age 1 of 132
WGU D027 Oncology & Clinical Assessment in Older
Adults Objective Exam – Latest
Goal of grief .......Answer.........NOT how to get over it, but how
to figure out how to go on living. Mourners should acknowledge
reality, embrace the pain of loss, convert relationship of person
to one of memory, develop a new self-identity, search for
meaning, receive ongoing support
Mourning Stages .......Answer.........1. numbness offers protection
2. yearning with or without anger
3. disorganization and despair
4. reorganized behavior, identify new normal
,age 2 of 132
When to expect Complicated or High Risk Mourning
.......Answer.........unexpected death, long length of illness, loss of
child, perception that death was preventable
Nurse role in grief process .......Answer.........listen without
judgement, have compassion, allow expression without criticizing,
offer presence over time
Possible needs and wishes of patients at end of life
.......Answer.........feeling of hopelessness: help to change focus of
hope to support for the family at end of life, hope for guidance
and emotional comfort, hope for dignity, pain free and holistic
treatment
Need for closure: Please forgive me, I forgive you, Thank you
and I love you
Financial cares: provide resources
,age 3 of 132
Spiritual and cultural resources: provide access to clergy, rituals,
ways to handle the body that is culturally sensitive, burial. Ask
patient and family about preference
Peaceful dying involved good memories, unite with family and
medical staff, avoid suffering, maintain dignity and control and
privacy. Become spiritually ready/ Say good-bye and die
quietly
Resources for end of life care .......Answer.........Hospice Care:
non-life prolonging care with life expectancy of 6 months or less
(AKA terminal illness)
Palliative care: person with life limiting illness not yet eligible for
hospice support
Recommend appropriate interventions to facilitate the wishes of
the dying and the family .......Answer.........Ask about rituals and
, age 4 of 132
customs to incorporate into care and during care of the body and
k k k k k k k k k k k
k burial.
Palliative Care Goals .......Answer.........determined by patient and
k k k k k k
family to relieve suffering while managing chronic conditions and
k k k k k k k k k
k provide for best quality of life
k k k k k
Organ function and medication effect
k k k k
.......Answer.........Decreaseddrugclearanceasliversize k k k k k
k decreases and blood flow to organ decreases. Kidney shrinks, gfr
k k k k k k k k k
k and renal blood flow decreases so elimination of waste and toxins
k k k k k k k k k k
k decline leading to accumulation of medications and uric acid in
k k k k k k k k k
k body
Functional changes and mobility issues .......Answer. ......... Decrease
k k k k k
in muscle tone, strength and endurance r/t eroded joints tendons
k k k k k k k k k
WGU D027 Oncology & Clinical Assessment in Older
Adults Objective Exam – Latest
Goal of grief .......Answer.........NOT how to get over it, but how
to figure out how to go on living. Mourners should acknowledge
reality, embrace the pain of loss, convert relationship of person
to one of memory, develop a new self-identity, search for
meaning, receive ongoing support
Mourning Stages .......Answer.........1. numbness offers protection
2. yearning with or without anger
3. disorganization and despair
4. reorganized behavior, identify new normal
,age 2 of 132
When to expect Complicated or High Risk Mourning
.......Answer.........unexpected death, long length of illness, loss of
child, perception that death was preventable
Nurse role in grief process .......Answer.........listen without
judgement, have compassion, allow expression without criticizing,
offer presence over time
Possible needs and wishes of patients at end of life
.......Answer.........feeling of hopelessness: help to change focus of
hope to support for the family at end of life, hope for guidance
and emotional comfort, hope for dignity, pain free and holistic
treatment
Need for closure: Please forgive me, I forgive you, Thank you
and I love you
Financial cares: provide resources
,age 3 of 132
Spiritual and cultural resources: provide access to clergy, rituals,
ways to handle the body that is culturally sensitive, burial. Ask
patient and family about preference
Peaceful dying involved good memories, unite with family and
medical staff, avoid suffering, maintain dignity and control and
privacy. Become spiritually ready/ Say good-bye and die
quietly
Resources for end of life care .......Answer.........Hospice Care:
non-life prolonging care with life expectancy of 6 months or less
(AKA terminal illness)
Palliative care: person with life limiting illness not yet eligible for
hospice support
Recommend appropriate interventions to facilitate the wishes of
the dying and the family .......Answer.........Ask about rituals and
, age 4 of 132
customs to incorporate into care and during care of the body and
k k k k k k k k k k k
k burial.
Palliative Care Goals .......Answer.........determined by patient and
k k k k k k
family to relieve suffering while managing chronic conditions and
k k k k k k k k k
k provide for best quality of life
k k k k k
Organ function and medication effect
k k k k
.......Answer.........Decreaseddrugclearanceasliversize k k k k k
k decreases and blood flow to organ decreases. Kidney shrinks, gfr
k k k k k k k k k
k and renal blood flow decreases so elimination of waste and toxins
k k k k k k k k k k
k decline leading to accumulation of medications and uric acid in
k k k k k k k k k
k body
Functional changes and mobility issues .......Answer. ......... Decrease
k k k k k
in muscle tone, strength and endurance r/t eroded joints tendons
k k k k k k k k k
