Exam 2 Flashcards
What does patient centered communication involves?
Informed consent, establishment of mutual goals, and shared decision making regarding treatment 
What are the characteristics of collaborative nurse, patient family communication ?
- Rules and boundaries
- individualize strategy
- Goal directed
- patient centered 
What are the characteristics of patient centered communication?
- empathy
- Respect
- boundaries 
What is the goal of patient centered communication
To deliberately help patients reach goals
When does patient centered, communication terminate?
When the health care objective has been achieved, or the patient has been discharged 
How does empathy tie into patient centered communication
Your aim is to find common ground upon which to base intervention to foster empathy. You can acknowledge in words with the patient is feeling. 
How does respect tied to patient centered communication?
Showing your patient respect using the proper name along them to finish, avoid being distracting and respond, fully and honestly. 
How to boundaries tie back to patient centered communication
Professional conversations focus on the patient’s thoughts or feelings, related to health issues. Nurses do not discuss their personal lives, nor share opinions. 
What is therapeutic communication?
Refers to a dynamic interactive process, by healthcare providers with their patients, and significant others for the purpose of achieving identified health related goals
What are four characteristics of the therapeutic communication process  for the sender?
Tongue, facial expression, choice of words and body gesture
What are the four characteristics of therapeutic communication process for the receiver?
Culture, timing, previous experience, and environment
What does active listening require?
Full attention to understand the patient’s perspective without making any judgment 
What is an open ended question?
Questions that are open to interpretation it cannot be answered by yes or no
What is an example of an open ended question?
Can you tell me what brought you in today?
Why are open Ended questions important?
They illicit the patient starts and perspectives, without influencing the direction of an acceptable response
What is a focused question?
Questions that require more than a yes, or no answer but place limitations on the topic to be addressed
When are focus questions most useful?
In emergencies and other situations went to median. Concise information is required.
What is the goal of a focused question?
To clarify the timing and sequence of symptoms, and concentrate on details about a patient’s health
What is an example of a focused question?
Can you tell me more about the pain in your arm?
What are circular questions?
A form of focused questions that look at how other people within the patient support circle respond to a patient’s health issue
What is the goal of circular questions?
To identify differences in the impact of an illness on individual family members, and to explore changes in relationships
What is a close ended question?
Nero focused questions for which a single answer like yes or no a simple phrase answer serves as a valid response
What is the goal of close ended questions?
To obtain information quickly in the context
What is an example of close ended questions?
Have you eaten today?
What are negative listening responses?
- false reassurance
- giving advice
- False inferences
- value judgments 
-Moralizing
What is meta-communication?
Describe all of the factors that influence how the message is perceived
What are the two style of communication
- verbal
- Nonverbal
What is a nonverbal style?
Facial expression gesture, body posture, movement, iContact, and distance from the other person
What kind of factors can influencechoice of word?
Age race, Socio, economic group, educational background, and gender
What is denotation?
Refers to the generalize meaning assigned to a word
What is connotation?
Points to a more precise, meaning of the word or phrase
What are the six verbal styles that influence, professional communication and nurse patient relationships?
- Moderate pitch and tone
- Varies vocalization
- Encourages involvement
- Validates worth
- Advocates for patients as necessary
- Appropriately provides needed information, briefly clearly and avoiding slang
What is the purpose of moderate pitch and tone in vocalization?
Tone and pitch can indicate have a message is to be perceived
What is varying vocalizations?
He talks about how pronunciation is important to the characteristics of voice tones
What is encouragement of involvement?
To encourage the patient to take charge of their own health
How can nurses validate patient’s?
To affirm autonomy in to convey caring messages of individual worse
What is advocating for the patient when necessary?
What is congruent nonverbal behaviors?
It is when your nonverbal behavior has to match with the verbal behavior 
Why is it important to use silence therapeutically?
To allow the patient needed time to think about things
What is kinesics?
Body language defined as involving the conscious or unconscious, body, positioning, or actions of the communicator
What are the four kinesics?
Posture, facial expression, iContact, and gestures
What is social cognitive competency?
The ability to interpret message Content within interactions from the other point of view of each of the participants
What are the nonverbal style factors that influence communication?
Proxemics, haptics, kinetics, posture and facial expression
What are the verbal star factors that influence communication?
Vocalics 
What are the three theoretical concepts and health promotion?
Penders health promotion model, Petrauskas, trans, theoretical model, the disease prevention, epidemiology, models, and Bandura’s social learning theory
What is the purpose Pender’s health promotion model?
Helps the nurse understand what motivates people to engage in specific health behaviors 
What three areas does Penders health promotion model focus on 
Characteristics and experience of individuals, their behavior specific cognition in effect and behavioral outcomes
What is Pender’s health belief model
A dynamic process affected by personal factors, social support systems, and situational variables 
What are the three critical elements of maintaining health and well-being? 
Healthy lifestyle, resilience, and well-being
What is an example of resilience?
Self efficacy
What is an example of well-being?
Personal satisfaction
What is Petrauskas trans theoretical model for change ?
Individual motivational readiness to intentionally change, their behavior and health habits 
What are the five stages of Petrauskas trans theoretical model for change 
Precontemplation, contemplation, preparation, action, and maintenance 
What is the main goal in Petrauskas trans theoretical model for change?
