Wk 10 Grief, Loss, Death, and Dying

Essential nursing vocabulary flashcards covering the concepts of grief, mourning, bereavement, loss classifications, death stages, palliative and hospice care, end-of-life ethics, and postmortem signs.

Grief

The individualized emotional response to a real, perceived, or anticipated loss, encompassing emotions such as anger, loneliness, sadness, guilt, regret, and peace.

Loss

The actual or perceived absence of a possession, circumstance, or individual, extending beyond death to include events like divorce, job loss, and medical diagnoses.

Mourning

The outward, social expression of grief shaped by cultural norms, rituals, personality, and social support systems.

Bereavement

The period and state encompassing both the internal feelings of grief and the outward expression of mourning after a loved one has died.

Takotsubo Cardiomyopathy

A stress-induced cardiac condition, also known as 'broken heart syndrome,' seen most often in older women after acute stress; characterized by reduced left ventricular mobility, decreased cardiac output, a systolic murmur, and symptoms mimicking acute coronary syndrome.

Actual Loss

A tangible, measurable loss clearly noticed and validated by others, such as the death of a loved one, loss of a job, or loss of a limb.

Perceived Loss

A subjective loss that is internal and not clearly evident to others, such as a disruption in identity, loss of independence, decreased mobility, or a shift in spiritual beliefs.

Anticipatory Loss

Grief experienced before an expected loss actually occurs, common in terminal illness, dementia, or divorce, which can lead to prolonged grieving and premature social withdrawal.

Maturational Loss

A category of loss tied directly to predictable, developmental life-stage transitions, such as leaving home, retirement, or becoming an empty-nester.

Situational Loss

An unpredictable loss brought about by specific external events or life changes, such as a natural disaster, loss of body image, or loss of freedom.

Engel's Six Stages of Grief

A sequential model formulated in 1961 that likens grief to a physical wound requiring healing, progressing through: 1. Shock and disbelief, 2. Developing awareness, 3. Restitution, 4. Resolving the loss, 5. Idealization of the deceased, and 6. Outcome.

Kübler-Ross's Five Stages of Grief

A non-linear grief framework identifying five stages that individuals may experience along a continuum, randomly, or skip entirely: Denial, Anger, Bargaining, Depression, and Acceptance.

Complicated Grief

A debilitating grief response that fails to follow normative cultural or temporal expectations and causes functional impairment, frequently occurring after suicide or sudden, violent deaths.

Chronic Grief

A type of complicated grief marked by ongoing, intense sorrow and mourning years after the loss, accompanied by persistent difficulty in performing daily self-care.

Delayed Grief

A grief response that is suppressed or avoided at the time of loss and subsequently emerges much later, often triggered by an unrelated event.

Exaggerated Grief

A severe grief reaction characterized by extreme, overwhelming responses such as persistent nightmares, intense phobias, debilitating fear, or maladaptive behavioral problems.

Masked Grief

A grief reaction in which the individual does not consciously recognize their distress as grief, expressing it instead as new physical symptoms or somatic complaints.

Physiological Death

The biological cessation of bodily organ system functions, rendering the individual incapable of breathing, eating, or sustaining vital physiological processes.

Psychological Death

The stage wherein an individual recognizes impending death and regresses inward, becoming quiet, withdrawn, and minimally responsive.

Societal Death

The withdrawal of family members, acquaintances, and healthcare providers from the dying person due to discomfort with impending death and loss.

Mottling

A bluish-red, lace-like skin discoloration caused by progressive vascular and circulatory collapse during the middle and late stages of active dying.

Cheyne-Stokes Breathing

An abnormal respiratory pattern occurring in the late stage of dying, marked by alternating cycles of deep, rapid breathing followed by periods of apnea.

Agonal Breathing

Gasping, labored, and sporadic breaths that present during the late stage of dying and signify impending death.

Terminal Illness

A progressive, life-limiting medical condition for which there is no known cure, where prognosis based on symptoms—specifically an estimated life expectancy of 6 months or less—determines hospice eligibility.

Palliative Care

Interdisciplinary care for patients with serious illnesses at any stage, focused on communication, collaboration, compassionate caring, comfort, and cultural care, which can be delivered alongside curative treatment.

Hospice Care

A specific form of palliative comfort care reserved for individuals with a terminal prognosis of 6 months or less that focuses entirely on quality of life and symptom relief without curative intent.

Advance Directive

A written legal document outlining specific medical interventions a person desires or refuses and often appointing a healthcare proxy to make decisions if the individual becomes incapacitated.

POLST (Physician Order for Life-Sustaining Treatment)

A portable, actionable medical order for individuals with advanced or progressive illnesses detailing specific wishes regarding resuscitation, transport, and interventions.

Allow Natural Death (AND)

An order similar to a DNR that focuses on allowing a natural dying progression, guiding clinicians to provide comfort and dignity rather than framing care around withholding interventions.

Terminal Weaning

The intentional withdrawal or discontinuation of mechanical ventilation or other life-sustaining treatments in the ICU when they are determined to be no longer therapeutic or restorative.

Palliative Sedation

The controlled administration of pharmacological agents to decrease consciousness in terminally ill patients experiencing intractable, refractory pain, severe dyspnea, delirium, or severe suffering.

Active Euthanasia

The direct and deliberate administration of a lethal dose of medication by another person to end a patient's life to stop suffering.

Passive Euthanasia

The withholding or withdrawal of life-prolonging medical interventions to permit a patient to die naturally from their underlying condition.

Provider-Assisted Death

A practice where a clinician prescribes a lethal medication that the patient self-administers to end their own life, authorized in select states and countries.

Pallor Mortis

The initial postmortem change characterized by extreme paleness of the skin occurring almost immediately after death due to the cessation of capillary blood flow.

Rigor Mortis

The progressive stiffening of skeletal muscles that occurs several hours after death as cellular energy stores are depleted.