Test 1 Flashcards
Define therapeutic communication
Face to face process of interacting and active listening
Focuses on advancing the physical and emotional well being of a patient
The ability to understand and share the feelings of another. (Or to put yourself in their shoes)
Empathy
Feelings of pity and sorrow for someone else’s misfortune
Sympathy
What is the first step in the nursing care plan ?
Assessment
The assessment step of the care plan consists of what :
Collection of data
Research of pt chart
Pt history
Reason for admission
Current meds, labs, and health status
What is the second step of the nursing care plan?
Diagnosis
THE diagnosis step of the care plan consists of what? And what should you begin with?
Clinical judgements about actual or potential problems a it may be facing
North American nursing diagnosis association (NANDA)
Beginning with the highest priority
Actual diagnosis
Risk for diagnosis
What is the third step of the nursing care plan ?
Planning
What consists of the planning step of the nursing care plan?
Decide which care measures are appropriate for your patients
Make your intervention specific to your patients
Be aware of The use of pronouns in your interventions
Use evidence/research based practice
What is the fourth step of the nursing care plan?
Implement
What does the implementation step of the nursing care plan consist of?
Tearing out the interventions you have identified as being necessary for your patient care
Ensure efficient, Safe, effective nursing care
Includes direct care, counseling, teaching, and prevention of complications
What is step five of the nursing care process?
Evaluate
What consists of the evaluation step in the nursing care plan step process?
Determine if the nursing process was effective
Determine whether the expected outcomes were achieved NOT if they were carried out or helpful
What does QSEN stand for ?
Quality Safety Education for Nurses
KSA stand for?
Knowledge Skills Attitudes
The verbal and nonverbal interaction between one or more people
Communication
Successful communication requires what?
Appropriate feedback mechanisms
Key aspects of the communication process
The sender
The message
The receiver
The response
Ways a message can be shared ?
Verbal
Written
Electronic - use in heath care
Non verbal
Factors that can affect communication include?
The patient’s age, developmental level, gender, ethnicity, and culture
What is the biggest barrier to communication?
Language
What is the purpose of therapeutic communication?
To foster communications that supports the patient’s health and wellness rather than give advice or opinions
What are other barriers to effective communication?
Physical impairments, Thor patient’s condition, ineffective listening, lack of trust, and cultural factors related to communication
The impact of illness or hospitalization can also disrupt normal communication patterns between patients and healthcare providers
Linear process of sending a message
Theoretical links
Positive attributes of communication styles
Active listening, Honesty, acceptance, flexibility, openness, sense of fairness, sense of trust, respect
How may HospitalizationOr illness contribute to poor/ negative communication attributes?
Defensiveness, power struggle, conflict avoidance, lack of trust, suppression of emotions, angry outbursts, verbal abuse, dishonesty, negativity, denial, hidden agendas, desire to win every argument or to always be right
5 related concepts of communication?
Collaboration, listening, culture, care coordination, critical thinking
Examples of therapeutic communication?
Interviewing Effective listening Patient education and evaluation of learning Conflict management Effective listening
Examples of professional communication?
SBAR
Documentation
Electronic records
End of shift report
What is the purpose of providing cultural competent care?
Provide safe quality care
The concept can be defined as shared socially transmitted behavior patterns, arts, believes, values, customs, lifeways, and all of their products of human work and thought characteristics of a population that guides worldview and decision-making that are primarily learned within the family
Culture
The shared foundation or ancestry of a group with common values, beliefs, customs, traditions and it times religious beliefs.
Ethnicity
This refers to social classifications based on outward characteristics of skin color and other biological factors
Race
A lack of understanding ethnic city and race or incorrectly applying beliefs about a person or a group
Stereotyping
Negative believes and that’s about those who are different than the mainstream
Prejudice
The pattern of believes that one’s own cultural believes are correct and all others are incorrect or inferior
Ethnocentrism
What are the four concepts of understanding cultural diversity in Purnell’s model
Global society
Community
Family
Person
What are the 12 domains That consist of aspects of a persons life which may be based on cultural beliefs
Overview and heritage-country of origin-current residents -migration reasons
Communication
Family roles
Workplace issues
Bio cultural ecology-genetic,diseases -skin color
High-risk behaviors Nutrition Pregnancy Death rituals Spirituality Healthcare practices Healthcare providers
Being aware of and sensitive to cultural differences
Culturally competent
Being unaware of an insensitive to cultural differences
Unconsciously incompetent
Having Inc. cultural awareness and sensitivity to theExtent that is addressed automatically
Unconsciously competent
5 Related concepts of culture
Coping, family dynamics, healthcare disparity, healthcare benefits, communication
How to become culturally competent
Develop cultural awareness and sensitivity
What are culturally based healthcare practices and beliefs
Symptoms, causes it builders, treatment, preferences, diet, nutrition, religious and spiritual healing practices, pharmacology and medication
How to become culturally competent of devElemental/family roles
Gender roles, childbearing practices, death and dying believes
How To become culturally competent ofPatient to provider communication
Eye contact, personal space, touch, language preferences, expression of emotion
What does QSEN stand for
Quality and safety education for nurses
What are QSeN and competencies based on?