By the last stage, the person or patient has no desire to return to their former unhealthy behavior 
What is Bandura social learning theory?
The social learning theory proposes that humans observe, and then copy a new behavior and a reciprocal interaction 
What is an example of a motivational reciprocal process?
Self efficacy and motivation. Increased self efficacy, strengthens motivation, which try to increase an individual capacity to complete learning task
What is the disease prevention epidemiological framework?
Primary disease prevention, secondary disease, prevention, and tertiary disease prevention
What are protective factors?
 Circumstances, resources, and personal characteristics, the delay, the emergence of chronic disease or lessen it’s impact
How can community based interventions be formally presented?
Through patient education screening programs and social media
What are common examples of general health promotion?
Developing a healthy lifestyle good nutrition, regular physical activity, adequate sleep patterns, and stress reduction
What is motivational interviewing?
A motivational intervention which encompasses a patient’s values, belief and preferences incorporated into relevant functional abilities and learned skills
What is the purpose of motivational interviewing?
It is to charge patients with taking a more active role in designing and implementing lifestyle changes
What are the two phases of motivational interviewing?
First phase focuses on, mutually exploring and resolving ambivalence to change by weighing pros and cons of the current situation, while the second phase strengthens and supports the patient’s commitment to change based on the patients choice and capacity for change
What is the epidemiological framework?
Concerned w/risk and protective factors associated w/ specific disease
What are the three disease prevention in the epidemiological framework?
.- primary
- secondary
- tertiary
What are protective factors?
Circumstances, resources and personal characteristics that delay chronic disease appearance
What are some community based interventions?
Pt education, screening programs, and social media
What is motivational interviewing?
An intervention in which the nurses uses empathetic exploration to help pt. Become aware of unhealthy habits
What are the two phases of motivational interviewing?.
1) exploring/ resolving
2) strengthening + supporting pt’s commitment to change based on choices and capacity to change
What is the purpose of bloom’s taxonomy for nurses?
To provide a common language
What is the purpose of blooms taxonomy for pt’s?
Helps remember, understand, analyze, apply, eval, and create
what are the diffrent components an of health assessment?
HH, PE, RHRD. DF
Health History
Physical Examination
Reviewing health record data (if available)
Documenting findings
what is healthy history?
subjective data collected during interview
what does health history include?
CSOH, CM, PI/S, FH, PH, RS
patient’s current state of health
current medications
previous illnesses and surgeries
a family history
personal and psychosocial history
review of systems.
what are the diffrent classes of subjective data (by source)?
primary source
secondary source
what kind of data is being collected when an physical exam is given?
objective data
what does objective data include?
VS, H, W, I, P, PR, A
vital signs
height
weight
inspection
palpation
percussion
auscultation
what are the diffrent kinds of types of health assessments?
CA, PB, E(fua), SA, SA
- Comprehensive Assessment.
- Problem-Based/Focused Assessment.
- Episodic/Follow-up Assessment.
- Shift Assessment.
- Screening Assessment.
what is a comprehensive assessment?
a detailed history and physical examination performed at the onset of care
what is a problem-based/focused assessment?
history and physical examination that is limited to a specific problem or complaint (e.g., a sprained ankle).
what is a episodic/follow-up assessment?
patient is following up with a health care provider for a previously identified problem
how is mental state assesed?
LABCOAT
level of arousal
Appearance
Behavior
Cognition
oranization
Thought process
What order should someone preform a physical assessment?
- inspect
- palpate
- percuss
- auscultate
What sound should be heard when percussing the lungs?
Loud hollow resonation
What sound should be heard when percussing the bone/ muscles?
Flat soft, high pitched dullness
What sound should be heard when percussing the solid organs?
Dull medium, thud like sounds
What sound should be heard when percussing the GI system?
Tympanic loud, drum like sounds
What sound should be heard when air is trapped in the lungs (emphysema)?
Hyperreasonation very loud and booming sounds
What is the purpose of a monofilament?
Check for peripheral sensation
What is a goniometer used for?
Check for ROM
What is a Doppler used for?
To increase sounds trying to be heard
what is a audio scope used for?
To test for hearing
What is common tool used to look at skin lesions?
Penlight
What is the earliest and most sensitive indication of altered cerebral function?
Change of level of consciousness
Which technique does the nurse use to assess the tricep reflex?
Hold the pts relaxed arm with the elbow flexed at 90 degrees, strike the appropriate tendon
What are the different types of headaches?
T, M, C, PT,
Tension headache
Migraine headache
Cluster headache
Post traumatic headache
What are the common characteristics of a tension headache?
Tight band around the head
Most common headache
bilateral
may be confined to a single lobe
Last several days
What are the common characteristics of a cluster headache?
Most painful
Intense episodes of excruciating unilateral pain
Repeats daily for weeks at a time
Average 12 months
Burning, boring, stabbing
What are the common characteristics of a margarine headache?
Second most common headache
Starts with aura caused by a vast spams of inner criminal arteries
Throbbing unilateral distribution
Can last up to 72 hrs
What are the common characteristics of a post traumatic headache?
Occurs secondary to a head injury
Dull generalized head pain
Symptoms of lack of ability to concentrate or dizziness
