Which of the following individuals is most likely experiencing a delayed grief reaction?

Answer to #1

ANS: C
Eric Lindemann pioneered the concepts of grief work based on interviews with bereaved persons suffering a sudden tragic loss. He described patterns of grief and the physical and emotional changes that accompany significant losses. Lindemann observed that grief can occur immediately after a loss, or it can be delayed. When symptoms of grief are exaggerated or absent, it is considered pathologic or complicated grief. People experiencing complicated grief may require psychologic treatment to resolve their grief and move into life again. The pilot is talking about the death; there is no evidence symptoms of grief are absent. Anniversaries will often trigger memories. Children often show regressive behavior, anger, or fear in response to the loss of a parent.

Answer to #2

ANS: A
Complicated grief can appear as an absence of grief in situations where it would be expected. When deaths and important losses are not mourned, the feelings don't just disappear; they reappear in unexpected ways, sometimes years later. Subsequent losses trigger an extreme reaction to a current loss. Complicated grief can result in clinical symptoms such as depression or anxiety disorders that require professional help. Blaming oneself, wanting to take the place of those who dies, and having sleep problems are normal grief reactions that occur in sudden or traumatic situations.

Answer to #3

ANS: D
Spiritual support for clients and family should be offered. Sitting quietly with the grieving client is supportive, but the grieving client should be encouraged to talk about the loss. Trite reassurances are not supportive.

Answer to #4

ANS: D
Immanent Death: Family Communication Needs
 Honest and complete answers to questions; repetition and further explanation, if needed
 Updates about the client's condition and changes as they occur
 Clear, understandable explanations, delivered with empathy and respect
 Frequent opportunities to express concerns and feelings in a supportive, unhurried environment
 Information about what to expectphysical, emotional, spiritualas death approaches
 Discussion of whom to call, legal issues, memorial or funeral planning
 Conversation about cultural and/or religious rituals at time of and after death
 Appreciation of the conflicts that families experience when the illness dictates that few options exist; for example, a frequent dilemma is whether life support measures are extending life or prolonging the dying phase
 Short, private times to be present and/or minister to the client
 Permission to leave the dying client for short periods with the knowledge that the nurse will contact the family member if there is a change in status

Answer to #5

ANS: D
Nurses are key informants about client status and changes in the client's condition. There are fundamental differences in the level of information an individual or family will desire. The response of the client should determine the content and pace of sharing information. Talking with families about care details and potential outcomes should happen often, but even more frequently when the client's health status begins to decline or show a change. It is often difficult for families to talk about death, and the nurse can facilitate communication. It is important to be honest; false information and reassurances can increase feelings of isolation.