Attitude
How does one learn and develop attitudes about nursing judgment safety or quality of care?
A
What are the QSEN competencies
Patient centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety and informatics
Who developed the QSEN and how often is it updated
The joint commission
Annually
This is a set of universal expectations and goals to support and enhance safety in all aspects of patient care
National patient safety goals NPSG
What are the goals that are involved with the NPSG
—-Improve accuracy a patient identification
Improve the safety of using medications
Reduce the risk of healthcare associated infections
Prevent mistakes in surgery
Identify the patient safety risks (most likely suicidal)
Improve staff communication
Use alarm safely
Prevent patient from falling
Identify patient safety risks
Prevent bedsores
The process of using evidence-based practice, critical thought in judgment, the nursing process, and application of theory to practice in order to develop clinical intuition that fosters safe quality care to all clients in all settings
Nursing judgment
Maintaining the knowledge, Skills, and attitudes necessary to ensure that a patient,staff , and the healthcare systemIs protected from potential harm (most important)
(Reducing risk individual)
Safety
Use of dataTo monitor the outcomes of care processes in use improvement methods to design and test changes to continuously improve the quality and safety of healthcare systems (closing gaps)
Quality improvement
In order to demonstrate that we are providing quality care there are systems in place to continuously assess and evaluate that care
Quality of care
By establishing a connection with the patient and family by understanding the culture of both the overriding ethnicity and diversity, as well as the family unit, the shared decision making team can develop an appropriate plan of care which is acceptable and age-appropriate
The plan of care should be based on sounds nursing judgment in the nursing process, developed using therapeutic communication skills and cultural, spiritual and patient family preferences
Patient centered care
Function effectively with in nursing and inter Fessional teams, I think medication, mutual respect, and sharing decision-making to achieve quality patient care (how we work well together)
Teamwork and collaboration
The use of information and technology to communicate, management of information, and support decision-making
Informatics
Do you know where that one is lacking knowledge about another culture
Consciously incompetent
A frequently used phrase that gives the impression that no further discussion is needed
Cliche
A hostile or argumentative meeting or situation between opposing parties
Confrontation
Communication technique used In a respectable tactical And nonthreatening manner in order to help someone move toward self examination and growth
Productive confrontation
Producing or giving rise to
Productive
Any situation event or agent that produces stress
Stressors
An expression of concern about another person situation that may hinder therapeutic communication with the client
Sympathy
What are the roles of the medical surgical nurse?
Director of care
Educator
Client advocate
What does a nurse need to be knowledgeable regarding?
Evidence-based practice, quality and safety competencies, informatics, and genetics
What does I-SBAR stand for?
What does it do or promote for the client?
Identification of self and client
Situation
Background
Assessment
Recommendation
Read-back
It promotes Safety and continuity of care and organizes/ prioritizes important client data
What should be on the end of shift checklist?
Check on your clients
Make sure all your work is done and charted
Make sure all medications are administered and charted on
Report to oncoming shift
The process of taking information and facts and processing it in to find an acceptable resolution to problems
Problem solving
The process of uncovering and clarifying information to make accurate judgment or belief
Critical thinking
This provides subjective and object of information and includes taking the clients vital signs, acquiring data by visualizing the client physically and watching for a client actions and responses, touching the client, and smelling for orders.
Assessment
Formulated by gathering physical psychological social emotional and spiritual data
Nursing diagnosis
This can also be defined as goalsetting
Planning
A detailed specific statement describing the methods to be used to achieve the goal
Expected outcome
Requires the nurse to plan client activities in such a way as to promote goal attainment
Implementing
This provides a judgment about an outcome and requires the nurse to measure factual results against land expectations to determine success
Evaluation
This results when factual data is used to draw conclusions
Clarity
Attention to truth within the understanding
Accuracy
When all clues or evidence supporting the data are confirmed
Precision
This is the importance of data in relation to the problem
Relevance
A measurement from the beginning of a matter to the end
Depth
A comprehensive understanding or understanding from another individual’s point
Breadth
This is being applied when data are categorized as important or not important to promote the best outcomes
Logic
The importance of data
Significant
When individuals are treated equally without bias
Fairness
What does ASSURE stand for ?
