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Nurs 1511 > Test #2 > Flashcards

Test #2 Flashcards

1
Q

what the nurse brings to a nurse client relationship

A
  • Client and nurse alike come to the relationship with unique, cognitive, affective, and psychomotor abilities that they use in a mutual way to enhance client well being
  • Nurses are responsible for encouraging this interchange of ideas, values, and skills
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2
Q

Outcome of a good nurse client relationship

A
  • Client satisfaction with the care

- Nurses feel a sense of accomplishment when their interventions have had a positive impact on client health

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3
Q

Components of Nurse Client Relationship

A
  • Trust
  • Empathy
  • Respect
  • Power (balance)
  • Relational intimacy
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4
Q

CNO: standard statements

A

The therapeutic nurse client relationship includes 4 standard statements that describe the nurses accountability:

  • Therapeutic communication
  • Client centered care
  • Maintaining boundaries
  • Protecting the client from abuse
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5
Q

Kinds of abuse

A
  • Neglect (failing to provide the necessities of life)
  • Physical (striking a client or causing discomfort)
  • verbal/emotional (shouting at or insulting a client)
  • Financial (soliciting gifts from a client)
  • Sexual (inappropriately touching a client)
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6
Q

Maintaining Boundaries

A
  • Nurses are responsible for effectively establishing and maintaining the limits or boundaries in the therapeutic nurse client relationship
  • A boundary crossing is the point at which the relationship changes from professional and therapeutic to unprofessional and personal
  • Maintaining and establishing a professional relationship
  • Establishing
    - Self reflection
    - Plan of care
    - Confidentiality
    - Type of relationship
  • Maintaining
    - Constantly reflect on your practice and care
    - Needs of the client are always the focus of your care
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7
Q

co-existing relationship

A

when a nurse has a relationship with a client prior to providing nursing care (friend, family)

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8
Q

Strategies for co-existing and ensuring objectivity and judgement

A
  • Reflecting on your practice
  • Talking with colleagues
  • Team meetings
  • Ethical framework
  • Asking yourself questions after seeing a client
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9
Q

LISTEN

A 
Look at the person
Show Interest
Stop talking...listen
Think about what the person is saying
Empathy
Never assume
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10
Q

FOCUS

A 
Feel
Observe
Connect
Understand
Share
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11
Q

Barriers to therapeutic nurse client relationships

A
  • Anxiety
  • Stereotyping and bias
  • Overinvolvement
  • Under Involvement
  • Violation of personal space
  • Time limitations
  • Cultural issues
  • Gender differences
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12
Q

Bridges to therapeutic nurse client relationships

A
  • Caring and respect
  • Trust and veracity
  • Empathy
  • Mutuality
  • Confidentiality
  • Ethical behaviour
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13
Q

Anxiety: Strategies to Cope

A
  • Slow down breaths
  • Explore medications with a doctor
  • Challenge negative thoughts
  • Talk to someone
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14
Q

reducing client anxiety

A
  • Active listening
  • Honesty and integrity
  • Explain what’s going on clearly
  • Be calm and unhurried
  • Teach deep breathing and other relaxation techniques
  • Using therapeutic touch as appropriate for the client
  • Suggest diversional activities
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15
Q

Safe(r) space

A

safe(r) spaces, means zero tolerance for discrimination, prejudicial behaviour, bullying, harassment, or any other disruptive or negative behaviours

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16
Q

Gender vs Sex

A
  • Sex is typically defined as the biological characterisitcs that describes a person (meaning do they have a penis or vagina)
  • Gender is typically known as the state of being male or female; typically used as reference to social and cultural differences, rather than biological one. It is related to self identity
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17
Q

Gender Identity

A
  • Gender identity is each person’s internal and individual experience of gender
  • It is a person’s sense of being a women, a man, both, neither or anywhere along the gender spectrum
  • A persons gender identity may be the same as or different form their birth assigned sex
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18
Q

Reducing Barriers

A
  • Establish trust
  • Demonstrate caring and empathy
  • Empower the client
  • Recognize and reduce client anxiety
  • Maintain appropriate personal distance
  • Practice cultural sensitivity and work to be multilingual
  • Use therapeutic relationship building activities such as active listening
  • Avoid medical jargon
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19
Q

Steps in the caring process - CARE

A

Connect with your client
Appreciate the client situation
Respond to client needs
Engage the client in collaborative care

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20
Q

what does inclusive health care mean?

A

The practice or policy of including people who might otherwise be excluded or marginalized on the basis of difference such as physical or mental disabilities or belonging to minority groups

21
Q

Communicating with people with disabilities

A

1) Talk directly to the patient, not to anyone else with them - even if the patient has cognitive disabilities or difficult speech
2) Avoid assumptions based on a patient’s condition or disability. For example, if a patient has severe anxiety and presents stomach pain many health care professionals will assume that their stomach pain is due to their anxiety. But this is not necessarily the case
3) Use person first language. For example instead of saying “the MS patient” say “the patient with MS”
4) Repeat back to patients what you understood them to say. Have them repeat your directions or explanations back to you, in their own words
5) Don’t finish patients’ sentences. If a patient has speech that’s difficult to understand, ask them to repeat themselves until you get their meaning

22
Q

culture

A

A complex social concept that encompasses socially transmitted communication styles, family customs, political systems, and the ethnic identity held by a particular group of people

23
Q

communicating with culturally diverse clients

A
  • Pronounce the clients name right
  • Speak clearly and do not rush
  • Avoid assumptions or interpretations without validating
  • Consider adding more time to your n-ct interaction
  • Show interest in learning about the client
  • Seek to learn if there are cultural meanings that guide the clients health practices
  • Ask about cultural practices that can become part of the plan of care
  • Seek permission with physical skills
24
Q

