The eye anatomy and physiology

Death is the permanent cessation of all biological
functions that sustain a living organism.
It occurs from distal to proximal, outside to inside
Signs of Approaching Death
Incontinence which results from loss of sphincter
control
Reduced intake of food and fluids
Cold extremities due to diminishing circulation

Hallucinations
Change in pattern of breathing, noisy
breathing called death rattle
Heartbeat and pulse become slow and weak
Patients become unresponsive to touch and
pain
Pupils become dilated and fixed

Signs of Death or Strong Indications
that Death has occurred:
Cessation of breathing
Cardiac arrest (no pulse)
Pallor mortis, paleness which happens in the 15–
120 minutes after death
Livor mortis, a settling of the blood in the lower
(dependent) portion of the body

Algor mortis, the reduction in body temperature
following death. This is generally a steady decline
until matching ambient temperature
Rigor mortis, the limbs of the corpse become stiff
and difficult to move or manipulate
Decomposition, the reduction into simpler forms
of matter, accompanied by a strong, unpleasant
odor.

Types of Death
Clinical Death
This is cessation of blood circulation and
breathing, the two necessary criteria to sustain
life.
It occurs when the heart stops beating in a
regular rhythm, a condition called cardiac arrest.
Brain/Biological Death
This is permanent cellular damage, resulting
from lack of oxygen, that is not reversible.

Stages of Dying by Kubler - Ross
Kubler-Ross described 5 stages of dying. These are:
1. Denial
2. Anger
3. Bargaining
4. Depression
5. Acceptance
Note: The stages do not necessarily appear in this
order. Each terminally ill patient presents differently
because of difference in personalities.

1. Denial
A person may act as though nothing has
happened and may refuse to believe or understand
what the impending loss means.
The person doesn’t believe the diagnosis and may
search for optional treatment from other health
care providers
Some may fail to comply with treatment and
refuse offers of comfort and isolate themselves
from sources of accurate information

Examples of responses:
Verbal: ‘This can not be me!’
Behavioral: A client is diagnosed with lung
cancer but continues to smoke two packs of
cigarette daily

Nursing Action
Support the patient’s emotions without supporting the
denial
Give company to the patient, with assistance from
relatives and friends
Be empathetic and listen to the patient
Encourage the patient to share fears and concerns
instead of telling him/her what they may not need to
hear

2.Anger
Occurs due to the feeling of hopelessness
It is directed towards self, others or God
The individual resists the loss and may be irritable
at everyone around them
The client becomes demanding, accusing and
when it is directed towards self, it causes anxiety
and can result to suicide
The patient may become hostile even to staff

Examples of Responses
Verbal: “Why me?”
Behavioral: Client stikes out at care givers or
relatives and may even attempt suicide

Nursing Actions
Provide explanation and guidance about
feelings and emotions
Do not take anger personally
Ensure that the patient’s needs are met
Do not provoke the patient

3. Bargaining
. The patient realizes nothing can be done and
starts bargaining for more time
The individual tries to postpone awareness
e.g. 'God ,if you give me life I will serve you
better' as though the loss can be prevented.

Verbal: Client prays, “Please God, just let me
live long enough to see my son graduate”
Behavioral: Client tries to “make deals” with
care givers

Nursing Actions
Allow expression of feelings by the patient
Offer information that help in decision making
and NEVER give false hope

4. Depression
This is sadness or grief as the patient realizes that
death is inevitable. The person realizes the impact
of the loss.
They feel very lonely and may withdraw from
interpersonal interaction, refusing to talk and even
suicidal.
They may resort to unhealthy behavior e.g. taking
drugs and sexual defiance

Verbal: “Go away, I just want to lie here in
bed. What’s the use of that?” referring to
medication or counseling
Behavioral: Client withdraws and isolates self.
May not feed or feed excessively. May also
experience insomnia or hypersomnia

