nursing 50 week 4 - day 1

Question 1

The Oxford American College dictionary defines communication
as

Answer 1

the successful conveying or sharing of ideas and feelings.”

Question 2

Communication is vital in all nursing activities
such as

Answer 2

care planning, interventions,
discharge, education and health promotion
Generates trust
Enhances therapeutic relationship
Strong communication is required for patient
advocacy and safety
Effective communication is essential for
collaboration of care with the interdisciplinary
team

Question 3

Intrapersonal: Communication that occurs within
an individual.

Answer 3

Also known as self-talk, self-verbalization, inner thought
• Provides mental rehearsal for difficult tasks or situations;
increase confidence.
• NURSING RELEVANCE: – internal critical thinking and planning

Question 4

Interpersonal:

Answer 4

• Between 2 or more people
• A 1:1 interaction between the nurse and another person.
e.g patient, family, physician, colleague
• Meaningful interpersonal communication results in exchange of
ideas and goal accomplishment.
• NURSING RELEVANCE: Assessment, teaching, providing
comfort and support

Question 5

Transpersonal:

Answer 5

Interaction that occurs within a spiritual domain.
Communication with a higher power/God
Nurses have a responsibility to assess a person’s spirituality

Question 6

Group Communication

Answer 6

Group Communication: Between two or more people
• A. Group communication: Interaction that occurs when a small number of
persons meet – usually goal-directed and requires understanding of group
dynamics; exchanges of ideas
• E.g staff meetings, committee meetings, educational grps, self help grps,
goals of care meetings
• NURSING RELEVANCE: Provide patient advocacy
• B. Public speaking: Involves interaction with an audience with varying
degrees of interaction
• e.g. presenting scholarly work in conferences and lectures
• NURSING RELEVANCE: Educating nurses with evidence based studies,
change of practice or policies and procedures, lobbying for new legislation

Question 7

Albert Mehribian’s Communication
Model

Answer 7

7-38-55 Formula
Research study in 1971; “ Silent
Messages”
Formula applies to communication
of feelings and attitudes; not to ALL
communications
Only 7% of meaning is in the words
that are spoken
38% of meaning is in the tone of
voice
55% of meaning is in facial
expression

Question 8

Verbal Communication:

Answer 8

Uses spoken or written words:
Influenced by educational
background, culture, age and
experiences, influenced by:
Vocabulary
Clarity and Brevity – appropriate
words
Intonation - tone
Pacing -speed
Credibility
Humor-Use cautiously

Question 9

Non Verbal Communication**

Answer 9

 Facial expression
 Gestures
 Personal Appearance****always overdress just in case
 provides clues to professionalism, culture, religion,
socioeconomic status, livelihood and feelings
 Touch - ex - touch patient’s hand and he calmed down. also provides a lot of information, skin is warm, purfusion is good.
 May convene affection, concern, or encouragement

Question 10

Environment

Answer 10

 Quiet, private, comfortable
Developmental differences
 Physical and cognitive
development
 Language skills
 Level of Education
 Maturity
Gender
 Difference in
communicating and
interpreting
 Males tend to be goal/task
focus
 Females also seek to
establish personal
relationship

Question 11

Personal Space (personal at 18)

Answer 11

 Varies according to
relationship with the
other person
 Intimate distance – <18”
 Personal distance – 18”
to 48’’
 Social distance – 4-12’;
formal or with a group
 Public Distance - > 12’;
when communicating
loudly, focus on group
not on individual

Question 12

Nurse-Healthcare team: (team is patient, family and community)

Answer 12

Teamwork and
collaboration
Nurse-Patient: Involve
patient in care
management
Nurse-Family: Involve
family in care of patients
and discharge teaching
Nurse-Community: health
fairs, public bulletin boards.

Question 13

-Transition of Care (transition the meds and fatigue)

Answer 13

(shift change report)
-High-alert Medications
-Recognizing Fatigue
* Be assertive not aggressive
* Advocate for patients
* Advocate for yourself
* If needed, decline
respectfully and explain
* Use proper chain of
command - 1st charge nurse, then attendant. trust your instincts.
for a chest tube, check for bubbling when patients takes a deep breath. make sure tube is connected to suction. check site to make sure there is no bleeding, etc.

Question 14

The client is the center of focus.

