Test 1 Blueprint (4) Flashcards
What are the 4 stages of the relationship?
(POW-T)
1) Pre-interaction
2) Orientation (Introductory)
3) Working
4) Termination
Which r’ship phase begins the initial assessment and allows nurse to become aware of personal responses to knowledge about the client?
Pre-interaction
What is the goal of the pre-interaction phase?
Examine one’s feelings about encounter
Building trust and rapport take place in the _____ phase.
orientation
Which stage allows the identification of the client’s strengths and limitations and allows nurse/client to devise nursing diagnoses and set goals/plans of action?
Orientation
What is the goal of the orientation phase?
Establish trust and contract development
What is the goal of the working phase?
Promote client change
The therapeutic work of the relationship is done in the _____ phase.
working
The termination phase begins upon ____.
admission
What are some reasons a relationship may be terminated?
- mutual goals are met
- client discharged
- end of rotation
- too difficult for client and/or nurse
What is the goal of the termination phase?
Evaluate goal attainment and ensure therapeutic closure.
What should we remember regarding termination?
- Set a plan for continuing care during stressful events (phone #)
- Explore client’s feelings about termination of relationship
- Instill confidence in client’s growth “I feel confident that you can be discharged…”
Define transference:
when the client unconsciously displaces or transfers to the nurse feelings formed toward a person from his/her past.
How should we address transference?
- Not always necessary to terminate relationship
- Help pt sort out these emotions
- Assign correct meaning to the r’ships based on present circumstances, not the past
_____ refers to the nurse’s behavioral and emotional responses to the client.
Countertransference
When does countertransference negatively effect the therapeutic relationship?
The nurse shows favoritism to the client or does anything that hinders the r/ship.
What should the nurse do in situations where countertransference is observed?
- Terminate r/ship only if necessary
- Identify misplaced feelings and work through them
- Evaluate sessions with client
What are 2 responses to stress?
Anxiety & Grief
List Peplau’s 4 levels of anxiety.
1) Mild
2) Moderate
3) Severe
4) Panic
What is positive about mild anxiety?
Heightened perception
Enhanced learning
Increased motivation
T/F: Mild anxiety is seldom a problem.
True
Which level of anxiety is characterized by:
- reduced alertness
- decreased attention span
- decreased concentration
- increased restlessness, HR, BP, etc
- feeling of discontent
- some impairment in r’ships
Moderate
Which level of anxiety is characterized by:
- greatly diminished perceptual field
- extremely limited attention span
- inability to concentrate or problem solve
- physical symptoms (HA, trembling, pain, insomnia)
- feelings of dread/loathing
- total focus on self
Severe
Which level of anxiety is characterized by:
- inability to focus on even one detail
- inability to concentrate
- inability to comprehend even simple directions
- immobility or purposeless hyperactivity
- inability to verbalize or incoherence
- terror
- may be a break with reality
Panic
Everyone has a _____ _____.
breaking point
Acute = \_\_\_\_ anxiety Chronic = \_\_\_\_ anxiety
state
trait
The greater the anxiety, the greater the risk for ____ and ____ and ____ in relating to others.
hallucinations
delusions
impairment
What are the 5 stages of grief (Kuebler Ross)?
(DABDA)
1) Denial
2) Anger
3) Bargaining
4) Depression
5) Acceptance
Do individuals always move through the stages of grief linearly?
No, they can move back and forth.
What is grief that occurs while anticipating an expected event?
Anticipatory grief
How is anticipatory grief helpful?
It allows the person to have time to prepare for the loss.
What is it called when an individual is unable to progress through the stages of grieving to resolution?
Maladaptive or complicated grief
What are 3 types of maladaptive grief?
1) prolonged
2) delayed
3) distorted
Prolonged grief: an intense ____ with ____ of the lost entity for ____ after the loss has occurred.
preoccupation
memories
years
Delayed grief: individual becomes ____ in the ____ stage of grieving.
fixed
denial
Distorted grief: fixed in the ____ stage of grief.
anger
What are 4 factors that contribute to prolonged grieving?
1) Ambivalence of r’ship; unfinished business
2) Guilt: feelings of anger toward self; feelings of contribution to death
3) The # of recent losses (especially for elderly)
4) Bereavement overload: accumulation of grief