Nursing Actions
Provide support and empathy
If the patient cries, let them do so and be
there for them
Listen to them
Ensure environment is safe to avoid risks of
self harm
Refer to mental health providers if necessary

5. Acceptance
Impending loss is accepted and they begin to look
to the future.
It may not be reached by all dying patients
The patient has no anger or depression. They look
happier and relaxed
They may be willing to talk or may withdraw from
others

Verbal: “I feel ready. At least I am more at
peace now.”
Behavioral: Client gets financial or legal affairs
in order. They say goodbye to significant others

Nursing Action
Share or provide an opportunity of sharing with
relatives
Show acceptance of the patient’s feelings
Assist patient to discuss future plans e.g. writing a
will
Incase of withdrawal, support family members
and encourage them to be with the patient

Detachment
It is the final stage and patient gradually separates
from the world
There is no more two way communication
Nursing Action
Explain to the relatives that the patient can hear
even though he/she does not respond and hence
they should continue talking to him/her and offer
support through touch

BEREAVEMENT CARE
It is the physical care of body after death and
immediate support of the family and relatives
Purpose
To offer final special service and respect to the
dead
Prepare the body for transfer to the mortuary
Provide support to the family and relatives to
enhance the understanding and management of
the grief process

Requirements
A clean trolley containing:
• Top Shelf
 3 pairs of gloves
 Basin of warm water
 Bath towel
 Flannel
 Soap dish
 Nail brush
• Bottom Shelf
 Scissors
 2 identification tags
 Cotton wool swabs in a bowl
 Long sinus forceps
 Dissecting forceps
 Hair brush
 Clean gauze in bowl
 Strapping bandage
 Shaving equipment (for male if
necessary)
 Kidney dish for urine
 Receiver with decontaminant
 Waste receiver
 Dirty linen bag

 Remove jewelry, label and keep safe
 Remove clothing, strip bed and place the linen dirty
linen bag
 Lay the body flat on its back, legs together and arms to
the side, ensuring the fingers are straight. To ensure
the legs remain straight, tie the big toes together
 Return the dentures, remove hair pins, ribbons
 Lay head gently on pillow
 Bandage jaw to keep it from sagging
 Moisten pieces of cotton wool in warm water and
place each piece over the eyelids, after closing the eyes

 Waste receiver
 Dirty linen bag
Steps
Note: The procedure should be carried out in an isolated
place and as calmly as possible to avoid causing anxiety to
other patients
 Arrange items appropriately on the trolley
 Wheel the trolley and dirty linen bag to bedside
 Wear gloves and gowns
 Remove all equipment such as O2 cylinder, IV apparatus
etc. and all pillows except one to support the head

 Leave the body in that state for one hour to allow RIGOR MORTIS to
take place and cover the body with a sheet and blanket
 After one hour, 2 nurses return to the bedside and wear gloves
 Remove pads of cotton wool from eyes
 Remove bandage from jaw
 Wash the body as per bed bath procedure
 Comb hair backwards
 In case of male – shave beard if necessary
 Using cotton wool and sinus forceps, pack all orifices lightly without
distorting the body features: ears, nostrils, mouth, anus and vagina

 Note: The anus may be packed when washing the back of
the body to avoid turning the body twice. If the diseased
had an operation, remove any drain but leave stitches or
clips in situ
 Pack any wound and bandage firmly
 Comb hair in normal hair style or backwards
 Place one identification tag on the body around the neck
 Wrap the body in a mortuary sheet and tie three times; at
the ankles, around the abdomen and on the neck
 Place the 2nd identification tag around the ankles
 Cover the body with a sheet

Call the mortuary attendant to collect the
body
Hand body to the attendant and ensure that
he signs that the has taken custody of the
body, time and date
Clear the equipment
Wash hands
Record in cardex: Date, time of disposal of the
body to the mortuary attendant

The eye anatomy and physiology

More Related Content

Similar to The eye anatomy and physiology (20)

More from MuniraMkamba (20)

Recently uploaded (20)

The eye anatomy and physiology