The patient's home has been demolished by a tornado. The ...

[daltonest1984]

The patient's home has been demolished by a tornado. The patient's spouse and child were killed and the spouse is in need of a leg amputation. The nurse realizes that which of the following is true?
 
  a. The patient will deal with his losses using usual coping strategies.
  b. A patient's normal coping strategies are always adequate.
  c. Patients usually seek new strategies to deal with loss.
  d. At the end of life, people still rely on the usual coping strategies.

Question 2

The patient has just returned to the postsurgical unit after undergoing surgery to remove a lung tumor. During one of the postoperative vital sign checks, the nurse notes that the patient's systolic blood pressure had dropped by 30 points.
 
  In addition to the drop in systolic blood pressure, the patient's skin is pale and clammy. The nurse should do which of the following? a. Report the findings to the health care provider immediately.
  b. Understand that the patient's arteries are constricting, causing pallor.
  c. Wait to see if the blood pressure increases in 30 minutes.
  d. Nothing; this is a normal occurrence following a thoracic surgery.

[yasmin]

Answer to Question 1

A
Individuals respond to loss by using their usual coping strategies. Sometimes when people experience multiple losses or lose something of great significance, their usual coping strategies are inadequate. At the end of life, people often find new coping mechanisms and new resources to maintain control and stability.

Answer to Question 2

A
Signs and symptoms associated with hypotension include pallor, skin mottling, clamminess, confusion, dizziness, chest pain, increased heart rate, and decreased urine output. Hypotension is usually life threatening and needs to be reported immediately to the patient's health care provider. Doing nothing can lead to the patient's death. Hypotension occurs when arteries dilate; the peripheral vascular resistance decreases, the circulating blood volume decreases, or the heart fails to provide adequate cardiac output.