Question

instructions
it is important for caregivers to understand and address the needs of the dying resident. for this journal entry, briefly describe:

1. at least 3 of the normal processes of the dying process (pg 489)
2. at least 3 changes that may occur to the body after death (pg 489)
3. the role of the nursing assistant when a resident is dying (see pg 486-487). include one nursing assistant intervention in each of these areas:
4. room environment
5. skin, nose, and mouth care
6. breathing problems
7. food and fluid issues
8. pain control and comfort
9. diminished senses

grading is based on completeness and meeting word count of 150 words. (50 points. see rubric for details).

Explanation:

Identify normal processes of dying

Using the Grief and Dying knowledge point, we identify three normal physiological processes that occur as a resident is dying:

1. Decreased circulation, leading to cold, pale, or mottled extremities.
2. Changes in respiration, such as shallow, irregular breathing or Cheyne-Stokes respirations.
3. Decreased muscle tone, causing difficulty swallowing, loss of bowel/bladder control, and relaxed facial muscles.

Identify postmortem changes

Using the Grief and Dying knowledge point, we identify three physical changes that occur to the body after death:

1. Rigor mortis: The stiffening of skeletal muscles due to chemical changes.
2. Algor mortis: The gradual cooling of the body to room temperature.
3. Livor mortis: The pooling of blood in dependent areas of the body, causing discoloration.

Determine nursing assistant interventions

Using the Nursing Assistant Care knowledge point, we outline one specific intervention for each of the six care areas:

1. Room environment: Keep the room well-lit, quiet, and clean to promote a peaceful atmosphere.
2. Skin, nose, and mouth care: Apply lip balm and perform frequent oral hygiene to keep mucous membranes moist.
3. Breathing problems: Elevate the head of the bed (semi-Fowler's position) to facilitate easier breathing.
4. Food and fluid issues: Offer small sips of water or ice chips if the resident is conscious and able to swallow.
5. Pain control and comfort: Reposition the resident gently using supportive pillows to prevent pressure points.
6. Diminished senses: Speak clearly and reassuringly, assuming the resident can hear everything, as hearing is often the last sense to go.

Answer:

Journal Entry: Care of the Dying Resident

1. Normal Processes of the Dying Process

• Decreased Circulation: Blood flow slows, causing cold, pale, or mottled skin in the extremities.
• Respiratory Changes: Breathing patterns become irregular, shallow, or display Cheyne-Stokes respirations.
• Muscle Relaxation: Muscle tone decreases, leading to jaw sagging, difficulty swallowing, and incontinence.

2. Changes to the Body After Death

• Rigor Mortis: The temporary stiffening of the body's muscles, beginning a few hours after death.
• Algor Mortis: The natural cooling of the body as it aligns with the surrounding room temperature.
• Livor Mortis: The pooling of blood in the lower (dependent) parts of the body, causing purplish discoloration.

3. Nursing Assistant Interventions

• Room Environment: Maintain a clean, quiet, and well-ventilated room with soft lighting to support a peaceful environment.
• Skin, Nose, and Mouth Care: Perform frequent oral care and apply moisturizer to dry lips to maintain comfort.
• Breathing Problems: Elevate the head of the bed to a semi-Fowler's position to help ease breathing difficulties.
• Food and Fluid Issues: Offer ice chips or small sips of fluids frequently if the resident is still able to swallow safely.
• Pain Control and Comfort: Reposition the resident gently using pillows for alignment to prevent discomfort and pressure injuries.
• Diminished Senses: Speak to the resident in a calm, normal voice, keeping in mind that hearing is typically the last sense to be lost.