5.3.6: FRAME 6- Evaluate Outcomes
- Page ID
- 90257
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CORRECT Answer
Question Type: Matrix Multiple Choice
Scoring: 0/1
NCSBN Item Type and Scoring: https://www.ncsbn.org/public-files/p...main_stage.pdf
Indicate on the table below what nursing actions would be appropriate or not appropriate for Rhys and his family at this time.
| Nursing Intervention | Indicated | Not Indicated |
|---|---|---|
| Provide emotional support and additional resources for the family | X | |
| Inform the family the client is nearing death | X | |
| Inquire if the family has cultural or spiritual traditions or rituals they would like to perform. | X | |
| Encourage the family to share last words and thoughts with the client | X | |
| Continue to provide comfort care to the client | X | |
| Encourage the family to remain strong and not show emotion until after the client has passed | X | |
| Reassure the family that symptoms are normal for end-of-life | X | |
| Encourage the family to be present | X |
RATIONALE
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. Being present when a family member dies can be challenging and emotional, especially if the family is not sure what to do or what to expect. Providing emotional and resource support for the family is an important nursing role.
- Informing the family that the client is nearing death. The nurse should explain the changes in the client’s status are a normal part of the dying process and indicate that death is impending.
- Inquiring if the family has cultural or spiritual traditions or rituals they would like to perform. If there are cultural or spiritual traditions or rituals the family would like to perform, encourage them to do so. The cultural or spiritual traditions or rituals may not align with the nurse’s beliefs, as long as the request is ethical and legal. The nurse should holistically allow the family to perform or incorporate their personal cultural or spiritual traditions or rituals.
- Encouraging the family to share last words and thoughts with the client. When a loved one is ready to die, saying “goodbye” or reminiscing on favorable events or experiences can assist with closure for the client and loved ones.
- Encourage the family to be conversational with the client.
- Continuing to provide comfort care to the client. Continue to ensure the client is as comfortable as possible through the dying process.
- Reassuring the family that showing emotions and crying are normal and natural part of saying “goodbye.” The family does not need to hide tears or apologize for them.
- Reassuring the family that symptoms the client is experiencing are normal for end-of-life. Assist the family in the transition by utilizing therapeutic communication and sharing what they can expect during.
FOCUSED GUIDE
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 on top of grieving 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.
There are many ways the nurse can foster a therapeutic relationship with the family. Many are listed above. Additional ways to foster a therapeutic relationship with the family include:
- Encouraging the family to play the clients favorite music.
- Allowing the family to sing hymns or songs significant to the client.
- Allowing expressions of guilt and fear.
- Be open to the family member(s) expressing concern about their own mortality.
- Being patient with answering questions repeatedly.
- Addressing the family’s concern about the client’s pain and care.
- Being respectful of silence.
- Allowing the family to be an active participant in the care of the client.
- Providing support and resources for the family during and after the process.