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Grief and Loss in the Childbearing Family

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Grief and Loss in the Childbearing Family Causes of Perinatal Loss: Maternal Complications Preeclampsia Abruptio placentae Placenta previa Renal disease Diabetes ... – PowerPoint PPT presentation

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Title: Grief and Loss in the Childbearing Family


1
Grief and Loss in the Childbearing Family
2
Causes of Perinatal Loss Maternal Complications
  • Preeclampsia
  • Abruptio placentae
  • Placenta previa
  • Renal disease
  • Diabetes

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Causes of Perinatal Loss Fetal Complications
  • Congenital anomalies
  • Fetal growth restriction
  • Alloimmunization

11
Diagnosis of Perinatal Loss
  • Spaldings sign
  • Decreased maternal estriol levels
  • Absence of fetal heart movement

12
Nurses Role
  • Assist families in mourning process
  • Explore wishes for viewing and holding deceased
    child
  • Provide support, answers questions, refers for
    grief counseling

13
Physical Responses
  • Physical symptoms of shock
  • Palpitations
  • Shortness of breath
  • Difficulty sleeping
  • Nausea and vomiting
  • Loss of appetite and dry mouth

14
Physical Responses (continued)
  • Feeling of emptiness in the pit of the stomach
  • Weakness/lethargy
  • Tightness in throat
  • Sighing
  • Fatigue
  • Oversensitivity to light and sound

15
Cognitive Responses
  • Denial/disbelief
  • Confusion
  • Sense of unreality
  • Disorientation/time confusion
  • Vigilance or obliviousness
  • Focused or detached

16
Cognitive Responses (continued)
  • Poor concentration
  • Preoccupation
  • Sense of presence
  • Hallucinations of the deceased infant

17
Emotional Responses
  • Sadness
  • Anger/rage
  • Guilt/self-reproach
  • Anxiety
  • Numbness
  • Flat affect

18
Emotional Responses (continued)
  • Indifference
  • Withdrawal or explosiveness
  • Repetitive storytelling
  • Loneliness
  • Yearning
  • Nostalgia

19
Behavioral Responses
  • Withdrawal
  • Dependence
  • Fear of being alone
  • Memorializing the loss
  • Disorientation
  • Sleep and appetite disturbances

20
Behavioral Responses (continued)
  • Absent-minded behavior
  • Dreams of the deceased
  • Crying and sighing
  • Restlessness
  • Avoiding of behaviors
  • Treasuring of mementos

21
Spiritual Responses
  • Blaming God (or spiritual equivalent)
  • Hostility toward God (or spiritual equivalent)
  • Lack of meaning or direction
  • Wishing to join the deceased
  • Isolation
  • Feelings of betrayal

22
Spiritual Responses (continued)
  • Hopelessness
  • Destruction or strengthening of beliefs
  • Feelings of being punished
  • Acceptance as Divine Will
  • Assigning of deceased infant as an angel in
    heaven

23
Personal Issues Complicating Grief
  • Age
  • Family dynamics
  • Gender

24
Other Complicating Factors
  • Insecurity
  • Anxiety or low self-esteem
  • Psychiatric history
  • Excessive anger and guilt

25
Other Complicating Factors (continued)
  • Physical disability or illness
  • Previous unresolved losses
  • Inability to express emotion
  • Concurrent problems of living

26
Spirituality
  • Honest exchange of information
  • Empathy and presence
  • Continuing bonds
  • Spiritual rites
  • Attachment with others
  • Grief support

27
Nursing Diagnoses
  • Anticipatory Grieving related to the imminent
    loss of a child
  • Powerlessness related to lack of control in
    current situational crisis
  • Compromised Family Coping related to death of a
    child/unresolved feelings regarding perinatal
    loss
  • Interrupted Family Processes related to fetal
    demise
  • Hopelessness related to sudden, unexpected fetal
    loss
  • Risk for Spiritual Distress related to intense
    suffering secondary to unexpected fetal loss

28
Nursing Interventions
  • Preparing the family for the birth and the death
  • Supporting the family in decision making
  • Providing postpartum care
  • Supporting siblings and family members

29
Nursing Interventions (continued)
  • Actualizing the loss
  • Providing discharge care
  • Making referrals to community services

30
Early pregnancy remembrance box
31
Memory Box
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Bereavement literature
34
Door card
35
Parents holding their deceased infant
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Nonhelpful Responses
  • Minimizing the pain
  • At least
  • Offering explanation for loss
  • Imposing belief system

38
Helpful Responses
  • Acknowledging that the infant is unique
  • Validate the loss
  • Acknowledge that future plans will not be
    realized
  • Offer reassurance that they are not alone
  • Address pain
  • Reassure them of the caring presence of nurses
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