Care of dying patient

care of dying patient

1. CARE OF DYING PATIENT Rohini Pandey 1 st Year M.Sc Nursing KGMU Institute of Nursing 1 3/14/2016

2. CONTENTS Introduction Definition Signs of approaching death Symptomatic management Signs of clinical death Summarization Conclusion 2 3/14/2016

3. INTRODUCTION 3 3/14/2016

4. DEFINITION A medical/nursing intervention defined as promotion of physical comfort and psychological peace in the final phase of life. 4 3/14/2016

5. STAGES OF LOSS & GRIEF 5 3/14/2016

6. SIGNS OF APPROACHING DEATH Facial appearance. Changes in sight, speech, and hearing. Respiratory system. Circulatory system. Gastro intestinal system. Genito urinary system. Skin and musculo skeletal system. Central nervous system . 6 3/14/2016

7. FACIAL APPEARANCE CHANGES IN SIGHT, SPEECH& HEARING 7 3/14/2016

8. RESPIRATORY SYSTEM CIRCULATORY SYSTEM 8 3/14/2016

9. GASTRO INTESTINAL SYSTEM “DEATH RATTLE” 9 3/14/2016

10. GENITO URINARY SYSTEM SKIN & MUSCULO SKELETAL SYSTEM 10 3/14/2016

11. CENTRAL NERVOUS SYSTEM Reflexes and pain are gradually lost. Patient may be restless due to lack of oxygen and due to raised body temperature, although the body surface is cool. 11 3/14/2016

12. CARE OF THE DYING PATIENT Psychological support Advance Planning For Imminent Death Financial Concerns Legal and Ethical Concern Helping the Patient Transition Pain Management The Patient's Right to Information Symptomatic Management 12 3/14/2016

13. SYMPTOMATIC MANAGEMENT Problem associated with breathing : Oxygen inhalation to remove his discomfort. Elevation of the patient’s head and shoulders may make breathing easier. Keep the room well ventilated and keep crowed away. Periodic suctioning is necessary. 13 3/14/2016

14. Problem associated with eating and drinking: Anorexia, nausea, and vomiting are commonly seen in dying patient. They are unable to take any form of food and if they taken, they are unable to retain the food. I.V fluids. Sips of water is given with teaspoon. Give frequent oral hygiene . Apply emollients to the dry lips. The denture are removed and kept safely. 14 3/14/2016

15. Problem associated with sense organ : Since the patient loses sight, before given any care to the patient, the nurse should touch the patient and say what she is going to do. Since the hearing is retained longer, speak only what is appropriate. Avoid whispering any thing in patient room. Speak distinctly so that patient may understand what is done for him. Since the eyes are opened, protect the eyes from corneal ulceration with protective ointment. 15 3/14/2016

16. Problem associated with cleanliness and grooming: Cleanliness and appearance are important until the end. Cleanliness of the skin, hair, mouth, and cloth has to be maintained. Problem associated with communication Confusion Withdrawal 16 3/14/2016

17. Problem associated with rest and sleep: Patient should not be disturbed while sleeping. The visitors should be instructed not to disturbed the patient during his resting. Maintain calm and quit environment. Pharmacological management Anti-pyretic Analgesic Anti-emetic Lifesaving drug if required 17 3/14/2016

18. SIGNS OF CLINICAL DEATH Absence of pulse, heart beat and respirations Pupil becoming fixed and not reacting to light Absence of all reflex. Rigor mortis: Stiffing of the body after death. The arms & legs cannot be bent or straightened while rigor mortis is present unless the tendons are torn. POSTMORTEM HYPOSTASIS - It is a dark red or bluish discoloration due to the settling of the blood. 18 3/14/2016

19. NURSING MANAGEMENT Role of Nurse Assessment History taking Physical Examination Nursing Diagnosis 19 3/14/2016

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21. SUMMARIZATION 21 3/14/2016

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