Chapter 36 Grief and Loss in the Childbearing Family

Chapter 36   Grief and Loss in the Childbearing Family

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

1) The nurse is planning an in-service presentation about perinatal loss. Which statements should the nurse include in this presentation?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. “Perinatal loss refers to third-trimester fetal death in utero.”
2. “Perinatal loss occurs more frequently in assisted reproduction.”
3. “Perinatal loss rates have declined in the United States over the past few years.”
4. “Perinatal loss includes 25% of stillbirths occurring before the onset of labor.”
5. “Perinatal loss rarely causes an emotional problem for the family.”

Answer:  2, 3

Explanation:  2. Pregnancies conceived by in vitro fertilization have higher rates of pregnancy loss and pregnancy complications.

3. Perinatal loss in industrialized countries has declined in recent years as early diagnosis of congenital anomalies and advances in genetic testing techniques have increased the use of elective termination.

Page Ref: 943

Cognitive Level:  Applying

Client Need/Sub:  Psychosocial Integrity: Grief and Loss

Standards:  QSEN Competencies: I. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome:  1 Discuss perinatal loss including etiology, diagnosis, and the nurse’s role in facilitating the family’s mourning process.

MNL LO:  5.5.2 Determine the care of the family experiencing a perinatal loss.

 

 

2) The nurse has returned from working as a maternal-child nurse volunteer for a nongovernmental organization. After completing a community presentation about this experience, the nurse knows that learning has occurred when a participant states which of the following?

1. “Malaria is a chronic disease, and rarely causes fetal loss.”
2. “Escherichia coli bacteria can cause diarrhea but not stillbirth.”
3. “Group B streptococci can cause infection and the death of the fetus.”
4. “Viral infections don’t cause fetal death in developing nations.”

Answer:  3

Explanation:  3. Group B streptococci can cause ascending infections prior to or after rupture of membranes.

Page Ref: 943

Cognitive Level:  Applying

Client Need/Sub:  Safe Effective Care Environment: Safety and Infection Control

Standards:  QSEN Competencies: V. B. 1. Demonstrate effective use of technology and standardized practices that support safety and quality. | AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care. | NLN Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome:  1 Discuss perinatal loss including etiology, diagnosis, and the nurse’s role in facilitating the family’s mourning process.

3) The community nurse has identified that the mother who gave birth to a stillborn baby last week is an intuitive griever. Which behavior has the nurse encountered that would lead to this assessment?

1. The mother verbalized that her problem-solving skills have been helpful during this process.
2. The mother repeatedly talks about her thoughts, feelings, and emotions about losing her child.
3. The mother talks little about her experience, and appears detached and unaffected by the loss of her child.
4. The mother has asked close friends, co-workers, and relatives not to call or visit.

Answer:  2

Explanation:  2. Intuitive grievers tend to feel their way through the loss and seek emotional and psychosocial support.

Page Ref: 948

Cognitive Level:  Analyzing

Client Need/Sub:  Psychosocial Integrity: Grief and Loss

Standards:  QSEN Competencies: I. B. 4. Assess presence and extent of pain and suffering. | AACN Essentials Competencies: IX. 1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches. | NLN Competencies: Relationship-Centered Care: Promote and accept the patient’s emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome:  2 Describe the physical, cognitive, emotional, behavioral, and spiritual responses experienced by parents during grieving associated with perinatal loss.

MNL LO:  5.5.1 Compare theories related to the grieving process.

 

4) The nurse is anticipating the arrival of a couple in the labor unit. It has been determined that the 37-week fetus has died in utero from unknown causes. What should the nurse include in the plan of care for this couple?

1. Allow the couple to adjust to the labor unit in the waiting area.
2. Place the couple in a labor room at the end of the hall with an empty room next door.
3. Encourage the father to go home and rest for a few hours.
4. Contact the mother’s emergency contact person and explain the situation.

Answer:  2

Explanation:  2. Upon arrival to the facility, the couple with a known or suspected fetal demise should immediately be placed in a private room. When possible, the woman should be in a room that is farthest away from other laboring women.

Page Ref: 955

Cognitive Level:  Analyzing

Client Need/Sub:  Psychosocial Integrity: Grief and Loss

Standards:  QSEN Competencies: I. B. 7. Initiate effective treatments to relieve pain and suffering in light of patient values, preferences, and expressed needs. | AACN Essentials Competencies: IX. 6. Implement patient and family care around resolution of end-of-life and palliative care issues, such as symptom management, support of rituals, and respect for patient and family preferences. | NLN Competencies: Relationship-Centered Care: Promote and accept the patient’s emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome:  4 Identify nursing diagnoses and interventions to meet the special needs of parents and their families related to perinatal loss and grief.

MNL LO:  5.5.3 Implement specific nursing interventions related to caring for families experiencing perinatal loss.

 

5) The client in the first trimester of pregnancy questions the nurse about the causes of fetal death. The nurse explains that factors associated with perinatal loss include which of the following?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Maternal diabetes
2. Paternal hypertension
3. Fetal chromosomal disorders
4. Maternal infections
5. Placental abnormalities

Answer:  1, 3, 4, 5

Explanation:  1. Fetal loss can be a result of a number of physiologic maladaptations, including maternal diabetes.

3. Chromosomal abnormalities can be associated with fetal loss.
4. Infections such as human parvovirus B19, syphilis, streptococcal infection, and Listeria can lead to fetal loss.
5. Placental abnormalities such as abruptio placentae and placenta previa can result in fetal death.

Page Ref: 943, 944

Cognitive Level:  Applying

Client Need/Sub:  Health Promotion and Maintenance: Ante/Intra/Postpartum and Newborn Care

Standards:  QSEN Competencies: I. B. 7. Initiate effective treatments to relieve pain and suffering in light of patient values, preferences, and expressed needs. | AACN Essentials Competencies: IX. 6. Implement patient and family care around resolution of end-of-life and palliative care issues, such as symptom management, support of rituals, and respect for patient and family preferences. | NLN Competencies: Relationship-Centered Care: Promote and accept the patient’s emotions; accept and respond to distress in patient and self; facilitate hope, trust, and faith. | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome:  1 Discuss perinatal loss including etiology, diagnosis, and the nurse’s role in facilitating the family’s mourning process.