Lecture Notes: Post-Mortem Nursing Care

Definition of Death

• Permanent cessation of respiratory and circulatory functions.
• Determined through physical examination (auscultation for absence of respiratory and circulatory indicators).

Family and Cultural Considerations

• Family encouraged to spend time with the deceased; privacy respected.
• Cultural rituals should be honored.

Post-Mortem Procedures

• Procedures vary by state and institution.
• Know your facility's protocol, especially regarding autopsies.

Removing Tubes and Drains

• Remove bandages and drains if death was due to known causes and verified.
• Leave tubes/lines in place if cause is unknown for potential autopsy.
• Always check policies and consider patient's and family's wishes.

Physical Assessment for Death

• General appearance is not enough; must document objective signs of life.
• Assess for:
  • Absence of breath sounds and circulatory evidence (check apical and carotid pulse).
  • Lack of response to stimuli, including pain and corneal reflex.
  • Must have confirmation by another nurse or physician.

Confirmation of Death

• Nurses generally cannot declare death; requires physician's confirmation.
• Notify family, coroner, morgue, and funeral home.

Organ Donation and Autopsy Considerations

• Contact transplant organizations for organ donation viability.
• Autopsy may be required to determine cause of death if unknown or unexpected.

Care of the Body Post-Mortem

• Bathe and prepare the body for viewing.
• Manage bowel and bladder; positioning of limbs and features.
• Clean the room, remove medical equipment.

Body Changes after Death

• Immediate decomposition begins; keep the room cool.
• Algor mortis, loss of moisture, and rigor mortis occur.

Transportation of the Body

• Tag the body on the toe or wrist.
• Transport to the morgue or funeral home discreetly.

Grief, Mourning, and Bereavement

• Grief: personal feelings about loss.
• Mourning: visible expressions of grief.
• Bereavement: period of mourning.

Interventions for Grief

• Support expression of feelings; refer to counselors if needed.
• Assess social support, coping skills, and signs of complicated grief.

Kubler-Ross's Five Stages of Grief

• Not linear; stages include denial, anger, bargaining, depression, and acceptance.

Nurses' Self-Care

• Importance of self-reflection and coping with frequent exposure to death.
• Express feelings, share coping skills, and seek closure through memorials.
• Prioritize self-care (healthy diet, exercise, sleep, stress reduction).