NUR 209 Exam III Review
Exam III Review
Post-Mortem Care
Procedures with Death of Patients
⟶ Request organ and tissue donation
⟶ Request for autopsy
⟶ Document occurrence of death
⟶ Provide postmortem care
*Must know federal and state regulations as well as facility policies and procedures
Care of the Body
⟶ Provide respect and allow for religious/cultural traditions
⟶ Recognize that the provider certifies death by pronouncing date and time of death,
therapies used, and actions taken prior to death
⟶ Elevate the patients head ASAP to prevent facial discoloration by raising the head of the
bed and placing a pillow under the head and shoulders of the patient
Preparing the Body (Pre-viewing)
⟶ Maintain privacy
⟶ Remove all tubes
⟶ Remove all personal belongings to be given to family
⟶ Cleanse and align the body supine with a pillow under the head and arms with palms
facing down outside the sheet and blanket, dentures in place, and eyes closed
⟶ Apply fresh linens with absorbent pads on bed and a gown
⟶ Brush hair and replace any hairpieces
⟶ Remove excess supplies, equipment, and soiled lines from the room
⟶ Dim the lights and minimize noise
Viewing Considerations (Viewing)
⟶ Ask the family whether they would like to visit with the body and honor any decision
⟶ Clarify where the patients’ personal belongings should go; with the body or with a
designated person
⟶ Adhere to the same procedures when the client is an infant
Post-viewing
⟶ Apply identification tags according to facility policy
⟶ Complete documentation
⟶ Remain aware of visitor and staff sensibilities during transport
Organ/Tissue Donation
⟶ Recognize that request for tissue and organ donations must be made by specifically
trained personnel
⟶ Provide support and education to family members as decisions are being made. Use
private areas for any family discussions concerning donation
⟶ Be sensitive to culture and religious influences
, ⟶ Maintain ventilatory and cardiovascular support for vital organ retrieval
Autopsy Considerations
⟶ Provider typically approaches the family about performing an autopsy
⟶ Nurses role is to answer the family’s questions and support their choices
⟶ Autopsies can be conducted to advance scientific knowledge regarding disease processes,
which can lead to the development of new therapies
⟶ Law can require an autopsy to be performed if the death is due to homicide, suicide, or
accidental death, or if death occurs within 24 hours of hospital administration
⟶ Most facilities require that all tubes remain in place for an autopsy
⟶ Documentation and completion of forms following federal and state laws typically
include the following
o Who pronounced the death and at what time it was pronounced
o Considerations of and preparation for organ donation
o Description of any tubes or lines left in or on the body
o Disposition of personal articles
o Who was notified, and of any decisions that were made
o Location of identification tags
o Time the body left the facility and the destination
Family and Postmortem Care
⟶ Be respectful
⟶ Allow for religious/cultural traditions
⟶ Give the family the option to assist with care
⟶ Comb hair and cover patient with a clean sheet
⟶ Provide a clean, quiet environment
⟶ Family may decide when they are ready for the funeral home to pick up the body
Loss of a Patient/Care of Grieving Nurses
*Long term patients can create personal attachments for nurses. Nurses can use coping strategies
such as:
⟶ Attend the funeral
⟶ Write a letter to the family
⟶ Attend debriefing sessions with colleagues
⟶ Use stress management techniques
⟶ Talk with a professional counselor
Genitourinary System
Structure/Anatomy of the Urinary Tract
1. Kidneys (2)
A. Nephrons
2. Ureters (2)
3. Bladder (1)
4. Urethra (1)
*May be abbreviated as BKU
, Function of the GU System
1. Urine formation (Kidney’s)
A. Filtration
⟶ Filters waste (metabolites, uric acid, creatinine)
⟶ Filters water
⟶ Filters electrolytes
B. Reabsorption
C. Secretion
2. Urine excretion (Bladder)
A. Micturition
⟶ Urge to urinate that happens when the bladder contains ~200mL
B. Voiding
C. Urination
Assessment
⟶ Subjective Data
o Normal pattern of urination
▪ 6-8 times/day
▪ Every 3-4 hours, avoid holding
o History
o Recent/current problems
⟶ Objective Data
o Assessment of Urine
▪ Color (Darker color indicates higher specific gravity)
• >1 is more concentrated
• < 1 is more dilute
• ~1 is normal
▪ Amount/Volume
• 250-400 mL per void
• 1,500 mL/15 hours or 100 mL/hour
• 30 mL/hour minimum if patient has a catheter
▪ Clarity
• Cloudy indicates trace amounts of blood in urine (infection)
• Hemacolt test tests for hematuria
• Pus indicates infection
▪ Odor
o Intake and Output
o Bladder Ultrasound (Need patient to have a full bladder for this test)
o Physical Assessment
▪ Inspection
▪ Percussion
• Empty: Hollow and not palpable
• Full (>600 mL): Dull and palpable
▪ Palpation
• Felt in the suprapubic area if it contains >600 mL
