4.3.6: FRAME 6- Evaluate Outcomes
- Page ID
- 90026
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Rhys’s respirations are shallow, with four breaths per minute. He has a notable change in color; his skin appears pallor, dusky, and grey. The nurse discusses with the family that Rhys’s death is imminent.
QUESTION: Matrix Multiple Choice
Scoring Rule: 0/1
Indicate on the table below what nursing interventions would be appropriate or not appropriate for Rhys and his family at this time. Each row should include a single choice.
| Nursing Intervention | Indicated | Not Indicated |
|---|---|---|
| Provide emotional support and additional resources for the family | ||
| Inform the family the client is nearing death | ||
| Inquire if the family has cultural or spiritual traditions or rituals they would like to perform. | ||
| Encourage the family to share last words and thoughts with the client | ||
| Continue to provide comfort care to the client | ||
| Encourage the family to remain strong and not show emotion until after the client has passed | ||
| Reassure the family that symptoms are normal for end-of-life | ||
| Encourage the family to be present |
Putting It All Together
DEBRIEF
End-of-life can be difficult for families. The nurse is an integral part of the process and influences the family’s perception of end-of-life. The nurse can foster the nurse-family therapeutic relationship by:
- Providing emotional support and additional resources for the family.
- Informing the family that the client is nearing death, the dying process, and indicating that death is impending.
- Inquiring if the family has cultural or spiritual traditions or rituals, they would like to perform. • Encouraging the family to share last words and thoughts with the client.
- Continuing to provide comfort care to the client.
- Reassuring the family that showing emotions and crying is a normal and natural part of saying “goodbye.”
- Reassuring the family that the symptoms the client is experiencing are normal for end-of-life.
- Encouraging the family to be present, hold the client’s hand, or touch them.
RECOGNIZING SOCIAL DETERMINANTS OF HEALTH (SDOH)
Cultural beliefs, attitudes, and personal experiences influence an individual’s response to death. Funerals can lessen the family’s grief through cultural or ritual expression, approval, and social support. Having the opportunity to honor or celebrate a loved one with a funeral service reduces grief, while poverty exacerbates grief (Becker et al., 2022).
Coping with financial concerns such as funeral costs and grieving a loved one’s death is difficult. Grief can be intensified or prolonged for individuals and families with no or limited financial reserve. Coping with financial concerns and not having the means to provide a satisfying funeral can lead to depression and worse mental health (Becker et al., 2022). Financial concerns can be heightened if the loved one did not have insurance to cover the costs of care during the dying process.
What Do You Think About?
- List three additional ways the nurse can foster a therapeutic nurse-family relationship.
- Examine your own beliefs on end-of-life and death. Where do you anticipate you would find solace? Where do you anticipate you would be challenged?
- Consider cultural approaches to end-of-life and death. How might end-of-life, death, and afterlife vary with other ethnic groups. How do traditions vary among people living in the United States?