dying pt

1. CARE OF DYING PATIENT
Rohini Pandey
1st Year M.Sc Nursing
KGMU Institute of Nursing 1
4/14/2016

2. CONTENTS
• Introduction
• Definition
• Signs of approaching death
• Symptomatic management
• Signs of clinical death
• Summarization
• Conclusion
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3. INTRODUCTION
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4. DEFINITION
A medical/nursing intervention defined
as promotion of physical comfort and
psychological peace in the final phase of
life.
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5. STAGES OF LOSS & GRIEF
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6. SIGNS OF APPROACHING DEATH
Facial appearance.
Changes in sight, speech, and hearing.
Respiratory system.
Circulatory system.
Gastro intestinal system.
Genito urinary system.
Skin and musculo skeletal system.
Central nervous system. 6
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7. FACIAL
APPEARANCE
CHANGES IN
SIGHT,
SPEECH&
HEARING
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8. RESPIRATORY
SYSTEM
CIRCULATORY
SYSTEM
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9. GASTRO INTESTINAL
SYSTEM
“DEATH RATTLE”
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10. GENITO URINARY
SYSTEM
SKIN & MUSCULO
SKELETAL
SYSTEM
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11. CENTRAL NERVOUS
SYSTEM
Reflexes and pain are
gradually lost.
Patient may be
restless due to lack of
oxygen and due to
raised body
temperature,
although the body
surface is cool.
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12. CARE OF THE DYING PATIENT
 Psychological support
 Advance Planning For Imminent Death
 Financial Concerns
 Legal and Ethical Concern
 Helping the Patient Transition
 Pain Management
 The Patient's Right to Information
 Symptomatic Management
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13. SYMPTOMATIC MANAGEMENT
 Problem associated with breathing:
Oxygen inhalation to remove his discomfort.
 Elevation of the patient’s head and
shoulders may make breathing easier.
Keep the room well ventilated and keep
crowed away.
Periodic suctioning is necessary.
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14.  Problem associated with eating and drinking:
Anorexia, nausea, and vomiting are commonly
seen in dying patient. They are unable to take any
form of food and if they taken, they are unable
to retain the food.
I.V fluids.
Sips of water is given with teaspoon.
Give frequent oral hygiene.
Apply emollients to the dry lips.
The denture are removed and kept safely.
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15.  Problem associated with sense organ:
Since the patient loses sight, before given any
care to the patient, the nurse should touch the
patient and say what she is going to do.
Since the hearing is retained longer, speak only
what is appropriate.
Avoid whispering any thing in patient room.
Speak distinctly so that patient may
understand what is done for him.
Since the eyes are opened, protect the eyes
from corneal ulceration with protective
ointment.
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16.  Problem associated with cleanliness and
grooming:
Cleanliness and appearance are important until the
end.
Cleanliness of the skin, hair, mouth, and cloth has to
be maintained.
 Problem associated with communication
Confusion
Withdrawal
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17.  Problem associated with rest and sleep:
Patient should not be disturbed while
sleeping.
The visitors should be instructed not to
disturbed the patient during his resting.
Maintain calm and quit environment.
 Pharmacological management
Anti-pyretic
Analgesic
Anti-emetic
Lifesaving drug if required 17
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18. SIGNS OF CLINICAL DEATH
Absence of pulse, heart beat and respirations
Pupil becoming fixed and not reacting to light
Absence of all reflex.
Rigor mortis: Stiffing of the body after death. The
arms & legs cannot be bent or straightened while
rigor mortis is present unless the tendons are torn.
 POSTMORTEM HYPOSTASIS- It is a dark red or
bluish discoloration due to the settling of the
blood.
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19. NURSING MANAGEMENT
A. Role of Nurse
B. Assessment
I. History taking
II. Physical Examination
C. Nursing Diagnosis
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21. SUMMARIZATION
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