NSG 1610 - Communication Flashcards
1
Q
What is the goal of a health assessment?
A
To obtain information or data about the patient
2
Q
What four components should you prepare before completing a general health assessment?
A
- proper equipment (i.e., stethoscope, gloves, pen light)
- perform hand hygiene - whether hand washing or ABHR
- prepare yourself - education on assessment techniques, leaving emotions at the door, etc.
- consent
3
Q
What are the three types of consent and define/give an example of each?
A
- Implied - someone giving their arm out after you say “Is it okay if I take your BP?”
- Implicit - someone saying “yes” when you ask “Is it okay if I take your BP?”
- Informed - patient agrees/disagrees on something after being educated about risks, benefits, etc. of treatment
4
Q
Who can obtain informed consent?
A
Physicians and NPs only
5
Q
What are the four different types of health assessment?
A
- Emergency
- Problem-centered/Focused
- Follow-Up
- Baseline/Comprehensive
6
Q
Describe an emergency health assessment (procedures, types of questions)
A
- ABCDEs (airway, breathing, circulation, disability, and exposure)
- close-ended questions because the assessment is focused on determining the problem to find critical interventions
7
Q
Describe an problem-centered/focused health assessment (focus, types of questions)
A
- trying to determine the status in relation to specific symptoms or patient concerns
- typically focused on one or two main systems where subjective data is collected that is relevant to the problem
- a mixture of open-ended and close-ended questions
8
Q
Describe a follow-up assessment (focus, types of questions)
A
- comparing a patient’s current state with previous presentations
- aiming to determine if any further assessments or treatment are required AND/OR aiming to determine if interventions utilized are actually working
9
Q
Describe a baseline/comprehensive assessment (procedures, types of questions)
A
- perform a complete health history and full physical exam
- intended to establish a baseline and serves as a comparison for future assessments
- should include ALL body systems/head-to-toe approach
- mixture of open-ended and close-ended questions
10
Q
What does IPPA stand for?
A
Inspection, Palpation, Percussion, Auscultation
11
Q
List/describe 4 general components we are observing through inspection
A
- physical appearance - symmetry, skin colour, signs of distress, etc.
- LOC - name, knows why they are there, current location, date & alert/responsiveness
- mobility - assess posture and ROM
- body structure - body size, shape, etc.
12
Q
What are the two types of palpation? Describe them
A
- Light - pushing down on the tissue to the depth of approx. 1cm (using 2-3 fingers)
- Deep - using one or two hands to the depth of 3-4cm to palpate deep structures (discontinuous pressure is used)
13
Q
What part of the hand do you use to palpate for moisture? For temperature?
A
Moisture - palmar
Temperature - dorsal
14
Q
What are we listening for with percussion? What are the two types of percussion?
A
We are listening for sounds produced in the body that allow for determination of the density of underlying tissue
- direct - tapping on the exact structure/area (bone, muscle, etc.)
- indirect - tapping the index finger on the second joint of the finger
15
Q
When do we use the bell of a stethoscope? The diaphragm?
A
Bell - utilized for low pitch and vascular sounds (ventricles, carotid artery, aortic artery, renal arteries)
Diaphragm - utilized for higher pitch sounds (intercostal spaces, BP)
16
Q
What are the four main goals/things we are attempting to demonstrate with caring/therapeutic communication?
A
- demonstrate interest
- respect
- empower the individual
- share decision making
17
Q
What does FOCUS stand for in nurse presence/caring communication?
A
Feel - stay in the moment, one thing at a time
Observe - watching your patients in terms of emotion, fear, verbal/nonverbal cues
Connect - approach, listen, share, and communicate with your patients
Understand - try to meet your patient where they are, see things without judgement
Share - each client should have your full attention
18
Q
What is geographical privacy?
A
if discussing a sensitive matter, moving your client to another room is most appropriate to ensure their privacy/protection
19
Q
What is psychological privacy?
A
Allowing the client to feel physically protected even if they may not be completely - closing curtains to provide a sense of security
20
Q
What 5 components are part of the linear model of communication? When is this form of communication best used?
A
- sender - the person initiating the communication
- message
- receiver - responsible for listening, observing, and decoding the message
- channel of communication
- context
Best used in emergency situations
21
Q
What are components of the transactional model of communication?