Communication Principles - LEARN

A 
Listen carefully
Explain what the client needs to understand
Acknowledge cultural differences
Recommend what the client should do
Negotiate mutually agreeable strategies
25
Q

cultural awareness

A

recognizing similarities and differences in cultures

26
Q

cultural sensitivity

A

respecting those differences

27
Q

cultural competence

A

skills, knowledge, and attitudes of practitioners

developing practical skills for interacting with people of other cultures in practical ways

28
Q

cultural safety

A

self reflection, leading to empathy and advocacy for clients

29
Q

adverse childhood experiences

A

include all types of abuse and neglect as well as parental mental illness, substance use, divorce, incarceration, and domestic violence

30
Q

health disparities

A

indicators of a relative disproportionate burden of disease on a particular population

31
Q

health inequities

A

point to the underlying causes of the disparities which sit largely outside of the the typically constituted domain of “health

32
Q

communication deficit

A

Impairment in the ability to receive, send, process, and comprehend concepts or verbal, nonverbal, and graphic symbol systems

33
Q

nursing goal

A
  • Maximize client’s ability to successfully communicate and to interact with the health care system to ensure optimal health and quality of life.
  • Nurses have an obligation to interact with all individuals and to make necessary adjustments/accommodations
  • Nurses should get to know patients with unique needs and identify how they perceive the impairment before being able to effectively help them.
  • The inability to communicate effectively is frustrating to clients and may lead to other communication-related problems.
34
Q

communicating with older adults with impaired hearing

A
  • Position self at client’s level
  • Get the client’s attention to start a conversation
  • Use the “better” ear
  • Assist with hearing aids
  • Face the client
  • Speak clearly and slowly—do not shout!
  • Lower the pitch of your voice
  • use hand gestures and signals
  • Look for client non-verbals for understanding
35
Q

sensorineural hearing loss

A

damage to the inner ear or the auditory nerve caused by noise

36
Q

conductive hearing loss

A

sound waves cannot reach the inner ear due to excessive wax (cerumen) buildup, fluid, or a punctured eardrum (tympanic membrane)

37
Q

presbycusis hearing loss

A

Hearing loss associated with aging (65+)

38
Q

Communication Strategies: Vision Challenges

A
  • Introduce yourself
  • Have glasses/contacts located close to the client
  • Use adequate lighting and minimize glare
  • Orient to surrounding and ensure physical safety
  • Get the client’s attention to start a conversation
  • Speak in a normal tone and pitch
  • Explain what you are doing and how long it will take
  • Let the client know you are leaving or moving around
  • Determine clients preferred ways of communicating
  • Use large font if communicating in writing
  • Communicate with respect, caring compassion and patience
39
Q

Aphasia

A

inability to speak

40
Q

expressive aphasia

A

client can understand what is being said but cannot express thoughts or feelings in words

41
Q

receptive aphasia

A

Difficulty receiving and processing written and oral messages

42
Q

global aphasia

A

Client has difficulty with both expressive and receptive language

43
Q

Communication Strategies: Linguistic Challenges

A
  • Assess client’s ability to understand what you are saying
  • Face the patient when speaking
  • Speak slowly with simple sentences
  • Allow extra time for processing and for replying
  • Address one topic and one question at a time
  • Encourage communication efforts
  • May find Yes-No questions easier to answer
  • Use visual cues
  • Encourage alternate means of communication such as
    • Pointing
    • Using pictures
    • Speech generating electronic devices eg. Smart phones, computer software programs
44
Q

Impaired Cognitive Processing

A
  • Understanding involves receiving new information and integrating it meaningfully with prior knowledge
  • Clients with impaired processing ability have to work harder and require more time for conceptual integration.
45
Q

Strategies to Assist the Client with Cognitive Challenges

A
  • Speak slowly use simple sentences
  • Talk and ask about one thing at a time
  • Give clients extra time to process and formulate a response, do not interrupt
  • Avoid long conversations, instead use frequent short talks
  • Praise efforts to communicate
  • Provide regular mental stimulation
  • Help clients to focus on faculties still available to them for communication
  • Use visual cues
  • Make referrals to speech language pathologist and other health care professional
46
Q

Communication with older adults with dementia

A
  • Establish quiet environment
  • Convey respect verbally and non-verbally
  • Use clear, simple messages
  • As one questions at a time
  • Talk to them not to their caregiver/partner
  • Include them in the conversation
  • Give instructions/directions one at a time
    - Give time to respond and be okay with silence
    - Repeat as needed, but don’t persist
    - Don’t ask “Do you remember me?” Gently tell them your name and how you know each other
    - Use touch, smile and gentle redirection
    - Do not confront or argue
47
Q

Communication disabilities can stem from:

A
  • Sedative medication
  • Polypharmacy
  • Mechanical ventilation
  • Isolation
  • Sleep deprivation
  • Disease processes
48
Q

Strategies for treatment related communication disabilities

A
  • Encourage client to display pictures or a simple object from home
  • Orientate the client to environment time and place
  • Ask many questions especially yes and no
  • Frequently provide client with information
  • Reassure client that cognitive and psychological disturbances are common
  • Provide information regarding procedures
  • Provide communication assistive devices, ranging from paper and pencil or communication cards to computerized communication
  • Always assess whether communication is successful
49
Q

Clients who are unresponsive/dying

A
  • Treat as though the client can understand
  • Orient client frequently
  • Provide familiar objects
  • Explain noises, procedures, and equipment
  • Encourage family to interact
  • Utilize technologies to enhance communication

Nurs 1511 (3 decks)

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