Final answer:
The appropriate nursing diagnosis for a patient beginning to process a terminal illness and expressing fear about dying is A. Death Anxiety. This diagnosis is supported by the Kubler-Ross model, which outlines stages including denial, anger, bargaining, depression, and acceptance. Hospice care and emotional support play critical roles in managing death anxiety and ensuring the patient's dignity and comfort.
Step-by-step explanation:
Nursing Diagnosis for Terminal Illness
When selecting an appropriate nursing diagnosis for a patient processing the fact of a terminal illness and expressing fear about dying, it is essential to consider the psychological impacts on the patient's health and well-being. The Kubler-Ross model, with its five stages of grief—denial, anger, bargaining, depression, and acceptance—provides a framework for understanding how individuals may react to news of a terminal illness. It is not uncommon for some people to become stuck in one of the early stages, such as denial, if they fight the reality of their illness.
Given the description of the patient's emotional state, the most appropriate nursing diagnosis from the options provided would be A. Death Anxiety. This diagnosis is consistent with reactions to the early stages of the Kubler-Ross model, particularly when confronting fears surrounding the end of life. This diagnosis reflects the anxiety and fear associated with the realization of a terminal diagnosis and the prospect of death.
Death anxiety can be distinguished from chronic sorrow, which is a sense of pervasive sadness related to a significant loss, and complicated grieving, which is an abnormal or prolonged response to grief. Lastly, risk for complicated grieving indicates a potential rather than an actual diagnosis, relevant in circumstances where there is an anticipation of a complicated bereavement process. In this scenario, the patient is already expressing an actual fear of dying, which directly relates to death anxiety.
Providing a nurturing environment, emotional support, and clear communication about prognoses and treatment options are ways to address death anxiety. Hospice care often plays a vital role in providing comfort and support to terminally ill patients and their families, focusing on palliative care rather than curative treatments.
Hospice care supports the values of dignity and comfort for the terminally ill and is in line with respecting the patient's wishes, often including advance care planning like living wills and Do Not Resuscitate (DNR) orders.
Addressing death anxiety requires comprehensive patient care that includes psychological support tailored to the individual's stage in the grieving process, offering the patient an opportunity to face their mortality with dignity and peace.