Analyze the learner
States objectives
Selects methods
Utilize media and materials
Require learner performance
Evaluate and revise
Guidelines that have been developed to direct nursing care from the nursing practice acts.
Standards of care
Nursing care that uses current and best practice by relevant valid research
Evidence based practice
This is the study of individual genes and their transmission of traits
Genetics
The study of all genetic material and how the genes interact with each other in the environment
Genomics
A field of research that validates how changes in genetic structure can affect individuals response to a certain drug
Pharmacogenomics
What can alter drug response
Genetic make up
How do you test for AMD and how many or what percent of people are traceable to a genetic inherited condition
Swab the cheek
80%
What characteristics are required to be a medical surgical nurse
Prioritization, organization, critical thinking, problem-solving
What are the five in nursing priorities from Maslows Hierachy?
Self actualization (hope,growth,spirituality)
Self esteem
Love and belonging
Safety and security
Basic physiological needs
What is the biggest problem with communication
Illusion that it has occurred
What is used as part of effective coping mechanisms and to help deal with stressors
Communication skills
What can happen in a difficult situation when someone has been effective communication skills?
I can make the situation much harder and unrecognized
This is listening to what the client says and attempting to understand the situation from the clients perspective
Active listening
What are the qualities that make communication effective
Compassion, discernment, and trust
This can be an important part of the communication process between the nurse and client if used in a respectful tactful and nonthreatening manner which can help client moved toward self examination and growth
Productive confrontation
The purpose of this includes promoting the personal, spiritual, and psychosocial growth and development of an individual in a supportive and safe environment
Family
Throughout each stage of life the family is confronted with what they can be managed productively
Stressors
What is the nursing process used to help ?
To help guide the nurse in promoting the best outcome
critical thinking and problem-solving be taken to a higher level by incorporating what?
Clarity, accuracy, precision, relevance depth, breadth logic significance, in fairness
This helps/motivates healthcare professionals to maintain and elevate professional standards
Code of ethics
When is nursing informatics used?
Education, research, administration, and nursing practice
Was the purpose of the human genome project?
To sequenced the genome, mapped the location of jeans on all chromosomes and increase our understanding of the human genome
What is the nurses role with a client who has a genetic disorder?
To support the client and family, relate our current facts about the genetic disorder, and refer the client to reliable resources for assistance
How can the nurse be effective with diverse families?
Show acceptance to all types of family units
In these types of families basic human needs are not met and members have poor communication techniques with ill defined roles. Also family members are not treated with equal respect or value
Distressed families
The distraction of the family unit or the start of a pattern of using unhealthy defense mechanisms
Family crisis
What are the three styles of parenting
authoritarian, authoritative and permissive
What type of person will cope the best when faced with the new stresses of parenting?
Someone who can adjust easily too many changes and has a naturally easy-going approach to life
How does a healthy functioning family communicate?
Openly, honestly, kindly, and with a candor in a trusting environment
In some families of poor interaction passed from generation to generation set the stage for what
Dysfunction
Defective communication between the nurse and the client is based on what type of relationship?
A warm and genuine relationship
This is defined as the socially transmitted behavioral patterns, believes, values, custom, lifeways, arts, and all other products of human work and thought characteristics of a population
Culture
This is the process of getting to know oneself personality values and believes
Self aware
This is genetic and includes physical characteristics of among members of the same group such as skin color blood type in here and I color
Race
Developing an awareness of one’s own existence sensations thoughts and environment of those from other backgrounds
Cultural competence
Personal attitudes and not seen things that might be offensive to someone cultural or ethnic background
Cultural sensitivity
This is used as a guide for assessing the culture of a patient
Purnell’s model for cultural competence
What are the three qualities that make a good nurse
Compassion -show empathy
discernment -judge situations well
and trust- honesty and rappor
What is SBAR?
Situation
Back ground
Assessment
Recommendation
What are the eight principles of patient centered care?
Respect for patients preferences
Coordination and integration of care
Information and education
Physical comfort
Emotional support
Involvement of family and friends
Continuity and transition
Access to care
Practice of caring for patients and their families in ways that are meaningful and valuable to the individual patient
Patient centered care
This is a principle of patient centered care of that involves patients in decision making, recognizing their individual with their own unique values and preferences
Respect for patients preferences
What are the three identified areas in which care coronation can reduce feelings of vulnerability? In patient centered care
Coordination of clinical care, coordination of support services, coordination of frontline patient care
Some patients express that they feel like they are not being completely informed about their condition or prognosis. What Type of communication can we use as a nurse to counter this fear?
Information on clinical status, progress and prognosis
Information on processes of care
Information to facilitate self-care and health promotion
Physical comfort has a significant impact on a patient experience, what are the three areas reported most important to patients?
