care of terminally patients for bsc nursing and gnm 1st year

1. Mrs DEVINA VICHRAM
NURSING TUTOR
GANGA COLLEGE OF NURSING
CARE OF TERMINALLY
ILL PATIENT

4. • Three major concepts associated with grieving are
loss
 grief
 mourning.

5. is the absence of a possession or future possession with
the response of grief and the expression of mourning.
• The feeling of loss can be associated with the loss of health,
changes in relationships and roles, and eventually the loss of
life.
• After a patient dies, the family members and other survivors
experience loss

7. • Grief is the emotional response to a loss, defined as the
individualized and personalized feelings and responses that an
individual makes to real, perceived, or anticipated loss.
• These feelings may include anger, frustration, loneliness,
sadness, guilt, regret, and peace.
• Grief affects survivors physically, psychologically, socially, and
spiritually.

8. • Mourning is the outward, social expression of loss.
• Individuals outwardly express loss based on their cultural
norms, customs, and practices, including rituals and traditions.
• Some cultures may be very emotional and verbal in their
expression of loss, such as wailing or crying loudly.
• Other cultures are stoic and show very little reaction to loss.

10. There are five different categories of grief:
Anticipatory grief
 Acute grief
Normal grief
Disenfranchised grief
Complicated grief.

13. Care of the Dying Patient
• Care of the dying patient generally refers to care in the last
days or hours of life. The goals of care during the last hours
and days of life are to ensure comfort and dignity. Good
palliative care does not hasten death.In humanitarian settings,
where healthcare providers may not have expertise in
palliative care, identifying when patients are at this stage of life
can be challenging. In addition, during this time, physical
symptoms can be difficult to control; the best way to ensure
they are well managed is to anticipate the symptoms and
develop a management plan.

30. Deathbed Will

31. Dying declaration
• A dying declaration is a statement made by a declarant,
who is unavailable to testify in court (typically because of
the declarant's death), who made the statement under a
belief of certain or impending death. The statement must
also relate to what the declarant believed to be the cause
or circumstances of the declarant's impending death.

33. Potential donor identification → brain death
determination → referral to OPO → donor
screening for acceptable organs →
approaching the family → authorization from
family → OPO evaluation → donor
management → organ recovery → organ
placement

36. • All brought dead cases should be informed to the nearest police station
by the medical officer on duty
• Death certificate should not be issued in such brought dead cases or
MLC before post mortum is done
• Identifition marks of the examinee should be noted
• Documents should be maintained including death summary, ivestigations
carried out and the treatment given
• Birth and death registrations are mandatory
• Detailed infmation includig name, age, gender, religion, address etc
should be included

37. • Information regarding cause of death, time of death evidenced by 12 lead
ecg should be safeguarded
• in MLC death , dead body to be released only to the police and not to the
relatives
• Any samples if needed to be preserved
• while filling death register , MLC register, etc short forms should be
avoided
• documents should be under custody of concerned personal along

48. • Cleaning: Cleaning with warm water and
detergent is a process that removes visual dirt and
contamination and in most cases is effective for
decontaminating both equipment and the
environment.
• Disinfection: sodium hypochlorite is the
most common hallogen used

51. • During an outbreak of infection or an unusual increase in the
incidence of a particular organism, enhanced routine
cleaning (minimum twice daily) is recommended. This will
entail cleaning/disinfecting the environment including
frequently touched surfaces such as bed tables, bed rails, the
arms of chairs, sinks, call bells, door handles and push
plates, and any area/piece of equipment that may potentially
be contaminated. Depending on the type of outbreak in the
healthcare facility,

52. Following an outbreak or increased incidence of
infection
Following discharge, transfer or death of a
patient who has had a known infection
Following isolation/contact precaution nursing
of a patient

53. • Gather all equipment required for the terminal clean at the point of
use e.g. mop bucket, mop, disposable colour coded cloths, disposable
roll, yellow clinical waste bags & tags, alginate & red bags, wet floor
sign, vacuum cleaner fitted with a HEPA filter.
• Don Personal Protective Equipment (PPE), i.e. disposable apron and
gloves, before entering the room, discard all disposables in the
room/bed space/unit (e.g. hand towels, magazines, bottles, toilet rolls,
etc.) All materials must be disposed of as clinical waste.

54. • Prepare cleaning/disinfecting solutions in a container
(dilution as per manufacturer’s instruction). Do not mix
chemicals and only use a cleaning product provided by
your employer.
• Ventilation of the area/room being cleaned must be
adequate; if there is no window, the door should be left
open when applying hypochlorite/chlorine dioxide
solutions.

55. • Disinfectant solutions should be used as per
Manufacturer’s instructions, particularly the contact time.
Also the Control of Substances Hazardous to Health
(COSHH) regulations must be adhered to when using
chemical disinfectants.
• After cleaning, rinse with water (if rinsing is required)
before drying. In particular it is important to rinse chlorine
containing solutions from stainless steel surfaces to
prevent corrosion.

56. • Use disposable cloths/paper roll for cleaning during
the terminal clean. Where available and
appropriate, use disposable mop heads. After use,
these should be disposed into a clinical waste bag
before leaving the area/room.
• Ensure that PPE is changed when moving from
one room/area to another and dispose into a
clinical waste bag.

57. • Always decontaminate your hands after removing
and disposing of PPE.
• Avoid leaving and re-entering the area until the
terminal clean is fully completed.

58. • An autopsy, also known as a post-mortem
examination
• A specialized surgical procedure used to determine the
cause and manner of death.
• The cause of death is the medical reason explaining
why a patient passed.
• The manner of death is the circumstances surrounding
the death.

60. A method of preserving a dead body by removing the blood and
replacing it with fluids, such as formaldehyde, which discourage
the growth of the organisms responsible for putrefaction.
1. It involves the injection of
embalming chemicals into the blood vessels usually via the right
common carotid artery. Blood is drained from the right jugular
vein.

62. It is the suction of the internal fluids of the cadaver and
the injecting embalming chemicals into body cavities by
using an aspirator and trocar
3.
Is injecting embalming chemicals under the skin as
needed.

63. Supplements the other methods especially for visible,
injured body parts.