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

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POST MORTEM CARE
LOSSIs an actual or potentialsituation in whichsomething that is valuedis changed, no longeravailable, or gone.
PHASES OF GRIEVING1. DENIAL2. ANGER3. BARGAINING4. DEPRESSION5. ACCEPTANCE
death:::IS THEULTIMATE LOSS
DEATHIt is the ultimate loss. It occurs when thelungs & heart cease to function, causinginadequate blood flow to major organs,acidosis, and tissue ischemia (MULTIPLEORGAN DYSFUNCTION SYNDROME-MODS
LOSS, GRIEVING AND DEATHTraditional Clinical Signs ofDEATH:Cessation of Apical Pulse,Respirations & BloodPressure.(HEART-LUNG DEATH)
The goal of care for client near the end oflife are:Control symptomsIdentify client needsPromote meaningful interactionsbetween the client & significantothers.Facilitate a peaceful death.
COMMON PHYSICAL SIGNS & SYMPTOMS OFAPPROACHING DEATH:Coolness of Extremities>Cover the person with a blanket. Do not usea hot water bottle, electric heating pad, orhair dryer to warm the person.Increased Sleeping>Spend time sitting quietly with the person.Do not force the person to stay awake. Talk tothe person as you normally would, even if heor 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 mouthmoist & comfortable.>Coat the lips with lip balm or petroleumjelly.
Incontinence>Keep the area clean & dry.If the person would be more comfortable, useurine catheters.Congestion & Gurgling>Suctioning can be used to remove secretions,but this may cause discomfort.>Medications can decrease the production ofsecretions.
Breathing Pattern Change>Elevate the person’s head.Position the patient on his or her side.Disorientation>Identify yourself wheneveryoucommunicate 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 inthe room.
CLINICAL SIGNS OF DEATHLoss of muscle toneRelaxation of the facial muscles (the jawmay sag)Difficulty in speakingDifficulty swallowing & gradual loss of thegag reflexDecreased activity of the gastrointestinaltractPossible urinary and rectal incontinenceDiminished body movement
Slowing of the circulation-Diminished sensation-Mottling and cyanosis of theextremities-Cold skin, first in the feet and later inthe hands, ears and nose-Profuse diaphoresis
Changes in vital signs-Decelerated and weaker pulse-Decreased blood pressure-Rapid, shallow, irregular or abnormallyslow respirations, mouth breathing, noisybreathing (death rattle- caused byaccumulation of mucous in the throat)
Sensory impairment-Blurred vision-Pupils become dilated and fixed-Patient often has a detached look in theeyes-Diminished sensory and motor functions inthe lower extremities progressing to theupper extremities-Diminished touch sensation; however,pressure and pain sensation remain intact-Impaired sense of taste and smell
HOME CAREASSESSMENT OF THECLIENT WITHPHYSICALMANIFESTATION OFDEATH

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Term
Winter
Professor
N/A
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attending physician

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