Pain management, assistance with activities of daily living needs, hospital surroundings and environment
What should nurses be paying attention to when it comes to emotional support, fear, and Anxiety in patients?
Anxiety over physical status, treatments and prognosis
Anxiety over the impact of the illness on themselves and family
Anxiety over the financial impact of illness
How should the nurse involve family and friends in patient care?
Provide accommodations for family and friends,
involve family and close friends in decision-making,
support family members as caregivers,
recognize the needs of family and friends
What are patients often concerned about when speaking of their ability to care for themselves after discharge? (Continuity and transition)
Information regarding medications, physical limitations, dietary needs,
Coordination and planning of ongoing treatment and services
Providing information regarding access to clinical, social, physical and financial support on a continuing basis
What do patients need to know about their access to care?
They need to know if they can access care when it is needed:
Access the location of hospitals, clinics and physician offices
Availability of transportation
scheduling appointments
Availability of appointments
Accessibility to specialist or specialty services when A referral is made
Clear instructions provided on when and how to get referrals
What is patient centered care based on?
Understanding, and sound nursing judgment
Universal expectations to support and enhance safety in all aspects of patient care
NPSG
Nurse to patient communication
Therapeutic
QSEN competency to -help provide quality of care
Knowledge
Variety of different cultural ethnic backgrounds
Diversity
I shared foundation or ancestery of groups who share the same values and believes
Ethnic city
Verbal communication which can impede communication at times
Language
This is the communication between healthcare providers regarding patient status
SBAR
Incorrectly applying characteristics to groups
Stereotyping
What is the best way A nurse can reach patient care expectations?
Positive attitude
The most important QSEN competency?
Safety
A specialty that integrates nursing science, computer science and information science to manage and communicate data information knowledge and wisdom in nursing practice
It is used in education, research, administration, and nursing practice
Informatics
What are the characteristics of a medical surgical nurse
Prioritization ,organization, critical thinking, problem-solving
What are the roles of the medical surgical nurse?
Director of care, caregiver, educator, client advocate
What do nurses need to be knowledgeable in because of the continuing changes of the healthcare delivery system
Evidence-based practice, quality and safety competencies, informatics, and genetics
What does CAB stand for
Circulation airway breathing
Are the categories of communication better essential to basic human social interaction
Verbal, nonverbal, electronic
Interviewing, patient education, conflict management, effective listening are all what type of communication
Therapeutic
S bar, documentation, electric records, and a shift reports are examples of what type of communication
ProFessional communication
Culture can be adapted or changed true or false?
True
What is one vital skill and coping with health and other life crisis
Good communication
Active listening, honest, security and acceptance, flexibility, openness, encouraging, sense of fairness, trust, love and kindness, respect is all characteristics of what type of family?
communicative traits in healthy families
Lack of trust, suppression of emotion, angry outburst, verbal abuse, dishonesty, negativity, denial, hidden agendas, desire to always be right our communicative traits and what type of families?
Distressed families
In some families, what patterns of interactions maybe passed from generation to generation that set the stage for dysfunctional family?
Abuse, authoritarian, or mental illness
What are four major traits or tendencies seen very commonly and distressed families?
Passive aggressiveness, defensiveness, power struggles, conflict avoidance
Negative or aggressive feelings that are expressed in directly such as pouting, giving the cold Shoulder, giving the silent treatment, stubbornness, intentional forgetfulness
Passive aggressive tendencies
This behavior seen one a person quickly assumes others are blaming or confronting them
Defensiveness
Ignoring uncomfortable confrontations or disagreements in order to not risk an argument
Conflict avoidance
If a patient has unresolved concerns what are some good ways to get them to talk about what they may be feeling?
Active listening skills -
What else is on your mind?
Are you still concerned about?
There are many things to consider. What else do you Feel needs to be discussed or explored?
What is used when somebody has a lack of compliance
Productive confrontation
What are some special communicative challenges for nurses
Not enough time spent with each client,
attempting to guess or judge what the problem may be in order to save time,
not taking the time to observe important nonverbal cues the client may have,
making assumptions,
Giving quick advice rather than offering to discuss other options,
jumping to conclusions about with the clients needs are,
clichés
What are some important things to remember when communicating with people from different cultures?
Don’t make Assumptions that everyone wants to be treated the way you want to be treated (like being told bad news)
Different cultures Are different when it comes to comfort of eye iContact, touch, personal space when communicating
Determine what the client who they wish to be involved when discussing important matters (many cultures like the entire family involved)
Not all cultures view Western medicine has the final authority. Discuss with your client what alternative forms of medicine they may be using.
