A patient diagnosed with testicular cancer tells the nurse that ...

[lindiwe]

A patient diagnosed with testicular cancer tells the nurse that he does not believe he has cancer. The nurse realizes that the patient may be progressing through the stages of grief. Place in order the stages of grief.
 
  Choice 1. depression
  Choice 2. acceptance
  Choice 3. anger
  Choice 4. denial
  Choice 5. bargaining

Question 2

The nurse is caring for a patient who is nearing death from a terminal illness. The patient is experiencing secretions in the back of the throat and dyspnea. Which medications should the nurse provide to assist this patient?
 
  Select all that apply.
  1. Oxygen
  2. Morphine
  3. Atropine
  4. Scopolamine
  5. Demerol

[ong527]

Answer to Question 1

Correct Answer: 4,3,5,1,2

The patient is currently in the stage of denial by refusing to accept the diagnosis. Kbler-Ross's stages of grieving begin with denial. The second stage is anger, when the patient demonstrates anger over the situation. The third stage is bargaining, in which the patient may make an agreement with God or another supreme being. The fourth stage, depression, occurs when the patient realizes the full impact of the loss. The final stage is acceptance and occurs when the patient accepts the conditions of the illness and begins to plan or hope for the future. A patient may or may not experience all of the stages in this process.

Answer to Question 2

Correct Answer: 1, 2, 3, 4

As death nears, respirations often become fast or slow, shallow, and labored. The patient may have apnea or Cheyne-Stokes respirations. Fluid may accumulate in the lungs, causing crackles, especially in patients who are well hydrated, and in those who are having difficulty swallowing or coughing. These manifestations may be treated with oxygen, opioids, and medications that reduce secretions, such as atropine and scopolamine. Meperidine (Demerol) is not useful for chronic pain because it has a short half-life and a toxic metabolite that can cause irritability and seizures.