Chapter 36 Grief and Loss in the Childbearing Family
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 nurses role in facilitating the familys mourning process.
MNL LO: 5.5.2 Determine the care of the family experiencing a perinatal
loss.
1
Copyright 2016 Pearson Education, Inc.
,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 dont 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 nurses role in facilitating the familys 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 patients 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 ex
2
Copyright 2016 Pearson Education, Inc.
perienced 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 mothers 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 patients emotions; accept and respond to distress in
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 nurses role in facilitating the familys mourning process.
MNL LO: 5.5.2 Determine the care of the family experiencing a perinatal
loss.
1
Copyright 2016 Pearson Education, Inc.
,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 dont 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 nurses role in facilitating the familys 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 patients 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 ex
2
Copyright 2016 Pearson Education, Inc.
perienced 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 mothers 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 patients emotions; accept and respond to distress in
