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Fundamentals in Nursing - Lecture > Therapeutic Communication > Flashcards

Therapeutic Communication Flashcards

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1
Q

Critical nursing skill used to gather data, teach and persuade, express caring and comfort

A

Communication

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2
Q

Interchange of information, ideas, or feelings between two or more people

A

Communication

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3
Q

Communication
Process:

A
  • To influence
  • To obtain information
  • Includes verbal and nonverbal methods
  • Includes self-talk
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4
Q

The Communication Process

A

Sender
Message
Receiver
Response

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5
Q

Source-encoder

A

Sender

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6
Q

A person or group who wishes to communicate a message to another

A

Sender

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7
Q

Selecting signs, symbols to transmit

A

Encoding

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8
Q

The message itself

A

Message

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9
Q

What is said or actually written

A

Message

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10
Q

The decoder

A

Receiver

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11
Q

Relating message perceived to receiver’s storehouse to sort out the meaning

A

Receiver

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12
Q

The listener

A

Receiver

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13
Q

Feedback

A

Response

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14
Q

Message that receiver returns to sender

A

Response

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15
Q

Modes of Communication

A

Verbal
Nonverbal
Electronic

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16
Q

Uses spoken or written word

A

Verbal Communication

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17
Q

Uses gestures, facial expressions, touch, and other forms

A

Nonverbal Communication

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18
Q

Makes up majority of communication

A

Nonverbal Communication

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19
Q

Technology such as e-mail

A

Electronic Communication

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20
Q

sometimes conveys meaning more effectively than words

A

Nonverbal Communication

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21
Q

Modes of Communication
Verbal communication

A
  • Pace and intonation (rise and fall of the voice in speaking)
  • Simplicity
  • Clarity and brevity (being brief, concise expression)
  • Timing and relevance
  • Adaptability
  • Credibility
  • Humor
  • Consider client’s perceptions
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22
Q

rise and fall of the voice in speaking

A

Intonation

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23
Q

being brief, concise expression)

A

Brevity

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24
Q

Modes of Communication
Nonverbal communication

A
  • Personal appearance
  • Posture and gait
  • Facial expression
  • Gestures
  • Consider cultural differences
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25
Q

Modes of Communication
Electronic communication
Advantages:

A
  • Fast, efficient
  • Provides record
  • Can improve communication and continuity of care
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26
Q

Modes of Communication
Electronic communication
Disadvantages:

A
  • Risk to client confidentiality
  • Socioeconomics
  • May not enhance communication with all
  • Avoid when information is urgent to client’s health, highly confidential, or potentially distressing or confusing
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27
Q

Factors Influencing the Communication Process

A
  • Development
  • Gender
  • Values and perceptions
  • Personal space
  • Territoriality
  • Roles and relationships
  • Environment
  • Congruence
  • Interpersonal attitudes
  • Boundaries
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28
Q
  • Knowledge of client’s stage
  • Varies across life span
A

Development

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29
Q
  • Girls seek confirmation, minimize differences, and establish intimacy.
  • Boys establish independence and negotiate status within group.
A

Gender

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30
Q
  • Standards that influence behavior
  • Personal view of an event
A

Values and perceptions

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31
Q

Personal space

A
  • Intimate
  • Personal
  • Social
  • Public
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32
Q

Intimate

A

touching to 1-1/2 feet

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33
Q

Personal

A

1-1/2 to 4 feet

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34
Q

Social

A

4 to 12 feet

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35
Q

Public

A

12 to 15 feet

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36
Q

Space, things that individual considers as belonging to self

A

Territoriality

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37
Q

Between sender and receiver

A

Roles and relationships

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38
Q
  • Most effective communication in comfortable environment
  • Privacy
A

Environment

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39
Q

Verbal and nonverbal aspects of message match

A

Congruence

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40
Q
  • Caring and warmth
  • Respect
A

Interpersonal attitudes

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41
Q

Limits crucial to nurse–client relationship

A

Boundaries

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42
Q
  • Similar to baby talk
  • Patronizing to older adults
A

