recovery. The client has just received the news that hersister has died and nursing actions are most appropriately directed towardproviding emotional support. The client should be offered the opportunity to seeand be with her sister one more time before the body is taken from the unit to themorgue.ImplementationPsychosocial IntegrityAnalysisD)The focus is not on the physical therapy that is scheduled, even though it isimportant in the client’s recovery. The client has just received the news that hersister has died and nursing actions are most appropriately directed towardproviding emotional support. The client should be offered the opportunity to seeand be with her sister one more time before the body is taken from the unit to themorgue.ImplementationPsychosocial IntegrityAnalysisE)The focus is not on the physical therapy that is scheduled, even though it isimportant in the client’s recovery. The client has just received the news that hersister has died and nursing actions are most appropriately directed towardproviding emotional support. The client should be offered the opportunity to seeand be with her sister one more time before the body is taken from the unit to themorgue.ImplementationPsychosocial IntegrityAnalysisF)The focus is not on the physical therapy that is scheduled, even though it isimportant in the client’s recovery. The client has just received the news that hersister has died and nursing actions are most appropriately directed towardproviding emotional support. The client should be offered the opportunity to seeand be with her sister one more time before the body is taken from the unit to themorgue.ImplementationPsychosocial IntegrityAnalysis3)A client has just died and the nurse is determining what physical preparation needs to be donewith the body before the family returns to the room for viewing. The nurse should most correctlyplan to:(Select all that apply.)3)A)Remove dentures and place in a clean denture cup to give to the family with theother belongings of the client.B)Elevate the head of the bed 30 degrees.3
C)Remove all tubes from the body, including nasogastric, Jackson-Pratt, and indwellingcatheter.D)Replace all wound dressings with clean bandages.E)Use gauze pads and tape to keep the eyes closed.F)Clean the body of any incontinent stool and other secretions or wound drainage.Answer:B, D, FExplanation:A)Soiled areas of the body should be cleaned and clean dressings applied to allwounds and surgical incisions. The head of the bed should be elevated slightly toprevent pooling of fluids in the head and face. Tubes should be removedaccording to facility policy and may be only shortened and covered. Generallywound drainage evacuation tubes, such as a Jackson-Pratt should not be notremoved until the body has been transported to the morgue. Dentures should beremoved and need to be transported with the client to the morgue, rather thangiven to the family. Eyes should not be covered with pads and taped closed untilafter the family has viewed the body.PlanningPhysiological Integrity — Basic Care and ComfortApplicationB)Soiled areas of the body should be cleaned and clean dressings applied to allwounds and surgical incisions. The head of the bed should be elevated slightly toprevent pooling of fluids in the head and face. Tubes should be removedaccording to facility policy and may be only shortened and covered. Generallywound drainage evacuation tubes, such as a Jackson-Pratt should not be notremoved until the body has been transported to the morgue. Dentures should beremoved and need to be transported with the client to the morgue, rather thangiven to the family. Eyes should not be covered with pads and taped closed untilafter the family has viewed the body.PlanningPhysiological Integrity — Basic Care and ComfortApplicationC)Soiled areas of the body should be cleaned and clean dressings applied to allwounds and surgical incisions. The head of the bed should be elevated slightly toprevent pooling of fluids in the head and face. Tubes should be removedaccording to facility policy and may be only shortened and covered. Generallywound drainage evacuation tubes, such as a Jackson-Pratt should not be notremoved until the body has been transported to the morgue. Dentures should beremoved and need to be transported with the client to the morgue, rather thangiven to the family. Eyes should not be covered with pads and taped closed untilafter the family has viewed the body.PlanningPhysiological Integrity — Basic Care and ComfortApplication4
D)Soiled areas of the body should be cleaned and clean dressings applied to allwounds and surgical incisions. The head of the bed should be elevated slightly toprevent pooling of fluids in the head and face. Tubes should be removedaccording to facility policy and may be only shortened and covered. Generallywound drainage evacuation tubes, such as a Jackson-Pratt should not be notremoved until the body has been transported to the morgue. Dentures should beremoved and need to be transported with the client to the morgue, rather thangiven to the family. Eyes should not be covered with pads and taped closed untilafter the family has viewed the body.PlanningPhysiological Integrity — Basic Care and ComfortApplicationE)Soiled areas of the body should be cleaned and clean dressings applied to allwounds and surgical incisions. The head of the bed should be elevated slightly toprevent pooling of fluids in the head and face. Tubes should be removedaccording to facility policy and may be only shortened and covered. Generallywound drainage evacuation tubes, such as a Jackson-Pratt should not be notremoved until the body has been transported to the morgue. Dentures should beremoved and need to be transported with the client to the morgue, rather thangiven to the family. Eyes should not be covered with pads and taped closed untilafter the family has viewed the body.PlanningPhysiological Integrity — Basic Care and ComfortApplicationF)Soiled areas of the body should be cleaned and clean dressings applied to allwounds and surgical incisions. The head of the bed should be elevated slightly toprevent pooling of fluids in the head and face. Tubes should be removedaccording to facility policy and may be only shortened and covered. Generallywound drainage evacuation tubes, such as a Jackson-Pratt should not be notremoved until the body has been transported to the morgue. Dentures should beremoved and need to be transported with the client to the morgue, rather thangiven to the family. Eyes should not be covered with pads and taped closed untilafter the family has viewed the body.PlanningPhysiological Integrity — Basic Care and ComfortApplication