You are on page 1of 13

c 




             .

.

#.      Ans-1 In her book in 1969. information. or with those close to them. !" : People dealing with emotional upset can be angry with themselves.  : It is a conscious or unconscious refusal to accept facts.com). On Death & Dying. Elisabeth Kubler Ross gave the model comprising of five stages of dying (http://www.azcentral.

Ñ.  $ % It involves attempting to bargain with whatever God the person believes in.

  %It's a sort of acceptance with emotional attachment. c ! &   '           '         .

      (  y.

D   y.

['   y.

[   y.

r  y.

v Ans-2 a.

b. Dpiritual: Raising awareness among nurses of the meaning of prayer practices in healthcare settings may strengthen holistic care.

´(Acedemon.2009) . Helping patients rebuild their relationships with their family by initiating contact or introducing family support groups may improve the patients' quality of life. Comfort: ³Patients may be provided with peer counseling or referring them to support groups.

c.

Cultural: Nursing department should also take of the cultural background of the patients. There might be some Do¶s and Don¶ts in the patient¶s culture. d.

Legal: There are many such cases or situations when nurses have to take care of the legal rights of the patients. Proper training should be imparted to the nurses so that they have knowledge of the legal rights which they should provide to the patients. e.

 c# . Pain: Nurses should take proper care of the patients so that the pain which they are suffering from is reduced to some extent.

   .

 .

  )  *    .

quiet. .   Ans-3. Providing quality care for patients who are dying is of primary concern. They should encourage the family members to stay with the dying patient.4. It would be nice to have a comfortable. critical care nurses are responsible for caring for these dying patients. Often. spacious room for those who are dying. Patients should also be moved to private room. because about 20% of intensive care unit (ICU) patients die while hospitalized. Q.

     .

 .

  .

  '   .

  " r  .

Gilmartin identified criteria specific to home management of chronically ventilated patients. respiratory. Discharge criteria for mechanically ventilated patients have been developed on the basis of expert consensus. 1443-1464. and psychological stability. Medical diagnosis is only one of several factors associated with the need for episodic home health care after hospital discharge for medical or surgical treatment. (2005  . not criteria for referral to home care.    ((  Ans4. and the existence of a comprehensive discharge plan. pp. (American Journal of Respiratory and Critical Care Medicine Vol 171. It is important to note that both of these sets of criteria indicate readiness for discharge. and include medical.

c     .

  ''      .

.

the unborn. death. Q. the living.(Essay sample). burial and afterlife are rich in meaning and metaphysical interpretation. all Australian Aborigines share many fundamental ideas about death and its relationship to life. as well varieties not practiced anywhere else. Aborigines use a wide variety of burial practices.      "             ((  Ans. Although these rites vary.5 In the Aboriginal tradition. and the dying. The most fundamental concept of death in the Aboriginal tradition is the doctrine of three worlds.6 º   . and the Land of the Dead. including all of those known to have been used in other parts of the world.

   .

 .

  .

 .

.

   .

.

  .

 .

    .

  .

 .

     y.

â.

 .

.

  .

 !"  # y.

â.

 .

.

   $"  # y.

â .

 .

  %   .

 & .

 .

  $"  # y.

.

  .

 %.

      .

 .

 .

 $"  # y.

â   %.

 .

.

.

.

 .

 $"  # y.

 .

which would only serve to prolong the process of dying of an individual who has a terminal illness.6 (a) By making an advance health directive. . Whenever you are in a hospital the medical staff would refer to these document before given medications.    $"  #  Ans. © If a patient does not have an ACD. the patient can mention what treatment he/she would like to have or would like to refuse in situations when you are seriously ill and unconscious or longer in a condition to make your own decision. (b) It is medical procedure or intervention that utilizes artificial means to sustain or replace a vital function. If the patient is in a condition to give his opinion he I asked for it else the doctor¶s decision is the final one. the doctor takes action as per the requirement of the illness which the patient is suffering from.

(d) Yes instructions can be written to the doctor in case to assist the client to die but only when the patient is in a persistent vegetative state. permanently unconscious due to brain damage or the patient has some terminal illness which has no cure. In case the patient is too sick to make decisions his attorney can write the ACD in place of him. (f) Yes a patient can change his ACD as per the current illness since the situation might change. . he can also take the help of his attorney while writing an ACD. (e) Along with the patient himself. But it can only be done if the patient is in a condition to make decisions.

c D.

         .

     +  y.

  .

  +  y.       .

   '.

 .

  .

