Exam III (Communication)
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define Interpersonal communication
one-to-one interaction between the nurse and another person.
Define Intrapersonal communication
occurs within an individual. Examples inclide positive self reassurance or rehearsing for a difficult task.
Define transpersonal communication
religious communication with a higher power such as in prayer.
define small group communication
interaction between a small number of people
define public communication
interaction with an audience
list and explain the 5 parts of communication...
- 1. stimulus: reason for communication
- 2. sender: person initiating the message
- 3. message: information sent
- 4. reciever: recipiant of message
- 5. feedback: response of reciever to message
what is the "referent" of communication?
what motivates one person to commuinicate with another
what is the "interpersonal variable" of communication?
factors that influence communication
what are "channels" of communication?
means of conveying and recieving a message
define "connotative meaning" and give an example of when this type of communication could cause a problem.
when a word can mean something in one context and has a completely different meaning in another. one nees to watch for this type fo communication when dealing with language barriers.
what is "intonation"?
the tone of one's voice
which can make more of an impact, verbal or non-verbal communication?
what is "territoriality"? how can it be detrimental?
the occupation and defense of a territory can give intimidating non-verbal signals
give examples of "symbolic forms of communication"
drawings, artwork, or dreams
messages that are incongruent with spoken words
what is "congruency"?
when two messages are in agreement
what is a "double message"?
when two verbal messages are not in agreement.
what is a "double-bind message"?
when verbal and non-verbal messages are not congruent. this is a no whin situation.
what should a nurse do when a patient picks up on a double-bind message?
acknowledge the situation and explain the reason behind it to prevent any anxiety for the patient. for example, stress during shift changes should be explained if a psych patient picks up on it unstead of just saying that everything is fine.
explain why stress and anxiety are important things to monitor on patients
they compund eachother and can cause patients conditions to worsen.
name and describe the 5 factors that influence communication...
- 1. Psychophysiological: internal factors such as physiological and emotional status
- 2. Relational: the nature of the relationship between those communicating
- 3. Situational: the reason for the communication
- 4. Environmental: the physical surroundings in which the communication takes place
- 5. Cultural: sociocultural elements (such as education, language, or customes)
how do personal relationships differ from proffesional relationships in regard to goals, focus on needs, intimacy, acceptance, trust, confidentiality, and boundaries.
- goals: in a personal relationship goals are not usually present vs proffesional relationships which are goal oriented.
- focus on needs: in a personal relationship both parties needs are important vs in a proffesional relationship the needs of the patient are the focuse
- intimacy: in a personal relationship intimicy is accepted vs in a proffesional relationship intimicy is avoided
- acceptance: in a personal relationship there is no obligation to accept people vs in a professional relationship acceptance of the patient is unconditional
- trust: in a personal relationship trust is earned on both sides vs in a professional relationship trust is earned by the healthcare provider
- confidentiality: in a personal relationship confidentiality is up to one's discretion vs in a professional relationship confidentiality is strict
- boundaries: in a personal relationship bounradies are flexible vs in a professional relationship boundaries are well-defined
what are 4 goals of theraputic relationships? explain them
- Facilitating communication of distressing thoughts and feelings
- Assisting patients with problem solving to help with ADLs
- Helping patients examine self-defeating behaviors and test alternatives
- Promote self-care and independance
why is it important for a nurse to have strong boundaries?
because patients are volnerable and may test a nurses boundaries.
explain some examples of "blurring boundaries." how can this be avoided?
- if a patient in attractive and the nurse tries to persue a relationship with them
- keeping secrets with patients
- having special clients that you spend extra time with
sometimes feedback from collegues can help a nurse avoid these type of issues. also, looking inside yourself and asking if what you are doing is for the patient's benefit or your own.
what are three signs that a nurse may be blurring their boundaries?
- Overhealping: doing things for patients that they are able to do themselves
- Controlling: asserting authority and assuming control for the "patient's own good"
- Narcissism: focusing on a patient's weakness instead of promoting their strengths
what is tranference?
when a patient unconciously displaces emotions and judgments from their childhood onto the nurse
what is countertransference?
when the nurse unconciously displaces their emotions or accuired judgements onto a patient
what are the 4 phases of a nursing relationship? explain them
- 1. Preinteraction: before the meeting (chart review etc)
- 2. Orientation: when the patient and nurse first meet and start to get to know eachother.
- 3. Working: when the nurse and the client work together to solve problems and accomplish goals
- 4. Terminate: the end of the relationship. use this time to evaluate goals and achievements.
when a patient is given dificult news they can sometimes "take it to the heard rather than the heart" whcih means that they deal with it in more of an intellectual way rather than dealing with the emotional acceptance of the situation.
what can confrontation be useful in dealing with a patient?
when the patient needs to be "woken up" to their situation. just be sure that it is for the patient's benefit and not just to make you feel better.
explain a common patient response in the orientation phase?