Elderspeak

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43
Q

Therapeutic Communication Techniques

A
  • Using silence
  • Providing general leads
  • Being specific and tentative
  • Using open-ended questions
  • Using touch
  • Restating or paraphrasing
  • Seeking clarification
  • Perception checking or seeking consensual validation
  • Offering self
  • Giving information
  • Acknowledging
  • Clarifying time or sequence
  • Presenting reality
  • Focusing
  • Reflecting
  • Summarizing and planning
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44
Q

Accepting pauses or silences that may extend for several seconds or minutes without interjecting any verbal response

A

Using silence

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45
Q

Sitting quietly (or walking with the client) and waiting
attentively until the client is able to put thoughts and
feelings into words

A

Using silence

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46
Q

Using statements or questions that (a) encourage the
client to verbalize, (b) choose a topic of conversation,
and (c) facilitate continued verbalization

A

Providing general leads

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47
Q

“Can you tell me how it is for you?”

A

Providing general leads

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48
Q

“Perhaps you would like to talk about . . . ”

A

Providing general leads

49
Q

“Would it help to discuss your feelings?”

A

Providing general leads

50
Q

“Where would you like to begin?”

A

Providing general leads

51
Q

“And then what?”

A

Providing general leads

52
Q

Making statements that are specific rather than general
and tentative rather than absolute

A

Being specific and tentative

53
Q

“Rate your pain on a scale of 0 to 10.” (What type of statement?)

A

specific statement

54
Q

“Are you in pain?” (What type of statement?)

A

general statement

55
Q

“You seem unconcerned about your diabetes.” (What type of statement?)

A

(entative statement)

56
Q

Asking broad questions that lead or invite the client
to explore (elaborate, clarify, describe, compare, or
illustrate) thoughts or feelings

A

Using open-ended questions

57
Q

specify only the topic to be discussed and invite answers that are longer than one or two words.

A

Using open-ended questions

58
Q

“I’d like to hear more about that.”

A

Using open-ended questions

59
Q

“Tell me more . . . ”

A

Using open-ended questions

60
Q

“How have you been feeling lately?”

A

Using open-ended questions

61
Q

“What brought you to the hospital?”

A

Using open-ended questions

62
Q

“What is your opinion?”

A

Using open-ended questions

63
Q

“You said you were frightened yesterday. How do you feel now?”

A

Using open-ended questions

64
Q

Providing appropriate forms of touch to reinforce caring feelings. Because tactile contacts vary considerably
among individuals, families, and cultures, the nurse
must be sensitive to the differences in attitudes and
practices of clients and self

A

Using touch

65
Q

Putting an arm over the client’s shoulder. Placing your
hand over the client’s hand.

A

Using touch

66
Q

Actively listening for the client’s basic message and
then repeating those thoughts or feelings in similar
words. This conveys that the nurse has listened and
understood the client’s basic message and also offers
clients a clearer idea of what they have said.

A

Restating or paraphrasing

67
Q

Client: “I couldn’t manage to eat any dinner last night—
not even the dessert.”
Nurse: “You had difficulty eating yesterday.”
Client: “Yes, I was very upset after my family left.”

A

Restating or paraphrasing

68
Q

A method of making the client’s broad overall meaning
of the message more understandable. It is used when
paraphrasing is difficult or when the communication is
rambling or garbled.

A

Seeking clarification

69
Q

“I’m puzzled.”
“I’m not sure I understand that.”

A

Seeking clarification

70
Q

Would you please say that again?”
“Would you tell me more?”

A

Seeking clarification

71
Q

“I meant this rather than that.”
“I’m sorry that wasn’t very clear. Let me try to explain
another way.

A

Seeking clarification

72
Q

A method similar to clarifying that verifies the meaning
of specific words rather than the overall meaning of a
message

A

Perception checking or seeking consensual validation

73
Q

Client: “My husband never gives me any presents.”
Nurse: “You mean he has never given you a present for
your birthday or Christmas?”
Client: “Well—not never. He does get me something for
my birthday and Christmas, but he never thinks of
giving me anything at any other time.”