They have an obligation to perform sufficient care. I would advise the family that it is their moral duty to take care of their family member in his last moments rather than leave all hope and allow him to die. c. not whether the patient's life is worth living. (b) In such a situation. personally I would encourage the family to give full emotional support to the patient and also may suggest the family to take the patient home where he can feel much more comfortable. and sound judgments about medical treatment.     +   Ans-7. Medical advances in recent years have made it possible to keep terminally ill people alive for beyond a length of time even if it is without any hope of recovery or improvement..  . not to refrain from giving the patient food and water until that person dies. (a)The physician's role is to make a diagnosis.

                            '  .    /                    0 )1   2 1 .

   */          .

 y.

â            +(  y.

would be give her a sponge bath. also keep the patient¶s wish of taking a complete bath. This would take care of the family¶s request. â        '  +(    Ans.8 (a). c3 [      . The most appropriate response to a patient who has been requested to be given bath every day. Even medically this would be appropriate as she is having very short breath so a full bath might make her breathless. (b) On arrival of the patient¶s family I would inform them that the patient was not feeling well and was having very short breath so as to keep her wish and also avoid breathlessness and further complications I have given her a sponge bath so that the family¶s request is also taken care of.

      .

    ' '        .

  (   y.

"' .

'   y.

X      y.

   .

' y.

 y.

 y.

š   y.

"' .

swallowing air.'   Bloating is not a disease by itself. And the most common cause is irregular digestion that produces gas at a higher rate than normal. Dome of the causes of bloated stomach are. as most people believe. lactose intolerance or certain food . eating too fast. It is more of an indication of some other serious underlying medical condition related to digestive disorders such as indigestion. eating food too fast. It most often occurs in the small intestine rather than the stomach.

A tablet of antacid might help relieve the patient from the discomfort. intolerances. y.

In addition. X      While breathing. Although labored breathing can sound very distressing to the caregiver. breathing that is irregular and shallow. decreased number of breaths per minute.  y. If the patient is able to swallow. a cool mist humidifier may help make the patient's breathing more comfortable. ice chips also may help. An external source of oxygen may benefit some patients. gurgling and rattling sounds do not cause discomfort to the patient. breathing that alternates between rapid and slow Breathing may be easier if the patient's body is turned to the side and pillows are placed beneath the head and behind the back. which may be loud.

   .

y. Also confirm whether its having allergic symtopms. ' Apply some cooling lotion which will moisturize and hydrate the skin. Give medications accordingly.

y. and then the balloon is deflated and removed. which gradually widens your oesophagus. It involves placing a small balloon inside your oesophagus. Dilation is a widely used technique in cases of obstruction. The balloon is inflated.  It can be difficult to achieve a complete cure for high dysphagia because the underlying neurological problems cannot usually be corrected using medication or surgery.

 .

y. Using techniques like talking slowly and repeating things. using gestures or drawings and avoiding noisy areas can be great help while dealing with dysphasia. Dpeech therapy can be used effectively to improve their communication.

paying special attention to your heart. š   One should perform a complete physical examination. and nervous system. lymph nodes.Tests that may be performed include the following: y. thyroid.

y. diabetes. Blood tests to check for anemia. and possible infection.

Thyroid. and liver function tests y. kidney.

Urinalysis    c( .

                  .

     .

.

 .

 .

    '4.

Patient. Although the principles of family- centered care are particularly suited to the practice of family medicine. and it may be practiced in any health care setting.and family-centered care is an innovative approach to the planning. and families. The ways in which family can provide a supportive environment is through (a)Giving respect and dignity (b) Information sharing (c) Participation (d)Collaboration Family practice is a medical specialty. and evaluation of health care that is grounded in mutually beneficial partnerships among health care providers. patients. delivery.and family-centered care applies to patients of all ages. they .   '     '  ((  Patient.

(IPFCC) c . transcend and cross medical specialties. Health professionals in all disciplines can practice family-centered care.

          .       '   y.  4 .

â    .

      ' .

         .

.

+ (  y.

â    +(  y.

 '.

because we are going to give oxygen mask which will improve her breathing. At present everything is under control and the patient is out of danger. the patient will feel much better. It is nothing to worry much.    +(   Ans. as soon as the medicines work. pain medication is also given so as to heal the ailments by relaxing the muscles or the injury so that the patient gains consciousness soon.11 (a) The patient though unconscious but needs to be given pain medication so that once he gets conscious he is relieved of the pain. Moreover.  c!/ . (b) The patient is having problem in breathing since she is not able to inhale oxygen problem due to obstructions in her respiratory system. (c) We have given proper medications and taking care of other symptoms.

  .

      .

'       .

    š  .

'.

imely nderstandable "lways objective .'  +!((   š"[."r% šocused on the client "ccurate [omplete .

regible  y.

   -'  y.

v.

  '     y.

v   '  0 ' '       y.

$      Ñ y.

&  2 (' !Ñ  y.

    5  y.