Exam III Review
Post-Mortem Care
Procedures with Death of Patients
⟶ Request organ and tissue donation
⟶ Request for autopsy
⟶ Document occurrence of death
⟶ Provide postmortem care
*Must know federal and state regulations as well as facility policies and procedures
Care of the Body
⟶ Provide respect and allow for religious/cultural traditions
⟶ Recognize that the provider certifies death by pronouncing date and time of death,
therapies used, and actions taken prior to death
⟶ Elevate the patients head ASAP to prevent facial discoloration by raising the head of the
bed and placing a pillow under the head and shoulders of the patient
Preparing the Body (Pre-viewing)
⟶ Maintain privacy
⟶ Remove all tubes
⟶ Remove all personal belongings to be given to family
⟶ Cleanse and align the body supine with a pillow under the head and arms with palms
facing down outside the sheet and blanket, dentures in place, and eyes closed
⟶ Apply fresh linens with absorbent pads on bed and a gown
⟶ Brush hair and replace any hairpieces
⟶ Remove excess supplies, equipment, and soiled lines from the room
⟶ Dim the lights and minimize noise
Viewing Considerations (Viewing)
⟶ Ask the family whether they would like to visit with the body and honor any decision
⟶ Clarify where the patients’ personal belongings should go; with the body or with a
designated person
⟶ Adhere to the same procedures when the client is an infant
Post-viewing
⟶ Apply identification tags according to facility policy
⟶ Complete documentation
⟶ Remain aware of visitor and staff sensibilities during transport
Organ/Tissue Donation
⟶ Recognize that request for tissue and organ donations must be made by specifically
trained personnel
⟶ Provide support and education to family members as decisions are being made. Use
private areas for any family discussions concerning donation
⟶ Be sensitive to culture and religious influences
, ⟶ Maintain ventilatory and cardiovascular support for vital organ retrieval
Autopsy Considerations
⟶ Provider typically approaches the family about performing an autopsy
⟶ Nurses role is to answer the family’s questions and support their choices
⟶ Autopsies can be conducted to advance scientific knowledge regarding disease processes,
which can lead to the development of new therapies
⟶ Law can require an autopsy to be performed if the death is due to homicide, suicide, or
accidental death, or if death occurs within 24 hours of hospital administration
⟶ Most facilities require that all tubes remain in place for an autopsy
⟶ Documentation and completion of forms following federal and state laws typically
include the following
o Who pronounced the death and at what time it was pronounced
o Considerations of and preparation for organ donation
o Description of any tubes or lines left in or on the body
o Disposition of personal articles
o Who was notified, and of any decisions that were made
o Location of identification tags
o Time the body left the facility and the destination
Family and Postmortem Care
⟶ Be respectful
⟶ Allow for religious/cultural traditions
⟶ Give the family the option to assist with care
⟶ Comb hair and cover patient with a clean sheet
⟶ Provide a clean, quiet environment
⟶ Family may decide when they are ready for the funeral home to pick up the body
Loss of a Patient/Care of Grieving Nurses
*Long term patients can create personal attachments for nurses. Nurses can use coping strategies
such as:
⟶ Attend the funeral
⟶ Write a letter to the family
⟶ Attend debriefing sessions with colleagues
⟶ Use stress management techniques
⟶ Talk with a professional counselor
Genitourinary System
Structure/Anatomy of the Urinary Tract
1. Kidneys (2)
A. Nephrons
2. Ureters (2)
3. Bladder (1)
4. Urethra (1)
*May be abbreviated as BKU
, Function of the GU System
1. Urine formation (Kidney’s)
A. Filtration
⟶ Filters waste (metabolites, uric acid, creatinine)
⟶ Filters water
⟶ Filters electrolytes
B. Reabsorption
C. Secretion
2. Urine excretion (Bladder)
A. Micturition
⟶ Urge to urinate that happens when the bladder contains ~200mL
B. Voiding
C. Urination
Assessment
⟶ Subjective Data
o Normal pattern of urination
▪ 6-8 times/day
▪ Every 3-4 hours, avoid holding
o History
o Recent/current problems
⟶ Objective Data
o Assessment of Urine
▪ Color (Darker color indicates higher specific gravity)
• >1 is more concentrated
• < 1 is more dilute
• ~1 is normal
▪ Amount/Volume
• 250-400 mL per void
• 1,500 mL/15 hours or 100 mL/hour
• 30 mL/hour minimum if patient has a catheter
▪ Clarity
• Cloudy indicates trace amounts of blood in urine (infection)
• Hemacolt test tests for hematuria
• Pus indicates infection
▪ Odor
o Intake and Output
o Bladder Ultrasound (Need patient to have a full bladder for this test)
o Physical Assessment
▪ Inspection
▪ Percussion
• Empty: Hollow and not palpable
• Full (>600 mL): Dull and palpable
▪ Palpation
• Felt in the suprapubic area if it contains >600 mL