A

Perception checking or seeking consensual validation

74
Q

Suggesting one’s presence, interest, or wish to understand the client without making any demands or
attaching conditions that the client must comply with to
receive the nurse’s attention

A

Offering self

75
Q

“I’ll stay with you until your daughter arrives.”

A

Offering self

76
Q

“We can sit here quietly for a while; we don’t need to
talk unless you would like to.”

A

Offering self

77
Q

“I’ll help you to dress to go home, if you like.”

A

Offering self

78
Q

Providing, in a simple and direct manner, specific factual information the client may or may not request.
When information is not known, the nurse states this
and indicates who has it or when the nurse will obtain it

A

Giving information

79
Q

“Your surgery is scheduled for 11 a.m. tomorrow.”

A

Giving information

80
Q

“You will feel a pulling sensation when the tube is
removed from your abdomen.”

A

Giving information

81
Q

“I do not know the answer to that, but I will find out
from Mrs. King, the nurse in charge.”

A

Giving information

82
Q

Giving recognition, in a nonjudgmental way, of a change
in behavior, an effort the client has made, or a contribution to a communication. May be with
or without understanding, verbal or nonverbal.

A

Acknowledging

83
Q

“You trimmed your beard and mustache and washed
your hair.”

A

Acknowledging

84
Q

“I notice you keep squinting your eyes. Are you having
difficulty seeing?”
“You walked twice as far today with your walker.”

A

Acknowledging

85
Q

Helping the client clarify an event, situation, or happening in relation to time

A

Clarifying time or sequence

86
Q

Client: “I vomited this morning.”
Nurse: “Was that after breakfast?”
Client: “I feel that I have been asleep for weeks.”
Nurse: “You had your operation Monday, and today is
Tuesday.”

A

Clarifying time or sequence

87
Q

Helping the client to differentiate the real from the unrea

A

Presenting reality

88
Q

“That telephone ring came from the program on
television.”
“Your magazine is here in the drawer. It has not been
stolen.”

A

Presenting reality

89
Q

Helping the client expand on and develop a topic of
importance. It is important for the nurse to wait until
the client finishes stating the main concerns before
attempting to focus. The focus may be an idea or a
feeling; however, the nurse often emphasizes a feeling to help the client recognize an emotion disguised
behind words.

A

Focusing

90
Q

Client: “My wife says she will look after me, but I don’t
think she can, what with the children to take care
of, and they’re always after her about something—
clothes, homework, what’s for dinner that night.”
Nurse: “Sounds like you are worried about how well she
can manage.”

A

Focusing

91
Q

Stating the main points of a discussion to clarify the
relevant points discussed. This technique is useful at
the end of an interview or to review a health teaching
session. It often acts as an introduction to future care
planning.

A

Summarizing and planning

92
Q

Directing ideas, feelings, questions, or content back to
clients to enable them to explore their own ideas and
feelings about a situation

A

Reflecting

93
Q

Client: “What can I do?”
Nurse: “What do you think would be helpful?”
Client: “Do you think I should tell my husband?”
Nurse: “You seem unsure about telling your husband.”

A

Reflecting

94
Q

“During the past half hour, we have talked about . . . ”
“Tomorrow afternoon, we may explore this further.”

A

Summarizing and planning

95
Q

“In a few days, I’ll review what you have learned about
the actions and effects of your insulin.”
“Tomorrow, I will look at your feeling journal.”

A

Summarizing and planning

96
Q

Barriers to Communication

A

Stereotyping
Agreeing and disagreeing
Being defensive
Challenging
Probing
Testing
Rejecting
Changing topics and subjects
Unwarranted reassurance
Passing judgment
Giving common advice

97
Q

Offering generalized and oversimplified beliefs about
groups of people that are based on experiences too limited to be valid. These responses categorize clients and
negate their uniqueness as individuals.

A

Stereotyping

98
Q

Similar to judgmental responses, agreeing and disagreeing imply that the client is either right or wrong and that
the nurse is in a position to judge this. These responses
deter clients from thinking through their position and may
cause a client to become defensive.

A

Agreeing and disagreeing

99
Q

Attempting to protect an individual or healthcare services
from negative comments. These responses prevent the
client from expressing true concerns. The nurse is saying,
“You have no right to complain.” Defensive responses
protect the nurse from admitting weaknesses in healthcare services, including personal weaknesses.

