Test 6 MH Communication

Question 1

3.Describe how Dr. Hildegard Peplau saw the nurse as.

Answer 1

-Resource person. Provides information.

-Counselor. Helps patients to explore their thoughts and feelings.

-Surrogate. By role-playing or other means, helps the patient to explore and identify feelings from the past.

-Technical support. Coordinates professional services

Question 2

Describe how Dr. Peplau saw the nurse pt relationship.

Answer 2

-Orientation: Patient feels a need and a will to seek out help.

-Identification. Expectations and perceptions about the nurse-patient relationship are identified.

-Exploration: Patient will begin to show motivation in the problem-solving process, but some testing behaviors may be seen; patient may have a need to “test” the nurse’s commitment to his/her individual situation.

-Resolution: Focus is on the patient developing self-responsibility and showing personal growth.

Question 3

5.Describe the major breakthroughs in pharmacologic help for mental illness and when this occurred. What were the first psychotropic medications?

Answer 3

-In 1955, a group of psychotropic medications called phenothiazines was discovered to have the effect of calming and tranquilizing people.

-Chlorpromazine HCI (Thorazine)

-Patients were able to function more independently & by the mid 1950’s & mid
1970’s the # of patients hospitalized w/mental illnesses in the U.S. was cut approx. in half due to the use of psychotropic drugs.

Question 4

9.Describe Aggressive Communication

Answer 4

-Communication that is not self-responsible.

-Aggressive statements most often begin with the word “you.”

-Aggressive communication, like aggressive behavior, is meant to harm another person.

-Aggressive communication can be nonverbal (A person’s tone, vocal pitch, or body language can be aggressive)

-It is a form of the defense mechanism projection, or blaming, and it attempts to put responsibility for the aggressor’s feelings on the other person.

Question 5

10. Describe Assertive Communication

Answer 5

• is self-responsible
• Use “I” messages, expresses the speaker’s thoughts and feelings honestly.

-Keep in mind right to say “no”

Question 6

11. What is “Therapeutic Communication?”

Answer 6

• “Communication between a health care professional and a patient that is aimed at improving the patient’s physical or psychological health and well-being”

• Therapeutic communication is purposeful: Nurses are trying to determine the patient’s needs.

Question 7

13. Give an example of the following blocks to therapeutic communication and its effect on the pt.

False Reassurances/Social Cliches:

Answer 7

• “Don’t worry! = Tells patient his or her concerns are not valid

-Everything will be just fine.” = May jeopardize patient’s trust in nurse

Question 8

Minimizing/Belittling:

Answer 8

“We have all felt that way sometimes.” = Implies that the patient’s feelings are not
special

Question 9

The word why:

Answer 9

-“Why did you refuse your breakfast?” = Patient feels obligated to answer something he or she may not wish to answer or may not be able to answer and Probes in an abrasive way

Question 10

Advising:

Answer 10

• “You should eat more.” = Places a value on the action
• “If I were you, I would take those pills so I would feel better.” = Gives the idea that
  the nurse’s values are the “right” ones and Sounds parental

Question 11

Agreeing or Disagreeing:

Answer 11

-“You were wrong about that.” = Places a “right” or “wrong” on the action

-“I think you’re right.”

Question 12

Give an example of the following blocks to communication and its effect on the pt.

Closed-Ended Questions:

Answer 12

“Can you tell me how you feel?” = Allows a “yes” or “no” answer

“Do you smoke?” = Discourages further exploration of the topic

“Can I ask you a few questions?” = Discourages patient from giving information

Question 13

Providing the answer with the question:

Answer 13

-“Are you afraid?” = Combines a closed-ended question with a solution

-“Didn’t the food taste good?” = Discourages patient from providing his or her own
answers

“Do you miss your mom today?”

Question 14

Changing the subject:

Answer 14

• The patient is asking a question about his/her prognosis, and the nurse, “Did the doctor say anything about discharging you today?” = Discounts the importance of
  the patient’s need to explore personal thoughts and feelings and May be a reflection of the nurse’s own discomfort with this topic

Question 15

Approving/Disapproving:

Answer 15

-“That’s the way to think about it!” = Can sound judgmental

-“Good for you!” = Can set the patient up for failure if the approval or disapproval
does not help; can lower the nurse’s credibility

-“That’s not a good idea.”

