Download presentation
Presentation is loading. Please wait.
1
Death and dying/terminology
Hospice Postmortem care Rigor mortis Death rattle Moribund
2
Stages of grieving as defined by Kubler-Ross
Denial Anger Bargaining Depression Acceptance
3
Emotional and spiritual needs of terminally ill residents
Contact with loved ones Communication Expression of emotions ie., guilt, anger, frustration, anxiety, depression Reminiscence
4
Emotional and spiritual needs of terminally ill residents #2
Approaches Respect religious cultural practices Provide physical/emotional/spiritual comfort to resident and family Accept resident emotions
5
The Dying Patient’s Bill of Rights
Be treated as a human being Hope Freedom to express feelings/emotions Medical and nursing care
6
The Dying Patient’s Bill of Rights #2
Not to die alone Freedom from pain Honesty Help for self/family in accepting death
7
The Dying Patient’s Bill of Rights #3
Die in peace and dignity Retain individuality and beliefs Expect respect of body after death Sensitive, knowledgeable care
8
Impending signs of death
Cold hands and feet Diaphoresis Pale Loss of muscle tone
9
Impending signs of death #2
Labored respirations “Death Rattle” Weak, irregular pulse or slow pulse Respiration
10
Impending signs of death #3
Blank staring expression Jaw drops Cheyne-Stokes respirations
11
Moribund signs No pulse No respiration No blood pressure
Pupils fixed and dialated
12
Care and comfort measures for the dying resident
Pain management Hygiene Oral hygiene Communication/ support
13
Care and comfort measures for the dying resident #2
Positioning/turning Provide comfort Attend to phychosocial needs Spiritual support
14
Procedures and responsibilities for postmortem care
Assist with postmortem care as directed by nurse Follow facility procedures Provide privacy, support and comfort
16
Vital Signs / Terminology #2
Febrile Metabolism Mucosa Pyrexia
17
Vital Signs / Terminology #3
Pulse Apical Brachial Carotid Radial arrhythmia
18
Vital Signs / Terminology #4
Bradycardia Tachycardia Bounding Pulse deficit thready
19
Vital Signs / Terminology #5
Respiration Apnea Cheyne-Stokes Orthopnea Shallow breathing Kussmaul’s respiration
20
Vital Signs / Terminology #6
Hyperventilation Cyanosis Diaphragm dyspnea
21
Vital Signs / Terminology #7
Blood pressure Aneroid manometer Diastolic Hypertension Hypotension diaphragm
22
Vital Signs / Terminology #8
Sphygmomanometer Stethoscope Systolic bell
23
Vital Signs / Purposes Temperature,pulse,respiration and blood pressure Assess functioning of vital organs Signify changes in the body
24
Vital Signs / Observations
Color and temperature of the skin How is the patient acting What does the patient tell you about the way he/she feels
25
Temperature Balance between heat gained and heat lost
The hypothalamus is the regulation center
26
Heat Production Heat is produced by cellular activity, food metabolism, muscle activity, and some hormones Infection Brain injury External factors
27
Heat loss Heat is lost from the body through the skin, the lungs in breathing, and by elimination Sweating Increased respiratory rate Increased flow of blood to skin
28
Heat conservation Reducing perspiration
Decreasing the flow of blood to the skin Shivering
29
Nursing measures to raise the temperature
Increase the temperature in the room Add coverings to the body Provide hot liquids to drink Give warm baths or soaks
30
Nursing measures to lower the temperature
Decrease the temperature in the room Remove coverings from the body Offer cool liquids to drink Provide cool bath or sponging Direct fan toward body
31
Major Pulse sites Carotid Apical Brachial Radial Femoral Popliteal
Dorasalis pedis
32
Factors that increase pulse
Exercise Strong emotions Fever Pain Shock Hemorrhage Anemia
33
Factors that decrease pulse
Rest Depression Drugs Respiratory center depression
34
Qualities of pulse Rate Rhythm Strength
35
Respiration Respiration is defined as the exchange of oxygen and carbon dioxide in the lungs It is regulated in the brain by the medulla
36
Factors that increase respiratory rate
Exercise Strong emotion Infection Increased body temperature Increased metabolism
37
Factors that decrease respiratory rate
Rest / Sleep Depression Respiratory center depression
38
Qualities of Respiration
Rate Rhythm Depth Effort Discomfort Position Sounds Color
39
Abnormal breathing patterns
Labored Orthopnea Stertorous Abdominal Shallow Dyspnea Tachypnea Bradypnea
40
Blood pressure Pressure exerted against walls of blood vessels
Systolic pressure Diastolic pressure Thumping sounds Sounds correspond to numbers First sound heard is systolic pressure Last sound heard is diastolic pressure
41
Factors that raise blood pressure
Strong emotion Exercise Excitement Pain Decrease of blood vessel size Digestion Cuff that is too narrow or too loose Cuff below heart level
42
Factors that lower blood pressure
Rest/Sleep Lying down Depression Shock Hemorrhage Cuff that is too wide Cuff above the heart level
43
Equipment needed to measure blood pressure
Manometer Cuff Stethoscope
44
Guidelines to take blood pressure
Is commonly measured at the brachial artery Do not use arm that is injured, has an intravenous infusion, or is in a cast Patient should be at rest Apply blood pressure cuff to bare arm Use appropriate sized cuff
45
Charting vital signs Report abnormal TPR and blood pressure to nurse
Record on hospital flow sheets, graphic records, and nurse assistant notes Write the blood pressure as a fraction: systolic/diastolic e.g., 120/80 Note location, e.g., 150/90, thigh
Similar presentations