During this time expect patient to try and test your competency. This is often due to their anxiety and is an unconcious reaction.
during the temination phase what can often be the patients reaction? how can we as nurses help prevent this?
it can awaken unresolved feelings of loss or abandonment and can make them feel lonely. this may happen to the nurse as well. make sure that the patient knows when your shift is over so that they aren't taken by surprise. also discuss any feelings that the patient may be having.
________ of relationship may change but _______ stay the same regardless.
scientific evidence that a policy or procedure is really the best way of doing things
what are some things that enhance a nurse patient relationship?
- positive initial impression
- promoting patient comfort
- promoting patient control
what are some factores that hinder a patient nurse relationship?
- failure to act on requests
- lack of knowledge
how does empathy differ from sympathy? which is the desired response of a nurse?
sympathy is actually feeling a patients feelings causing the nurse to lose all abilty to help and support the patient. Empathy however is when a nurse understamds a patient's feelings but retaines their abilty to be helpful and supportive thus this is the preffered nursing reaction.
what are some of the responsibilities of a nurse during a clinical interview?
- allow patient to set the pace
- use a setting that promoted a feeling of security
- use open ended questions for maximum information
- keep eye contact when appropriate
- have appropriate clinical supervision
what are examples of cultures where there is dramatic use of body language? those that react in a calmer way? how may this be useful knowledge for nurses?
Hispanic, french, and italian use much body language whereas asian, german, or british people are calm under deres. african americans often use guarded communication. a nurse needs to take into considderation a patient's cultural background so that they can be comfortable with a patient and understand what is normal or abnormal.
what cultures view eye contact as disrespectful? what cultures view it as important?
hispanics, asians, and native americans view eye contact as disrespectful, whearas germans, americans, french, and british consider it important
what cultures view touch as comforting? what cultures view it as inapropriate?
hispanic, mexican american, italian, and french view touch as comforting. however, german, british, sweedish, indian, japanese, and chinese view it as intrusive.
what is SOLER and what does it stand for?
it is an acronym to aid in "non-verbal listening"
- S - Sit facing the client
- O - Open body posture (not having arms crossed etc). gives a non-defensive impression
- L - Lean in slightly to express interest
- E - Eye contact is important
- R - Relax
which has been prooven more effective for clients?
A- whole hand touch
B- fingertip touch
what should one always do before proceeding to touch patient?
how can asking "why" questions of an adolecent be antiproductive?
they will often react with an attempt to intelctualize their response in order to justify. this in often unhelpful
what is "aphasia"? how can this effect communication?
loss of ability to express or comprehend language. this makes communication very difficult.
what is "dysarthria"?
difficulty articulating speech due to disturbances in muscule control resulting from CNS or PNS damage.
what is "mutism"?
difficulty or refusal to speak. most often due to deafness
why should a nurse avoid using children as interpreters for sick adult family members?
it places the child in a position where they must understand and convey difficult messages. things that may be beyond their years.
what should a nurse do when presented with a why child patient?
speak to parents first in order to allow child time to get comfortable with their surroundings
at what level is it best to address patients?
eye level whenever possible
should a nurse allow children to touch and examine objects that will come into contact with them?
yes. this makes the child's surroundings feel less mysterious
is it best to use direct speech or analogies with children?
direct speech. analogies can often confuse children
give some examples of threatening behaviors that should be avoided when addressing children.
- broad smiles
- sudden advances
what term should we avoide using to describe an elderly patient? why?
"cute" etc because is it makes them seem infantile
what are the 5 levels used to describe facial expression? explain them
- superficially bright (happier than what would be normal for a situation)
- constricted (less expression than would be expected)
- blunted (much less expression than what would be expected)
- flat (no expression at all)
is a patient's mood subjective or objectiv
is a patient's mood subjective or objective?
mood by definition is how someone feels so that is subjective data
what are "perceptual disturbances"?
what is "cognition"?
what is a MSE? what is it's purpose?
a Mental Status Evaluation evaluates a client's current psycological state. this involves mainly subjective data.
what is a psycosocial assessment? how does it differ from a MSE?
it provides additional information to develope a care plan beyond the initial MSE.
what are the 12 components of a psychosocial assessment?
- -chief complaint
- -history of violent, or suicidal behavior
- -alcohol or substance abuse
- -family psyc history
- -any personal psychiatric treatment
- -stressors and coping mechanisms
- -quality of life
- -personal background
- -support system
- -patient's weaknesses, strengths, and goals
- -racial, ethnic, and cultural beliefs
- -spiritual and religious beliefs/practices.
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