Answer 14

Therapeutic relationship focuses on improving the health of the
client.
Therapeutic communication is client-centered communication
directed at achieving client goals

Question 15

1. Pre-interaction Phase:

Answer 15

Before meeting patient
Review chart/pre-lab
Talk with caregivers/nursing handoff
As Student- prelab for clinical
As patient – anxiety may be high as pt acknowledges the need
for healthcare
Goal – Get info about patient to establish plan of care

Question 16

Orientation Phase: hi, how are you?

Answer 16

When nurse and patient first meet
 Introduce yourself
 Ask how pt wants to be addressed
 Set tone by adopting a warm and empathetic manner
 Students often tentative and uncertain
 Expect to test your competence and commitment
 Goal – establish rapport and trust using verbal and non-
verbal communication; leads to more openness from patient
 Clarify roles


Question 17

Working Phase: (the therapy is working)

Answer 17

 Bulk of therapeutic relationship occurs in this phase – active part
 Goals: pt able to clarify feelings and concerns honestly
 Mutual respect maintained
 Active listening, providing clear instructions
 Professional relationship requires trust, confidentiality mutual respect
 Work together towards a goal

Question 18

Termination Phase:

Answer 18

Evaluate goals achievement with the patient
Reviewing the care achieved and care needed to be passed on to
the next shift
Achieve a smooth transition for the patient to other caregivers
Prepares for future interaction
Affects patient outcome and nurses’ job satisfaction

Question 19

Active Listening:

Answer 19

-Pay attention
-Show that you are listening
-Use clarification
-Respond appropriately

Question 20

Share Observations (share questions and silence)

Answer 20

“You seem quiet today. What’s in your mind?”
3. Reflection of feeling: “I see that you are upset of the phlebotomist.”
4. Restating/Clarifying
5. Use open-ended questions
6. Focusing: pursing a topic until its importance is clear
7. Using silence – allows
person time to organize
thoughts

Question 21

 Excessive use of

Answer 21

closed-ended questions
 Avoid asking “why”; Say “what concerns you” instead
 Giving advice – giving solution negates pt’s participation in decision making
 False reassurance: “everything will be alright”
 Showing approval and disapproval- don’t impose your personal beliefs on someone else
 Stereotyping: assumptions made based on patients background, education, culture etc.
 Patronizing – communicates superiority or disapproval
 “You should have called before getting up”

Question 22

Medications that might interfere with speech, cognition, or LOC

Answer 22

 Language barriers such as primary language, whether an interpreter (native language or sign language) is needed
 Health literacy
 Baseline cognitive function/LOC
 Hearing, vision impairment
 Expressive or receptive aphasia
 Physiological barriers such as dyspnea, artificial airway, anxiety, pain

Question 23

aphasia

Answer 23

Use yes/no answers
Visual cues
Communication aids such as a writing board or keyboard
Allow for extra time
Let patient know if you have not understood them

Question 24

cognitive impairment

Answer 24

Use simple sentences
Present one question,
instruction, or statement at a
time
Involve the patient’s family
Allow for extra response time

Question 25

mental health issues

Answer 25

Avoid denying or arguing with them about their reality
Use short sentences in a calm and non-threatening voice
Validate the person’s own experience of frustration or distress
Reflection of feelings
Re-direct focus to the person’s positive experience
Avoid denying or arguing with the person’s about their reality

Question 26

if you see the word “why” on NCLEX,

Answer 26

this answer is WRONG

Question 27

don’t give the patient

Answer 27

advise.

Question 28

stage of patient and nurse relationship

Answer 28

termination phase

Question 29

reconginze open and closed

Answer 29

statements

Question 30

ineffective communicaiton techniques

Question 31

stages of nurse

Answer 31

to patient relationship

Question 32

list one example of ineffective techniques

Answer 32

giving hope, false reassurance etc.

Question 33

Communication is the basic element of human interactions

Answer 33

allows people to establish, maintain, and improve contact with
one and other

Question 34

Denotative Meaning (de note is literal)

Answer 34

literal

Question 35

Connotative Meaning -

Answer 35

implied

Question 36

when does orientation phase end? (I’m oriented to the role)

Answer 36

Once relationship/ role is defined, orientation phase ends

Question 37

what phase affects future outcomes?

Answer 37

termination phase