Question 16

15. Using the Therapeutic Communication Technique of Reflecting/Repeating/Parroting has what effect on the pt?

Answer 16

-Encourages exploring the meaning of the statement

-Can be irritating if overused

Question 17

24. Describe HIPAA, include who developed it, what it does, what it allows, and what it addresses.

Answer 17

• The Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Joint Commission are intimately involved in documentation and privacy issues.

-Was developed by the Department of Health and Human Services to provide national standards pertaining to the electronic transmission and communication of medical information between patients, providers, employers, and insurers.

-HIPAA allows more control on the part of the patient as to what part of his or her information is disclosed.

-It addresses the security and privacy involved with medical records and how that information is identified and passed between care providers.

Question 18

26. Describe Voluntary Commitment versus Involuntary Commitment.

Answer 18

Involuntary commitment:
-People who need to be hospitalized against their will (this is reserved for those exhibiting behavior that makes them potentially dangerous to themselves or to others).
- Average legal hold is 48-72hrs.

Voluntary commitment:
- patients who are hospitalized for some type of mental illness are there voluntarily; that is, at some point they realized they needed help.
-Patients who agree to voluntary treatment are legally allowed to sign themselves out; however, this is often discouraged by the treatment staff except under certain

Question 19

29. List the different forms of help that each community should offer to people in need, according to the Mental Health Centers Act of 1963.

Answer 19

• Hospital emergency rooms
• Shelters
• Crisis centers
• Social service offices

Question 20

31. Define Ethnicity.

Answer 20

Ethnicitv: defines one’s more personal traits and identifies a person with his or her shared heritage (language, country of origin, skin color).

Question 21

Dietary preferences for Hispanic American

Answer 21

-Rice, corn, tortillas, tropical fruits, vegetables, nuts, legumes, eggs, cheese, seafood, poultry, infrequent sweets & red meat

-Tortillas eaten @ most meals

-Animal protein from ground poultry, pork, goat Veggies often incorporated into the main dish

Question 22

Dietary no-no for the Orthodox Jewish Pt

Answer 22

• Blood by ingestion (blood sausage, raw meat, blood transfusion ok)

-Mixing dairy products & meat dishes at same meal

-Pork

-Predatory fowl

-Shellfish & scavenger fish (shrimp, crab, lobster, escargot, catfish, fish w/fins & scales ok)

-Foods labeled “pareve” are neutral & can be consumed w/milk or meat.

Question 23

32. Give an example of how some cultures view illness. Asian-American;

Answer 23

• yin-yang theory, which promotes the idea that energy forces exist between organisms and objects in the universe.

-the hot/cold theory, which says that diseases should be treated by adding or subtracting heat or cold or dryness or moisture to restore balance.

Question 24

32. Give an example of how some cultures view illness. Native-American

Answer 24

Naturalistic or holistic perspective: espouses that human beings are only one part of nature. Natural balance or harmony is essential for health.

Question 25

33. What is the general rule of thumb when considering cultural issues?

Answer 25

Differences exist within all groups, and nurses are responsible to ask when unsure of certain practices

Question 26

34. Define primary prevention

Answer 26

Primary: prevention of the development of disease in a susceptible or potentially susceptible population (includes health promotion & immunization)

Question 27

34. Define secondary prevent

Answer 27

Secondary: Early diagnosis and treatment to shorten duration and severity of an illness, reduce contagion, and limit complications

Question 28

34. Define tertiary prevention.

Answer 28

Tertiary: Health care to limit the degree of disability or promote rehabilitation in chronic, irreversible disease

Question 29

35. Define Cultural Awareness

Answer 29

Cultural Awareness:
Being conscious of one’s own culturally shaped values, beliefs, perceptions & biases.????

Question 30

Define Cultural Blindness.

Answer 30

Cultural Blindness: is an inability to recognize the values, beliefs, and practices of others because of strong ethnocentric preferences.