A
It is a co-created model of communication, reciprocal (the client has a role) and it has feedback loops (can mediate, correct, vary)
requires more time and is complex
22
Q
What is are the components of a therapeutic model of communication?
A
dynamic, interactive, follows a process, has purpose, goal-directed, and always with the intent of advancing the best interest of and outcomes of the client
23
Q
What does SURETY stand for in active listening?
A
Sit, Uncross, Relax, Eye contact, Your intuition
24
Q
What five factors are at the core of patient-centred communication?
A
- Engage the patient
- Build rapport
- Develop a shared partnership
- Find common ground
- Observe nonverbal cues
25
Describe clarification as a method of active listening
Clarifying the patient's statements, asking for more detail through open-ended questions
Used as a way to ensure that we have heard the client correctly and to check or verify information that feels unclear
26
Describe restatement as a method of active listening
repeating the client's word almost exactly as they were said to prove you are listening/understand
27
describe paraphrasing as a method of active listening
The ability to repeat in your own words the essential thoughts, ideas, and feelings a client is trying to convey
By using this method, the client understands that we are actively listening, are engaged, and care
28
describe reflection as a method of active listening
allow yourself and the patient to reflect on the conversation or life events together
29
describe summarizing as a method of active listening
at the end of conversations or statements, summarize the content to prove and synthesize understanding
30
describe silence as a method of active listening
we allow our patients time and space to think of what they want to say and to sit in their own thoughts/emotions by using silence
31
describe minimal cues and leading as a method of active listening
we want to do this as little as possible to ensure patient autonomy - we want to allow them to state their thoughts in their own words without guidance
32
What does it mean to listen for themes in communication with clients?
underlying emotions that are not being expressed in words, body language, etc.
33
What are open-ended questions?
the what, why, when, where, how, and who questions
the intent is to encourage the client to talk by exploring, clarifying, or describing their thoughts and feelings
34
What is a focused question?
Questions that focus on a specific topic or problem
35
What are close-ended questions?
Questions that elicit yes/no responses
36
What is matching in verbal communication?
you recognize your client's limitations and strengths to utilize those in conversations
also, pulling out information from what they said in conversation
37
What is metacommunication?
Looking at both verbal and nonverbal
what factors can influence how my message is being received?
38
What are the verbal components in communication?
pitch, tone, frequency of the voice is all affected by choices and life experiences
39
What are the differences between denotation and connotation?
denotation - a word has a generalized meaning (the literal meaning)
connotation - a word has a personal meaning (subjective and comes from emotional experience)
40
What are the 6 verbal styles that influence communication?
1. moderate pitch and tone
2. vary vocalizations
3. encourage involvement (not having conversations TO the pt)
4. advocate for the pt
5. validate worth
6. appropriately provide information - give as many times as needed
41
what 6 factors influence nonverbal styles of communication?
1. allow/use of silences - allow them to reflect, think, and prepare
2. use congruent nonverbal behaviours - "my office is always open"
3. facilitate appropriate physical body language
4. touch
5. proxemics
6. watch the pt's nonverbal cues
42
what is the accommodation theory?
when communicating with other people, we will adjust and change our speech to accommodate their needs
things such as vocal pattern, enunciation, word choices, etc. may be altered
43
What are examples of organizational/system barriers in therapeutic relationships?
- heavy workloads
- production expectations (only having 15 mins of funding to complete a task)
- inconsistent caregivers
44
What are 10 factors that are bridges or barriers to therapeutic relationships?
1. respect
2. caring
3. empowerment
4. trust
5. empathy
6. mutuality (finding common ground)
7. veracity (truthfulness)
8. patient centered
9. acceptance
10. confidence/anxiety
45
What is the definition of communication deficits in patients?
some impairment in the ability to receive, send, process/comprehend, verbal, nonverbal, graphic, or symbols
could be congenital or acquired
46
How does hearing create functional impairments to communication? what are behaviours you may notice?
Clients will try to hide their deficits and withdraw from communication – they will be less likely to ask questions because they are embarrassed
47
What are 5 things we can do to improve/provide successful aging to an older adult?
1. create situations of empowerment
2. provide assistance as needed
3. provide opportunities to stay active
4. create moments that support autonomy
5. create moments that allow engagement
48
What are 6 factors that could increase empowerment in older adults?
