Nurses and other health care provides often have difficulty helping a terminally ill patient through the necessary stages leading to acceptance of death. Which of the following strategies is most helpful to the nurse in achieving this goal?
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Solution
According to thanatologists, reflecting on the significance of death helps to reduce the fear of death and enables the health care provider to better understand the terminally ill patient’s feelings. It also helps to overcome the belief that medical and nursing measures have failed, when a patient cannot be cured.
A terminally ill patient usually experiences all of the following feelings during the anger stage except:
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Solution
Numbness is typical of the depression stage, when the patient feels a great sense of loss. The anger stage includes such feelings as rage, envy, resentment, and the patient’s questioning “Why me?”
Kubler-Ross’s five successive stages of death and dying are:
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Solution
Kubler-Ross’s five successive stages of death and dying are denial, anger, bargaining, depression, and acceptance. The patient may move back and forth through the different stages as he and his family members react to the process of dying, but he usually goes through all of these stages to reach acceptance.
Which of the following is the nurse’s legal responsibility when applying restraints?
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Solution
When applying restraints, the nurse must document the type of behavior that prompted her to use them, document the type of restraints used, and obtain a physician’s written order for the restraints.
Restraints can be used for all of the following purposes except to:
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Solution
By restricting a patient’s movements, restraints may increase stress and lead to confusion, rather than prevent it. The other choices are valid reasons for using restraints.
Nursing interventions that can help the patient to relax and sleep restfully include all of the following except:
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Solution
Napping in the afternoon is not conductive to nighttime sleeping. Quiet music, watching television, reading, and massage usually will relax the patient, helping him to fall asleep.
The natural sedative in meat and milk products (especially warm milk) that can help induce sleep is:
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Solution
Tryptophan is a natural sedative; flurazepam (Dalmane), temazepam (Restoril), and methotrimeprazine (Levoprome) are hypnotic sedatives.
Vivid dreaming occurs in which stage of sleep?
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Solution
Other characteristics of rapid eye movement (REM) sleep are deep sleep (the patient cannot be awakened easily), depressed muscle tone, and possibly irregular heart and respiratory rates. Non-REM sleep is a deep, restful sleep without dreaming. Delta stage, or slow-wave sleep, occurs during non-REM Stages III and IV and is often equated with quiet sleep.
When bathing a patient’s extremities, the nurse should use long, firm strokes from the distal to the proximal areas. This technique:
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Solution
Washing from distal to proximal areas stimulates venous blood flow, thereby preventing venous stasis. It improves circulation but does not result in vasoconstriction. The nurse can assess the patient’s condition throughout the bath, regardless of washing technique, and should feel no strain while bathing the patient.
The most important nursing intervention to correct skin dryness is:
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Solution
Dry skin will eventually crack, ranking the patient more prone to infection. To prevent this, the nurse should provide adequate hydration through fluid intake, use nonirritating soaps or no soap when bathing the patient, and lubricate the patient’s skin with lotion. Bathing may be limited but need not be avoided entirely. The attending physician and dietitian may be consulted for treatment, but home-laundered items usually are not necessary.