Highlights Test #1 Flashcards
interpersonal communication
Interpersonal communication occurs between two or more people with a goal to exchange messages. Most of the nurse’s day is spent communicating with patients, family members, and members of the health care team. The ability to communicate effectively at this level influences your sharing, problem solving, goal attainment, team building, and effectiveness in critical nursing roles (e.g., caregiver, teacher, counselor, leader, manager, patient advocate).
intrapersonal communication
Intrapersonal communication, or self-talk, is communication within a person. This communication is crucial because it affects the nurse’s behavior and can enhance or detract from positive interactions with the patient and family. Imagine two different nursing students preparing for the first experience with a critically ill patient. Both are frightened. One tells herself, “Calm down, you’ve been in challenging situations before and always survived. You can handle this.” The other repeatedly tells himself, “There’s no way you can survive this experience. The instructor will be all over you, and you might as well admit defeat before you start.” Obviously, the first student’s positive self-talk is more helpful than that of the second student.
nursing values
Values
Communication is influenced by the way people value themselves, one another, and the purpose of any human interaction. Nurses who believe that teaching is an important aspect of nursing and who value empowering patients will communicate this to patients. Conversely, a nurse who believes teaching is an unimportant chore is unlikely to be an effective teacher. Similarly, the patient’s motivation (or lack of motivation) to develop new self-care behaviors cannot help but influence nurse–patient communication.
during admission the nurse is to the patient
During admission, the nurse acts not only as a health care provider but also as an advocate concerned about the welfare of the patient and the family. The admission period corresponds to the orientation phase of the helping relationship described in
admission to the hospital and advanced directives
the patient is asked to sign forms that give consent to treatment and allow the hospital to contact health care insurance companies or public facilities (e.g., Medicare) for reimbursement of services. Patients are asked if they have established advance directives, such as a living will or durable power of attorney, to indicate their treatment preferences about prolonging life. If they have established advance directives, a copy becomes a part of their hospital record. If they have not, the purpose is explained and they are given a form to complete if they wish to do so.
Maslow’s Hirearchy of needs
Because basic needs must be met before a person can focus on higher ones, patient needs may be prioritized according to the following hierarchy:
Physiologic needs
Safety needs
Love and belonging needs
Self-esteem needs
Self-actualization needs
For example, a geriatric patient who is incontinent of urine and sitting in a wet disposable brief (physiologic need) will be unable to participate fully in a music therapy diversional activity (self-esteem need) until the more basic need is met. (Chapter 4 more fully discusses basic human needs.)
why are the elderly at such a high risk of falls?
Although one of every four older people (>65 years old) falls each year, less than half of them tell their provider (CDC, 2017b). Many falls at home go unreported because they do not cause injuries requiring medical attention. However, injuries from falls may also go unreported because older adults fear activity restrictions, loss of independence, or placement in a long-term care facility. The fear of falling can also cause anxiety and panic, which may make an older adult more vulnerable to a fall. One out of five falls causes a serious injury such as broken bones or a head injury. Falls are actually the most common cause of traumatic brain injuries
what would we need to assess for risks of falls?
Assessment of the risk for falling includes the use of nursing history and physical examination. The nursing history and physical examination include inquiring about and inspecting for factors that contribute to falls, and an understanding of the types of and reasons for falls. Falls can be categorized as either accidental (clutter or a spill cause a person to trip), an anticipated physiologic fall (a direct consequence of gait imbalances, effects of medication, or dementia), unanticipated physiologic falls (caused by unknown or unexpected medical issues such as a stroke or seizure), or intentional falls (occur when patients act out behaviorally with intent to fall) (Quigley & Goff, 2011). Some of these falls are preventable and nursing assessment can determine the optimal interventions to promote patient safety.
what would mobility affect in the elderly
Any limitation in mobility is potentially unsafe. An older adult with an unsteady gait is more prone to falling. Furthermore, if the patient is in an unfamiliar setting, such as a health care facility, the problem may be aggravated. Someone with paralysis or a spinal cord injury may require assistance with even simple movements. Supportive devices—such as canes, walkers, and wheelchairs—may facilitate movement, but they require careful patient instruction and preparation for safe use. Recent surgery or a prolonged illness can temporarily affect a patient’s mobility and necessitate special precautions to prevent falls or injuries. Nurses must assess a patient’s risk for injury with a view toward maintaining independence and fostering self-esteem while providing a safe and predictable environment.
