Sunday, March 17, 2019

Signs of Dying Patient | Ethical Nursing Issues in Death and Dying

Who is a Critically Ill Patient?
This type of patients is known as those patients who are at high risk for actual or potential life-threatening health problems. The more critically sick patient is, the more likely he or she is to be highly vulnerable and unstable and complex, thereby requiring intense and vigilant nursing care. 
Dying patient signs and symptoms
Fig: Dying patient signs and symptoms
Signs and Symptoms of Dying Patient:
All the sign and symptoms of a dying patient have listed in the below:
  1. Deceased blood perfusion,
  2. The skin may become mottled and discolored,
  3. Decreased cerebral perfusion,
  4. Drowsiness or disorientation,
  5. Decreased cardiac output and intravascular volume,
  6. Tachycardia,
  7. Decreased level of consciousness or terminal delirium,
  8. Possible urinary incontinence,
  9. Decreased urinary output,
  10. Weight loss,
  11. Food pocketed in cheeks or mouth,
  12. Swallowing difficulties,
  13. Hypotension,
  14. Central and peripheral cooling,
  15. Concentrated urine,
  16. Decreased interest in food and fluid,
  17. Dehydration,
  18. Choking with eating,
  19. Coughing after eating,
  20. The skin may become mottled or discolored,
  21. Patches of purplish or dark pinkish color can be noted on the back and posterior arms or legs,
  22. Noisy respirations-usually no cough or a weak cough,
  23. Dyspnea,
  24. Sleeping more,
  25. More withdrawn and detached from surroundings,
  26. Shortness of breath,
  27. Profound weakness and fatigue,
  28. Drowsy for extended periods,
  29. May appear to be in a comatose-like state.
End of Life Ethical Issues in Nursing:
The following are the key ethical issues of nursing for dying patient:
  1. The person who deals with the dying patient must commit to deal with mental anguish and fear of death.
  2. Try to respond accurately to patients needs by listening carefully to the complaints.
  3. She should be fully prepared to accept their own counter transference as doubts, guilt and damage to their narcissism are encountered.
  4. Interventions of the dying patient sometimes elicit anxiety in nursing staff. Role-playing and education can develop perspective taking and empathetic skills, respect each other’s point of view as well as appreciate the situation of the patient and their families.
  5. Develop a sense of control and efficacy.
  6. Encouraging peer groups for families coping with death-related situations.
  7. Recognize that a moderate level of death anxiety is acceptable.
  8. Developing our understanding of pain and suffering will also develop communication and effective interactions.
  9. The contemporaneous practice of palliative care raises significant ethical issues which deserve thoughtful consideration.
  10. Each and every patient has a right to refuse life-sustaining treatment, even if they die as a consequence. In this situation, the patient must have the ability to comprehend the available choices and their risks and benefits to think rationally and to express a treatment preference.
There are three elements of Informed consent and refusal to life-sustaining treatment. Those are in the below:
  • Adequate information must be conveyed to the patient,
  • The patient must be able to decide,
  • The patient must have freedom from coercion.
More questions related to this article:
  1. Who does critically ill patient mean?
  2. Describe the management of a dying patient?
  3. How will you manage a dying patient?
  4. What are the clinical features of a dying patient?
  5. What are the most common symptoms of a dying patient?
  6. Mention some sign and symptoms of a dying patient.
  7. Describe the nursing interventions for dying patient.
  8. What are some important issues in caring for a dying patient?
  9. What is the care of the dying patient for the last hours or days of life?
  10. What are the signs and symptoms of the last days of life?
  11. What are the stages of death and dying?
  12. What are the signs of the last hours before death?