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4.Share with Frank memories of own grandparents.Bertha now lies quietly with her eyes closed. She no longer responds verbally, but she smiles when herfamily speaks to her.To assist Frank and Bertha in life review, what is the best intervention by the nurse?1.Encourage visitors to talk quietly so Bertha is not disturbed.2.Suggest that Frank bring photo albums to show Bertha.3.Urge Frank to talk to Bertha about their experiences. Correct4.Encourage visitors to use touch when communicating with Bertha.Problem Set 10What other physical symptom should the nurse anticipate?1.Hyperreflexia in legs and arms.2.Increased urinary output.3.Mottling of hands and feet.4.Head turned away from light.End-of-Life CareFrank decides to go home to sleep in his own bed. Bertha's daughter, Carol, spends the night at thebedside. Early the next morning, Bertha's vital signs are pulse 50 beats/min andthready, respirations 10breaths/min and shallow, BP 70/30 mmHg, Glasgow Coma Scale 3.Based on the assessment findings, what action should the nurse take?1.Inform Carol that Bertha's condition is worsening.2.Suggest that Carol tell Frank to rush back to the hospital immediately.3.Hold Carol's hand, but do not disclose Bertha's vital signs.4.Notify the family that Bertha will probably die today.Carol has been observing the nurse and the UAP perform oral suction for Bertha. Carol says, "I knowMama is dying. I can do the suctioning. Would you watch me once?"How should the nurse respond?1."Do you think you are strong enough?"2."Yes. I would be happy to watch you."3."I am not sure that is a good idea."4."I think there is a policy against it."Carol notifies her father that her mother's condition is worsening. Frank arrives with his son-in-law andgrandchildren. The rabbi is called to be with the family. The family recites the Shema, which reaffirmsthe basic tenets of the Jewish faith. Bertha moves her lips as they speak but does not open her eyes. As
the day goes on, at least one family member remains at Bertha's side at all times. Members of thesynagogue bring food to the waiting room for the family to eat.Problem Set 11Postmortem CareThe family members are at the bedside very early the next day when Bertha stops breathing. Thehealthcare provider arrives and pronounces the death. As the rabbi is being consulted regarding thepreparation of the body, a group of women from the synagogue arrive to assist with postmortemcare.How should the nurse respond?1.Instruct the family and the rabbi to leave the room.2.Remain available to assist the women of the synagogue as needed.3.Tell the rabbi that postmortem care must be done by the hospice staff regardless of religion.4.Remind the family that an autopsy must be performed before the burial.Problem Set 12Case OutcomeFrank comes to the nursing station to say goodbye and offers his thanks. He says, "I will miss my dearwife, but it helped that we could all be with her when she died." Frank and his family leave whenthefuneral home staff arrive to take Bertha's body. The nurses are able to spend time talking with oneanother about the experience of helping Bertha and her family through the dying process beforetheyreturn to caring for other hospice patients.