14.-Post-Mortem-No-Rationale.pdf - POST MORTEM CARE LOSS •...

POST MORTEM CARE

LOSS
• Is an actual or potential
situation in which
something that is valued
is changed, no longer
available, or gone.

PHASES OF GRIEVING
1. DENIAL
2. ANGER
3. BARGAINING
4. DEPRESSION
5. ACCEPTANCE

death
:::
IS THE
ULTIMATE LOSS

DEATH
• It is the ultimate loss. It occurs when the
lungs & heart cease to function, causing
inadequate blood flow to major organs,
acidosis, and tissue ischemia (MULTIPLE
ORGAN DYSFUNCTION SYNDROME-
MODS

LOSS, GRIEVING AND DEATH
Traditional Clinical Signs of DEATH:
• Cessation of Apical Pulse,
Respirations & Blood
Pressure.
(HEART-LUNG DEATH)

The goal of care for client near the end of
life are:
• Control symptoms
• Identify client needs
• Promote meaningful interactions
between the client & significant
others.
• Facilitate a peaceful death.

COMMON PHYSICAL SIGNS & SYMPTOMS OF
APPROACHING DEATH:
• Coolness of Extremities
>Cover the person with a blanket. Do not use
a hot water bottle, electric heating pad, or
hair dryer to warm the person.
• Increased Sleeping
>Spend time sitting quietly with the person.
Do not force the person to stay awake. Talk to
the person as you normally would, even if he
or she does not respond
.

• Fluid & Food Decrease
>Do not force the person to drink or eat.
Offer ice chips or small sips of liquids @
frequent intervals if the person is alert.
Use glycerine swabs to keep the mouth
moist & comfortable.
>Coat the lips with lip balm or petroleum
jelly.

• Incontinence
>Keep the area clean & dry.
If the person would be more comfortable, use
urine catheters.
• Congestion & Gurgling
>Suctioning can be used to remove secretions,
but this may cause discomfort.
>Medications can decrease the production of
secretions.

• Breathing Pattern Change
> Elevate the person’s head.
Position the patient on his or her side.
• Disorientation
>Identify yourself whenever you
communicate with the person.
>Speak softly, clearly, and truthfully
.

• Restlessness
>Play soothing music.
Do not restrain the person.
Massage the person’s forehead.
Reduce the number of people in
the room.

CLINICAL SIGNS OF DEATH
• Loss of muscle tone
– Relaxation of the facial muscles (the jaw
may sag)
– Difficulty in speaking
– Difficulty swallowing & gradual loss of the
gag reflex
– Decreased activity of the gastrointestinal
tract
– Possible urinary and rectal incontinence
– Diminished body movement

• Slowing of the circulation
-Diminished sensation
-Mottling and cyanosis of the
extremities
-Cold skin, first in the feet and later in
the hands, ears and nose
-Profuse diaphoresis

• Changes in vital signs
-Decelerated and weaker pulse
-Decreased blood pressure
-Rapid, shallow, irregular or abnormally
slow respirations, mouth breathing, noisy
breathing (death rattle- caused by
accumulation of mucous in the throat)

• Sensory impairment
-Blurred vision
-Pupils become dilated and fixed
-Patient often has a detached look in the
eyes
-Diminished sensory and motor functions in
the lower extremities progressing to the
upper extremities
-Diminished touch sensation; however,
pressure and pain sensation remain intact
-Impaired sense of taste and smell

HOME CARE
ASSESSMENT OF THE
CLIENT WITH
PHYSICAL
MANIFESTATION OF
DEATH