   . š'2.

he groaned with pain. Timely medications were given and complete care was being taken of him.  c#. whenever he was moved. The patient had been admitted 7days back. The treatment was provided to the patient without any loss of time. Respiration of the patient was 8 and moist. Family has been very supportive and had been frequently asking questions regarding the progress in the improvement of the health of the patient. It was being observed from past few days that the patient was motionless. The oral intake recorded for the patient was 150ml in last 24 hours. Oxygen was being given to the patient. It was recorded that he did not have bowel for past 4 days. After the administration of analgesia the pain score recorded was 7. For past few days urine output recorded was zero.  Ans-12. As on the final day the following observations have been made.

 .

  .

   .

  4 ' '         .

talk.  (   Ans. . Family members and caregivers may wish to sit with the patient. the following steps can be taken.13 After the patient has passed away. When the family is ready. there is no need to hurry with arrangements. or pray.

y.

Place the body on its back with one pillow under the head. If necessary. caregivers or family members may wish to put the patient's dentures or other artificial parts in place. y.

do not call 911. If the patient has requested not to be resuscitated through a Do-Not-Resuscitate (DNR) order or other mechanism. Contact the appropriate authorities in accordance with local regulations. y.

Contact the patient's doctor and funeral home. y.

call other family members. y. and clergy. friends. When the patient's family is ready.

Provide or obtain emotional support for family members and friends to cope with their loss.   cÑâ X $ ' .

 0                             '      â .

 2 .

After which as an advice I would add my prescription of the increase in the dosage of her present medicine or the change is medicine to a higher dosage one. I would then prescribe a pain killer with a higher dose or might increase the dose of the medicine which was taking. Also would add the previous dosage of medicine which was taking and also the number of days she was on medication. I would mention the patient¶s past history of pain and ailment. The amount of medicine which was prescribed to her and the percentage of relief she was experiencing before. While documenting the patient¶s case. .14 I would first take down the whole history of the patient as to from when she is having the pain.'   +(6(   Ans.

cX 7 .

      '  ((('   0.

       8''â .

 2  .

'     .

+(6(  .

.

.

.

.

.

.

.

.

evoked by touching the soft palate. In patient¶s record. I would document about the patients symptom of gag reflex and the consequences which could follow it.Ans. Jones so that he could have his requisite 1000mls of fluid without actually drinking it. I would add my advice of giving the patient drip of fluid rather than oral drinking so that his requisite 1000mls of fluid without actually drinking it is fulfilled. c9 . It prevents something from entering the throat except as part of normal swallowing and helps prevent choking.15 The pharyngeal reflex or gag reflex is a reflex contraction of the back of the throat. I would give the fluid as a drip to Mr.

.

.

    .

 .

     .

 .

Coping mechanisms are usually conscious methods that the individual uses to overcome a problem or stressor.      (  Ans. I could take care of ineffective coping by .16 Ineffective coping is an applicable nursing diagnosis evident in several of the patients. they may lead to changed behavior Inappropriate coping mechanisms can be changed because the patient is usually aware of using them. They are learned adaptive or maladaptive responses to anxiety based of problem solving.

Talking out problems with others .

crying. Expressing emotion²yelling. laughing .

food. Deeking comfort from friends. treasured objects. smoking. or mind-altering substances .

.

Using humor to relieve tension in a way that avoids fully acknowledging a difficult situation .

Exercising .

Avoidance of upsetting situation or confrontation .

The nurse¶s psychosocial assessment of the patient and family should focus on the effect of the illness rather than the physical symptoms. Using step-by-step approaches to resolution of the problem.              .

[: . :š::.

com/health/wellness/articles/0824ross-stages-ON.html . http://www.azcentral.

2009 . http://www.com/Term-Paper-The-Comfort-Theory-in-Nursing/113113.academon.

  .

 .  v .

.

July/August 2005. pp. 1443-1464.1164/rccm.2504001 .   š    7 . (2005) © 2005 American Thoracic Docietydoi: 10.Pages 147 ± 154 ë  Joul of Rpo  Cl C M  Vol 171.Volume 19 Number 4.

http://www.com/essay/002469.essaysample.html .

org/faq.ipfcc. http://www.html .

. (2002). Caregivers of frail rural older adults: Effects of an advanced practice nursing intervention. M. & Zerbe.Dellasega. T. 28(10). D. Journal of Gerontology..

Gorman. L.F. Dultan..13 and 16 . F.. (2002).) p.M. Raines.A. Davis Company: Philadelphia. Psychosocial Nursing fo Gl p C 2nd Ed. D. M. L.

Kaiser Permanente. A voice for nursing education. 1948 to 1991 : oral history transcript / 2004 .

ë  .

  .

 .

 .

  .

.

 .

.

.

.

.

 .