CHAPTER 36
 Grief intensity depends on the meaning the person attaches to the loss
o Physical, psychological and spiritual response to loss
 Mourning is the actions associated to the grieving process
o Wailing, wearing black clothing—normal and natural responses to loss
 Bereavement—period of mourning and adjustment after a loss
 TYPES OF GRIEF
o NORMAL
 Uncomplicated—characterized by complex responses to loss and death—
common and universal
o Anticipatory
 Experienced before a loss occurs—wife caring for husband through
chronic illness—man changes and anticipates death
 When love one has Alzheimer’s
 If the survivors detach from the ill loved one before they die that can
cause serious emotional loneliness in individual—no emotional support
o Disenfranchised (ambiguous)
 In connection with a loss that’s not social supported or sanctioned
 An unplanned termination of a foster child’s placement
 Family lost that child but there is no sanctioned grief
 A mistress loses her man
o Complicated (chronic, exaggerated, delayed, masked)
 A person has prolonged or hard time moving on—they are emotionally
numb or anxious
 An intensity of emotion and a longer time
 Persons responses are dysfunctional or harmful
 As much pain many years later loved one passes
 Maturational loss- life keeps moving or kids move off to college
 Situational loss- sudden or unexpected external events—unpredictable
 THEORIES OF GRIEF AND MOURNING
o STAGES OF DYING
 Unique process to each person
 Fewer than 10% of patients die suddenly—most after long illness where
they enter active dying satge
 1-3 months before dying—sleep more, low apetite, prefer liquid foods
 1-2 weeks—skin might yellow, congestion or rattling sound, reduced BP,
increased or decreased RR, temp decreased
 Hours or days—quick surge in mental clarity, tends to be more
dehydrated, shallow breathing, decreased peristalsis, agitated,
o GRIEF IS CYCLICAL
o ATTACHMENT THEORY, GRIEF TASKS MODEL, RANDO’S R PROCESS MODEL,
DUAL PROCESS MODEL
CHAPTER 1: Public health and nursing practice






This provides nurses with skill and knowledge that allows them to answer questions
related to
o Individuals
o Populations
o Communities
Population health
o Mass of people making up a definable unit to which measurements pertain
Public health is the science and art of
o Preventing disease
o Prolonging life
o Promoting health
3 core factors of public health
o Assessment
o Policy development
o Assurance
Lillian wald- mother of public nursing
Health promotion
o The process of enabling people to improve their own health
o Individual/family level
o GOAL
 Change behaviors
 Biological
 Behavioral
o