A

Being defensive

100
Q

“Two-year-olds are brats.”
“Women are complainers.”
“Men don’t cry.”
“Most people don’t have any pain after this type of surgery.”

A

Stereotyping

101
Q

Client: “I don’t think Dr. Broad is a very good doctor. He
doesn’t seem interested in his clients.”
Nurse: “Dr. Broad is head of the department of surgery
and is an excellent surgeon.”

A

Agreeing and disagreeing

102
Q

Client: “Those night nurses must just sit around and talk
all night. They didn’t answer my light for over an hour.”
Nurse: “I’ll have you know we literally run around on
nights. You’re not the only client, you know.”

A

Being defensive

103
Q

Giving a response that makes clients prove their statement or point of view. These responses indicate that the
nurse is failing to consider the client’s feelings, making the
client feel it is necessary to defend a position

A

Challenging

104
Q

Client: “I felt nauseated after that red pill.”
Nurse: “Surely you don’t think I gave you the wrong pill?”
Client: “I feel as if I am dying.”
Nurse: “How can you feel that way when your pulse is 60?”
Client: “I believe my husband doesn’t love me.”
Nurse: “You can’t say that; why, he visits you every day.”

A

Challenging

105
Q

Asking for information chiefly out of curiosity rather than
with the intent to assist the client. These responses are
considered prying and violate the client’s privacy. Asking
“why” is often probing and places the client in a defensive
position.

A

Probing

106
Q

Client: “I was speeding along the street and didn’t see the
stop sign.”
Nurse: “Why were you speeding?”
Client: “I didn’t ask the doctor when he was here.”
Nurse: “Why didn’t you?”

A

Probing

107
Q

Asking questions that make the client admit to something.
These responses permit the client only limited answers
and often meet the nurse’s need rather than the client’s.

A

Testing

108
Q

“Who do you think you are?” (forces people to admit their
status is only that of client)

A

Testing

109
Q

“Do you think I am not busy?” (forces the client to admit
that the nurse really is busy)

A

Testing

110
Q

Refusing to discuss certain topics with the client. These
responses often make clients feel that the nurse is rejecting not only their communication but also the clients
themselves.

A

Rejecting

111
Q

“I don’t want to discuss that. Let’s talk about . . . ”
“Let’s discuss other areas of interest to you rather than
the two problems you keep mentioning.”

A

Rejecting

112
Q

Directing the communication into areas of self-interest
rather than considering the client’s concerns is often a
self-protective response to a topic that causes anxiety.
These responses imply that what the nurse considers
important will be discussed and that clients should not
discuss certain topics.

A

Changing topics and subjects

113
Q

“I can’t talk now. I’m on my way for a coffee break.”
Client: “I’m separated from my wife. Do you think I should
have sexual relations with another woman?”
Nurse: “I see that you’re 36 and that you like gardening.
This sunshine is good for my roses. I have a beautiful
rose garden.”

A

Changing topics and subjects

114
Q

Using clichés or comforting statements of advice as a
means to reassure the client. These responses block the
fears, feelings, and other thoughts of the client.

A

Unwarranted reassurance

115
Q

“You’ll feel better soon.”
“I’m sure everything will turn out all right.”
“Don’t worry.”

A

Unwarranted reassurance

116
Q

Giving opinions and approving or disapproving responses,
moralizing, or implying one’s own values. These
responses imply that the client must think as the nurse
thinks, fostering client dependence

A

Passing judgment

117
Q

“That’s good (bad).”
“You shouldn’t do that.”
“That’s not good enough.”
“What you did was wrong (right).”

A

Passing judgment

118
Q

Telling the client what to do. These responses deny the
client’s right to be an equal partner. Note that giving
expert rather than common advice is therapeutic.

A

Giving common advice

119
Q

Client: “Should I move from my home to a nursing home?”
Nurse: “If I were you, I’d go to a nursing home, where
you’ll get your meals cooked for you.”

A

Giving common advice

Fundamentals in Nursing - Lecture (10 decks)

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