1. remind them of their lifetime of strengths
2. get to know your older adults - listen to their stories
3. reminisce with your clients
4. encourage social and spiritual supports
5. support independence
6. medication supports
48
What is transference and countertransference?
transference - a pt projects their feelings about someone or something onto the practitioner
countertransference - the practitioner projects their feelings onto the pt.
49
What is the importance of theories of communication?
they provide us an understanding patient issues, concerns, helps guide communication
50
What are the 4 phases of Peplau's theory?
1. pre-interaction phase
2. orientation phase
3. working phase
4. termination
*note: in order for communication to be successful, pt. needs to pass through each phase correctly and fully
51
Describe the pre-interaction phase
patient is not participating, entirely you
patient will be unprepared and lost if you do not complete this step
i.e., looking in their charts, observe them, look at resources
52
describe the orientation phase
patient is involved, it is when they realize they need help (awareness)
52
describe the termination phase
met the needs of the patient, working relationship has come to an end
53
What are the six nursing professional roles?
1. You are responsible for yours and patient’s conduct and boundaries
2. We keep this type of communication on a specific health-related purpose that has goals to be met
3. Communication focuses on the needs of the patient
4. The only reason for a relationship is because the patient has a need
5. Pre-designed roles – nurse is nurse, patient is patient
6. Limited self-disclosure by the nurse, but expected self-disclosure by the patient
54
Define/describe Rogers theory of communication
client-centered model
pt. has the innate ability to heal themselves, meaning the pt. has capacity to do so if given support, respect, and unconditional positive regard
55
What are the three main factors of Rogers model?
1. authenticity - nurse has to be real
2. prizing - trust and respect are demonstrated
3. empathetic - nurse demonstrates understanding
56
Define the five stages of Maslow's hierarchy of needs
1. deficiency needs - fundamental needs that have to be met for survival/basic physiological needs (i.e., hunger, thirst, appetite)
2. safety and security - basic physical and emotional safety (i.e., financial safety, freedom from injury or abuse, safe neighbourhoods)
3. love and belonging - emotional connecting
4. self-esteem - individual has a need for recognition and appreciation, sense of dignity, respect, and approval
5. self-actualization - assist in achieving the client's true potential
57
Describe Leininger's theory of communication
nurses must have knowledge of diverse cultures to provide care that fits the client
*first major theory based on culture related within healthcare
58
Describe Purnell's theory of communication
an all encompassing cultural competence from a micro to macro level
understanding individual differences leads us to create a comprehensive cultural assessment which leads to culturally congruent individualized patient-centred approach to patient care
leads us to understand the patient's healthcare concerns from a cultural perspective
59
Define relational continuity & what are the three C's at the core of it
therapeutic relationships with a practitioner span more than one episode
it extends across time
it is centred, collaborative, and coordinated
60
define informational continuity
deals with the use of data - how we use information to tailor patient care and specific treatments to their needs
requires accurate, real-time, specific record sharing
61
define management continuity
appropriate care management approaches - they need to be consistent, coherent, and flexible
62
what is the goal of interprofessional communication? what five factors does it require?
provide quality care safely and function as a purposeful team member
should be timely, accurate, complete, unambiguous, and understood
63
What are the three considerations for teamwork and communication?
1. be aware of barriers
2. be aware of past conflicts in a team setting
3. be aware of disruptive behaviours, and what potentially could go wrong
64
what are the six considerations for collaborative communication?
1. common goal - the patient
2. open and safe communication
3. should be demonstrating mutual respect
4. shared decision making
5. role clarity needs to occur
6. message clarity
65
What are the three steps of conflict resolution?
1. identity source of the conflict (possible causes and identify own feelings)
2. set goals (immediate, specific, measurable)
3. implement solutions that are high quality and mutually accepted
66
what are six considerations or steps to take when implementing solutions in conflict resolution?
1. reframe
2. assume responsibility
3. identify goal(s)
4. obtains factual data
5. intervene early
6. DESC - describe, express concerns, specify course of action, and consensus
67
What are 6 special considerations for conflict resolution?
1. avoid negative statements (i.e., this is your fault)
2. consider others' viewpoints
3. manage emotions
4. talk and listen
5. problem solve together
6. act it out
68
