DEAD BODY CAREMANDIRA DAHAL

Death

Death is a irreversible cessation of circulatory, respiratory function or the irreversible cessation of all functions of the entire brain, including the brainstem.Signs of Death

  Absence of heartbeat and respirations.  Fixed pupils Skin color turns to a waxen pallor and extremities may darken. Body temperatures drops Muscles and sphincters relax, sometimes resulting in release of stool or urine

PHYSIOLOGICAL CHANGES AFTER DEATH

1. Rigor mortisStiffening of the body that occurs about 2-4hrs after death.Results from a lack of ATP, which causes the muscles to contract, which in turn immobilize the jointsIt starts in the involuntary muscles( heart, bladder) then progress to head, neck, trunk , extremities.

2.Algor mortisGradual decrease of the body temperature after death.When blood circulation terminates and hypothalamus ceases to function , body temperature falls down. 

3.Livor mortisDiscoloration of body after death.After blood circulation has ceased , the RBC broken down , - leads to discoloration of surrounding tissues

4. DecompositionTissues after death become soft and eventually liquified by bacterial fermentation .The hotter the temperature, the more rapid the change.So bodies are stored in cool places / embalming

Purpose of dead body care

1. To prepare the body for the morgue.2. To prevent discoloration or deformity of the body.3. To protect the body from post mortem discharge.

DEAD BODY CARE

After death the body undergoes many physical changes. So care must be provided as early to prevent tissue damage /disfigurement of body parts.

PROCEDURESCare of dead body ,often depends upon the customs and religious beliefs.

Nurses provide dignity and sensitivity to the client and family1.  Check orders for any specimens2.  Ask for special requests to family (eg: shaving , a special gown , Bible in hand )3.  Remove all equipments , tubes , supplies and dirty linens.4.  Cleanse the body thoroughly , apply clean sheets5.  Brush and comb the hairs6.  The eyelids are closed and held in place for a few seconds , so they remain closed.7.  Dentures should be in the mouth to maintain facial alignment.

8.  Mouth should be closed.9.   Remove all the ornaments.10.  Absorbent pads are placed under the buttocks to take up any feaces and urine released because of muscle sphincter relaxation11.  All the orifices should be closed.12.  Cover with a clean sheet up to the chin.13.  Spray a deodorizer to remove unpleasant odor.14.  Apply name tag  ( wrist , right big toe)15.  Allow the family members to view the dead body16.  The body is wrapped in a large piece or plastic or cotton material used to enclose a body after death. Identification is then applied outside of the wrapper.

17.  Hand over all the belongings to the relatives.18.  Do complete documentation in the nursing notes. Time of death and actions taken to prevent the death. Who pronounced the death. Any organ donation Personal articles left on the body Personal items given to family Time of discharge and destination of the body  Location of name tags on the body Special request by family19. Hand over the dead body to the relatives / sent to the mortuary.

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