fundamentals- chapter 8

Question 1

communication

Answer 1

• occurs when one person sends a message and another person receives it, processes it, and indicates that the message has been interpreted
• continual circular process
• verbal or nonverbal

Question 2

verbal communication

Answer 2

spoken or written words

Question 3

nonverbal communication

Answer 3

without words

• gestures
• posture
• intonation
• general appearance

Question 4

factors affecting communication

Answer 4

• cultural differences
• past experiences
• emotions and mood
• attitude of the individual

Question 5

cultural differences

Answer 5

• personal space
• eye contact
  
  • averting eyes is normal in some cultures
• meanings of words
• cultural norms
  
  • older people might not want instructions from
    younger people
• religious beliefs

Question 6

past experience and communication

Answer 6

how we perceive communication depends on:
- cultural values
- level of education
- familiarity with the topic
- occupation
- previous life experiences

Question 7

emotions and mood

Answer 7

• anxious patients may not hear or interpret you correctly
• an upset person may speak loudly
• a depressed person may communicate minimally
• a person’s attitude may affect how a message is received

Question 8

active listening

Answer 8

• requires concentration and focused energy
• uses all senses to interpret verbal and nonverbal messages (feedback)
• listens for feelings as well as words
• maintains eye contact without staring
• makes a conscious effort to block out distractions

Question 9

interpreting nonverbal messages

Answer 9

observe for:
- posture
- gestures
- tone
- facial expression
- smiling or frowning
- eye contact

Question 10

obtaining feedback

Answer 10

• checking to see if you interpreted a message in the way the speaker meant it
• accomplished by rephrasing the meaning of the message or directly asking a feedback question
• helps assess if a patient understands what you are saying

Question 11

focusing

Answer 11

• keeping attention focused on the communication task at hand
• continually check to see that the patient is still the topic of interaction

Question 12

adjusting style

Answer 12

• patient’s style and level of usual communication should be considered
• if the person is a slow, calm communicator, adjust to that pace
• if a response is slow in coming, allow plenty of time for consideration and a response

Question 13

therapeutic communication

Answer 13

• promoting communication between sender and receiver, obtaining feedback
• focusing on the communicator
• using silence and open-ended communication
• restating the message
• clarifying
• using therapeutic touch

Question 14

therapeutic communication techniques

Answer 14

• general leads
• open-ended questions or statements
• offering self
• restatement
• reflection
• seeking clarification
• focusing
• encouraging elaboration
• giving information
• looking at alternatives
• silence
• summarizing

Question 15

blocks to effective communication

Answer 15

• changing the subject
• offering false reassurance
• giving advice
• making defensive comments
• asking prying or probing questions
• using cliches
• listening inattentively

Question 16

general leads

Answer 16

“go on”
“I see”
“please continue”

Question 17

open ended questions or statements

Answer 17

“tell me more about that feeling”
“I’d like to hear more about…”

Question 18

offering self

Answer 18

“I’m here to listen”
“can I help in some way?”

Question 19

restatement

Answer 19

• restates in different words what the patient said
• encourages further communication on that topic

Question 20

reflection

Answer 20

• reflects received message (verbal or nonverbal) back to patient
• reflects feelings
• encourages further verbalization
• can be useful if patient struggles with verbalization

Question 21

seeking clarification

Answer 21

• seeks clarification about the source of an upset feeling
• helps patient clarify their own thoughts

Question 22

focusing

Answer 22

asking a goal-directed question helps the patient focus on key concerns

ex. “do you have any questions about your chemotherapy?”

Question 23

encouraging elaboration

Answer 23

'’tell me what that felt like”
“I need more information about that”

Question 24

giving information

Answer 24

provides patient education relevant ton specific health care needs

Question 25

looking at alternatives

Answer 25

"have you thought about...?" "would this be an option?"

Question 26

silence

Answer 26

allows patient time to gather thoughts and sort them out

Question 27

summarizing

Answer 27

sums up the important parts of an interaction

Question 28

interviewing skills

Answer 28

- establish a rapport - the nurse-patient relationship - empathy - becoming nonjudgemental - maintaining hope - truth telling - application of the nursing process - nurse-patient communication

Question 29

sympathy vs. empathy

Question 30

changing the subject

Answer 30

deprives the patient of the chance to verbalize concerns

Question 31

giving false reassurance

Answer 31

negates the patients feelings and may result in false hope

Question 32

judgmental response

Answer 32

- implies patient must take on nurse's values - demeaning to the patient

Question 33

defensive response

Answer 33

- nurse responds by defending the doctor - prevents patient from feeling free to express feelings

Question 34

asking probing questions

Answer 34

- pries into patient's motives - invades privacy

Question 35

using cliches

Answer 35

- negates the patient's individual situation - sounds flippant and prevents building trust

Question 36

giving advice

Answer 36

- controlling - diminishes patient's responsibility for taking charge of their own health

Question 37

inattentive listening

Answer 37

- indicates the patient is not important, the nurse is bored, or what is being said doesn't matter

Question 38

interviewing skills

Answer 38

- establish rapport (relationship of mutual trust) - introduce yourself and ask how the patient wishes to be addressed - include family in greeting - explain purpose of interview - provide privacy - ask if patient wishes guests to remain in the room - eliminate excess noise - be certain patient is comfortable - draw up chair within 3-4 feet - sit facing patient

Question 39

the nurse-patient relationship

Question 40

empathy

Question 41

becoming nonjudgmental

Question 42

maintaining hope

Question 43

truth telling

Question 44

application of the nursing process

Question 45

nurse-patient communication

Question 46

communicating with the hearing-impaired

Answer 46

- speak very distinctly - do not shout - speak slowly - get the person's attention - maintain a good distance (2.5 to 4 feet) - watch for nonverbal feedback - use short sentences - paraphrase for clarification

Question 47

communicating with an aphasic patient

Answer 47

- aphasia = difficulty expressing or understanding language - this patient requires specialized nursing interventions - a speech therapist can identify methods to facilitate communication for these patients

Question 48

strategies for communicating with an aphasic person

Answer 48

- make sure you have their attention before you start - make the environment as relaxed & quiet as possible

Question 49

communicating with older adults

Answer 49

- assess for

Question 50

communicating with children

Answer 50

- approach at eye level - use a calm, friendly voice - keep parent in the room when possible - use short sentences - give simple explanations and demonstrations - allow child to handle equipment

Question 51

assisting older adults from other cultures

Answer 51

- determine the language spoken - obtain an interpreter if necessary - enlist the help of a family member if appropriate - give printed materials if available and answer questions - beware of cultural differences in eye contact & personal space

Question 52

communication within the health care team

Answer 52

- nurse's notes - physician's orders and progress notes - dietician's notes - OT, PT, and speech therapy notes - shift report - radiology and lab findings

Question 53

ISBAR-R

Answer 53

Introduction Situation Background Assessment Recommendation Readback

Question 54

SBAR-Q

Answer 54

Situation Background Assessment Recommendation Questions

Question 55

walking rounds

Question 56

computerized documentation

Question 57

telephoning primary care providers

Answer 57

- have patient data in hand (lab data, vitals, output, med record, etc) - keep chart handy and anticipate info the physician may request - know patient allergies and perform a quick assessment before calling - prepare a concise problem statement - document the call and physician's response

Question 58

assignment considerations and delegating

Answer 58

- give clear, concise messages and listen carefully to feedback - include

Question 59

computer communication

Answer 59

- computer communication skills are essential - transmit requests for lab, dietary, radiology, PT, RT, and other services - medication orders - supplies for patient care - update care plans - computerized form of charting

Question 60

communication in the home and community