Interviewing Chapter 2 Flashcards
Pre-Introductory Phase
reviews the medical record before meeting with the client
Pg. 13
Introductory Phase
- explains the purpose of the interview,
- discusses the types of questions that will be asked,
- explains the reason for taking notes, and
-assures the client (privacy) that confidential information will remain confidential.
(WIPER)
Pg. 13
True or False
It is important for the nurse to document during the interview and assessment process, which requires the nurse to look away from the client, at times, and toward the documentation form or computer screen.
True
The four Phase of Interviewing a Patient
preintroductory, introductory, working, and summary/closing phases
Working Phase
Gathers all the subjective data-
the nurse elicits the client’s comments about major biographical data, reasons for seeking care, history of present health concern, past health history, family history, review of body systems (ROS) for current health problems, lifestyle and health practices, and developmental level
then interprets, validate info. collaborates to identify the problem and goals.
Pg 13
Summary and closing Phase
the nurse summarizes information obtained during the working phase and validates problems and goals with the client
also identifies and discusses possible plans to resolve the problem (nursing diagnoses and collaborative problems) with the client
pg 14
Non verbal communication
our appearance, demeanor, posture, facial expressions, and attitude
Appearance
should be professional.
Demeanor
When you enter a room to interview a client, display poise. Focus on the client and the upcoming interview and assessment.
Greet the client calmly, by name and not with references such as honey, sweetie, or sugar
pg 15
Facial expression
keep your expression neutral and friendly
pg 15
Attitude
nonjudgmental attitude
pg 15
Silence
Periods of silence allow you and the client to reflect and organize thoughts,
pg 15
Listening
you need to maintain good eye contact, smile or display an open, appropriate facial expression, and maintain an open body position (open arms and hands, and lean forward).
pg 15
COMMUNICATION TO AVOID
Excessive or Insufficient Eye Contact
Distraction and Distance
Standing
Biased or Leading Questions
Rushing Through the Interview
pg 15
Open-ended question
to elicit the clients feelings and perceptions.
Ex;
“How have you been feeling lately?
pg 16
closed-ended questions
to obtain facts and focus on specific information.
“When did your headache start”
“when or did” type of questions
pg 16
Laundry List
providing the patient with a list of words to choose from when describing symptoms.
pg 16
Rephrasing
rephrasing what the patient has told you.
well-placed phrases
encouraging the patient by using well-placed phrases.
ex;
“uh-huh, yes, or i agree”
inferring
Inferring information from what the client tells you and what you observe in the client’s behavior may elicit more data
pg 16
providing information
throughout the interview is to provide the client with information as questions and concerns arise
Gerontologic Variations in Communication
Interviewing an older client -
When interviewing an older client, you must first assess hearing acuity. Hearing loss occurs normally with age, and undetected hearing loss is often misinterpreted as mental slowness or confusion.
pg 16
Cultural Variations in Communication
f misunderstanding or difficulty in communicating is evident, seek help from an expert, what some professionals call a “culture broker.” This is someone who is thoroughly familiar not only with the client’s language, culture, and related health care practices but also with the health care setting and system of the dominant cultur
When interacting with an anxious client
- Provide the client with simple, organized information in a structured format.
- Explain who you are, along with your role and purpose.
- Ask simple, concise questions.
- Avoid becoming anxious like the client.
- Do not hurry, and decrease any external stimuli.
pg 19
When interacting with an Angry Client
- Approach this client in a calm, reassuring, in-control manner.
- Allow him to ventilate feelings.
- However, if the client is out of control, do not argue with or touch the client.
- Obtain help from other health care professionals as needed.
- Avoid arguing and facilitate personal space so that the client does not feel threatened or cornered.
- Never allow the client to position him or herself between you and the door.
When interacting with a depressed client
- Express interest in and understanding of the client and respond in a neutral manner.
- Do not try to communicate in an upbeat, encouraging manner. This will not help the depressed client.
When interacting with a manipulative client
- Provide structure and set limits.
- Differentiate between manipulation and a reasonable request.
- If you are not sure whether you are being manipulated, obtain an objective opinion from other nursing colleagues.
When interacting with a seductive client
- Set firm limits on overt sexual client behavior and avoid responding to subtle seductive behaviors.
- Encourage client to use more appropriate methods of coping in relating to others.
- If the overt sexuality continues, do not interact without a witness.
- Report inappropriate behavior to a supervisor.
pg 16
What is a chief complaint
reason for the patient seeking health care
History of Present Health Concern Using
COLDSPA;
Character (How does it feel, look, smell, sound, etc.?)
Onset (When did it begin; is it better, worse, or the same since it began?)
Location (Where is it? Does it radiate?)
Duration (How long does it last? Does it recur?)
Severity (How bad is it on a scale of 1 [barely noticeable] to 10 [worst pain ever experienced]?)
Pattern (What makes it better? What makes it worse?)
Associated factors (What other symptoms do you have with it? Will you be able to continue doing your work or other activities [leisure or exercise]?)
review of systems (ROS),
body system is addressed and the client is asked specific questions to elicit further details of current health problems or problems from the recent past that may still affect the client or that are recurring
