Exam 1 : Key Terms Flashcards
Preinteraction Phase
begins before the nurse’s first contact with the patient. The nurse’s self-analysis in the Preinteraction phase is a necessary task.
Other tasks in this phase include gathering data about the patient if information is available and planning for the first interaction with the patient.
Introductory, or Orientation Phase-
it is during the introductory phase that the nurse and patient first meet.
One of the nurse’s primary concerns is to find out why the patient sought help. The reason for seeking help forms the basis of the nursing assessment, helps the nurse focus on the patient’s problem, and determines the patient’s motivation for treatment.
It is important for the nurse to realize that help-seeking varies among different cultures, social, and ethnic groups.
Another task is for the patient and the nurse to establish their partnership and agree on the nature of the problem and the patients’ treatment goal.
Working Phase
Most of the therapeutic work is carried out during the working phase.
The nurse and the patient explore stressors and promote the development of insight in the patient by linking perceptions, thoughts, feelings, and actions. The nurse helps the patient master anxieties, increase independence and self-responsibility, and develop constructive coping mechanisms.
Actual behavioral change is the focus of this phase.
Termination Phase
is one of the most difficult but most important phases of the therapeutic nurse-patient relationship.
It is a time to exchange feelings and memories and to evaluate mutually the patient’s progress and goal attainment.
Levels of trust and intimacy are heightened, reflecting the quality of the relationship and the sense of loss experienced by both nurse and patient.
Together the nurse and the patient review the progress made in treatment and the attainment of specified goals. Successful termination requires that the patient work through feelings related to separation from emotionally significant people.
Helping the patient work and grow through the termination process is an essential goal of each relationship.
o Transference
is an unconscious response in which patients experience feelings and attitudes toward the nurse that were originally associated with other significant figures in their life.
Transference is characterized by the inappropriate intensity of the patient’s response.
o Countertransference
is a therapeutic impasse created by the nurse’s specific emotional response to the qualities of the patient. This response is inappropriate to the content and context of the therapeutic relationship and inappropriate in the degree of intensity of emotion.
Countertransference is transference applied to the nurse.
o Listening
an active process of receiving information and examining reaction to the message received. The first rule of a therapeutic relationship is to listen to the patient. It is an active, not passive, process.
o Informing
the skill of information giving. Is an essential nursing technique in which the nurse shares simple facts or information with the patient.
o Broad Openings
encouraging the patient to select topics for discussion. Broad openings let the patient know that the nurse is accessible and following what the patient is saying.
o Focusing
questions or statements that help the patient expand on a topic of importance. It can help the patient become more specific, move from vagueness to clarity, and focus on reality.
o Restating
repeating the main thought the patient expressed. Restating shows that the nurse is listening.
o Sharing Perceptions
asking the patient to verify the nurse’s understanding of what the patient is thinking or feeling.
o Theme Identification
underlying issues or problems experienced by the patient that emerge repeatedly during the course of the nurse-patient relationship.
o Clarification
attempting to put into words vague ideas or unclear thoughts of the patient to enhance the nurse’s understanding or asking the patient to explain what he means.
o Reflection
directing back the patient’s ideas, feelings, questions, or content.
o Silence
lack of verbal communication for a therapeutic reason. Silence allows the patient time to think and to gain insights.
o Humor
the discharge of energy through the comic enjoyment of the imperfect. It is a constructive coping behavior.
o Suggesting
presentation of alternative ideas for the patient’s consideration relative to problem solving.
o Sympathy
is a feeling of pity or sense of compassion; it is when you feel bad for someone else who’s going through something hard.
o Genuineness
means that the nurse is an open, honest, sincere person who is actively involved in the relationship. Genuineness means that the nurse’s response is sincere.
o Empathy
is the ability to enter into the life of another person, to accurately perceive the person’s current feelings and their meanings, and to communicate this understanding to the patient. Empathy is an essential part of the therapeutic process.
o Immediacy
involves focusing on the current interaction of the nurse and the patient relationship. It is significant dimension because the patient’s behavior and functioning in the nurse-patient relationship reflect functioning in other interpersonal relationships.
o Amines
are neurotransmitters that are synthesized from amino acid molecules such as tyrosine, tryptophan, and histidine. Found in various regions of the brain, amines affect learning, emotions, motor control and other activities.
Monoamine
• Norepinephrine (NE)
levels fluctuate with sleep and wakefulness. Plays a role in changes in levels of attention and vigilance. Involved in attributing a rewarding value to a stimulus and in regulation of mood. Plays a role in affective and anxiety disorders. Antidepressants block reuptake of NE into presynaptic cell or inhibit monoamine oxidase from metabolizing it. Excitatory or Inhibitory.