NUR 209 Exam III ReviewPost-Mortem Care
Procedures with Death of Patients
⟶ Request organ and tissue donation
⟶ Request for autopsy
⟶ Document occurrence of death
⟶ Provide postmortem care
*Must know federal and state regulations as well as facility policies and procedures
Care o...
nur 209 exam iii review exam iii review post mortem care procedures with death of patients ⟶ request organ and tissue donation ⟶ request for autopsy ⟶ document occurrence of death ⟶ provide postmorte
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NUR 209 Exam III Review
Exam III Review
Post-Mortem Care
Procedures with Death of Patients
⟶ Request organ and tissue donation
⟶ Request for autopsy
⟶ Document occurrence of death
⟶ Provide postmortem care
*Must know federal and state regulations as well as facility policies and procedures
Care of the Body
⟶ Provide respect and allow for religious/cultural traditions
⟶ Recognize that the provider certifies death by pronouncing date and time of death,
therapies used, and actions taken prior to death
⟶ Elevate the patients head ASAP to prevent facial discoloration by raising the head of the
bed and placing a pillow under the head and shoulders of the patient
Preparing the Body (Pre-viewing)
⟶ Maintain privacy
⟶ Remove all tubes
⟶ Remove all personal belongings to be given to family
⟶ Cleanse and align the body supine with a pillow under the head and arms with palms
facing down outside the sheet and blanket, dentures in place, and eyes closed
⟶ Apply fresh linens with absorbent pads on bed and a gown
⟶ Brush hair and replace any hairpieces
⟶ Remove excess supplies, equipment, and soiled lines from the room
⟶ Dim the lights and minimize noise
Viewing Considerations (Viewing)
⟶ Ask the family whether they would like to visit with the body and honor any decision
⟶ Clarify where the patients’ personal belongings should go; with the body or with a
designated person
⟶ Adhere to the same procedures when the client is an infant
Post-viewing
⟶ Apply identification tags according to facility policy
⟶ Complete documentation
⟶ Remain aware of visitor and staff sensibilities during transport
Organ/Tissue Donation
⟶ Recognize that request for tissue and organ donations must be made by specifically
trained personnel
⟶ Provide support and education to family members as decisions are being made. Use
private areas for any family discussions concerning donation
⟶ Be sensitive to culture and religious influences
, ⟶ Maintain ventilatory and cardiovascular support for vital organ retrieval
Autopsy Considerations
⟶ Provider typically approaches the family about performing an autopsy
⟶ Nurses role is to answer the family’s questions and support their choices
⟶ Autopsies can be conducted to advance scientific knowledge regarding disease processes,
which can lead to the development of new therapies
⟶ Law can require an autopsy to be performed if the death is due to homicide, suicide, or
accidental death, or if death occurs within 24 hours of hospital administration
⟶ Most facilities require that all tubes remain in place for an autopsy
⟶ Documentation and completion of forms following federal and state laws typically
include the following
o Who pronounced the death and at what time it was pronounced
o Considerations of and preparation for organ donation
o Description of any tubes or lines left in or on the body
o Disposition of personal articles
o Who was notified, and of any decisions that were made
o Location of identification tags
o Time the body left the facility and the destination
Family and Postmortem Care
⟶ Be respectful
⟶ Allow for religious/cultural traditions
⟶ Give the family the option to assist with care
⟶ Comb hair and cover patient with a clean sheet
⟶ Provide a clean, quiet environment
⟶ Family may decide when they are ready for the funeral home to pick up the body
Loss of a Patient/Care of Grieving Nurses
*Long term patients can create personal attachments for nurses. Nurses can use coping strategies
such as:
⟶ Attend the funeral
⟶ Write a letter to the family
⟶ Attend debriefing sessions with colleagues
⟶ Use stress management techniques
⟶ Talk with a professional counselor
Genitourinary System
Structure/Anatomy of the Urinary Tract
1. Kidneys (2)
A. Nephrons
2. Ureters (2)
3. Bladder (1)
4. Urethra (1)
*May be abbreviated as BKU
, Function of the GU System
1. Urine formation (Kidney’s)
A. Filtration
⟶ Filters waste (metabolites, uric acid, creatinine)
⟶ Filters water
⟶ Filters electrolytes
B. Reabsorption
C. Secretion
2. Urine excretion (Bladder)
A. Micturition
⟶ Urge to urinate that happens when the bladder contains ~200mL
B. Voiding
C. Urination
Assessment
⟶ Subjective Data
o Normal pattern of urination
▪ 6-8 times/day
▪ Every 3-4 hours, avoid holding
o History
o Recent/current problems
⟶ Objective Data
o Assessment of Urine
▪ Color (Darker color indicates higher specific gravity)
• >1 is more concentrated
• < 1 is more dilute
• ~1 is normal
▪ Amount/Volume
• 250-400 mL per void
• 1,500 mL/15 hours or 100 mL/hour
• 30 mL/hour minimum if patient has a catheter
▪ Clarity
• Cloudy indicates trace amounts of blood in urine (infection)
• Hemacolt test tests for hematuria
• Pus indicates infection
▪ Odor
o Intake and Output
o Bladder Ultrasound (Need patient to have a full bladder for this test)
o Physical Assessment
▪ Inspection
▪ Percussion
• Empty: Hollow and not palpable
• Full (>600 mL): Dull and palpable
▪ Palpation
• Felt in the suprapubic area if it contains >600 mL
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