Therapeutic Communication Flashcards
Sender or encoder
Initiator of message
Encoding
Selecting words, gestures, tone of voice
Message
Actual information that is sent, verbal or nonverbal, content matter, substance
Channel
Medium used to send the message:
face-to-face, written pamphlets, telephone or text messages, Internet
Receiver or decoder
Person to whom the messages sent, uses a variety of senses to decode the message
Feedback
Interpreting and reacting to the message, evidence that the intended message has been received
Attending
Involve facing the other person squarely, adopting an open pasture, leaning forward, maintaining eye contact
Clarifying
Method of eliciting clear or more specific information.
Requesting more specific information
4 phases of the therapeutic helping relationship
Pre-interaction/ preparatory
introductory,
working,
termination
Introductory phase consists of three stages:
Opening the relationship,
clarifying the problem,
establish a structure and form of the contact
Working phase of therapeutic relationship
2 stages:
1-Exploration and understanding of thoughts and feelings
2-Facilitating the clients decision making and supporting appropriate action
Preintroduction phase / preparatory phase
Nurse has basic demographic and illness data on patient but has not met them
Nurse sets up room to ensure privacy and comfort
Termination phase of a therapeutic relationship
Concludes ideally when the client is having a positive attitude and feelings capable of functioning independently in the future
Three domains of learning as identified by Bloom in 1956
Cognitive domain is involved in thinking
Affective domain is involved with emotional responsiveness
Psychomotor domain addresses motor skills
Basic principles of learning three principles To be considered
The clients motivation to learn,
the clients readiness to learn,
and the learning environment
Basic principles of teaching-
Steps in planning a specific education or learning class
establish priorities- by either client’s ranking or by Maslows needs
schedule and plan
Write educational objectives,
Guide content with objectives
Select appropriate teaching methods
Evaluation
Learning Objectives are best when they contain outcomes.
What are 4 parts of and objective?
1- patient behavior- what will the client do?
2- observable behavior- “draw up right amount of insulin using proper technique”
3-modifier- if necessary.
4- time period- “by the end of this session”
General adaptation syndrome GAS or stress syndrome
Occurs with the release of certain hormones and subsequent changes in the structure and chemical composition of the body.
G.I. tract, the adrenal gland, and lymphatic structures.
Local adaptation syndrome LAS
The body can react locally as in one organ or part of the body reacts alone. Can be inflammation
Three stages of GAS and LAS
Alarm Reaction
resistance
exhaustion
Alarm reaction
Initial reaction of the body and alerts the body’s defenses divided into two parts:
Shock phase
Countershock phase
Alarm reaction -chemical reaction in body
Stressors stimulate sympathetic nervous system which stimulates the hypothalamus.
Hypothalamus releases Corticotropin releasing hormone which stimulates the anterior pituitary gland to release adrenocorticotropic hormone.
Adrenal medulla releases epinephrine and norepinephrine
Alarm reaction- body responses to epinephrine (5)
1- increased myocardial contractility. Increase cardiac output and blood flow to active muscles
2- bronchial dilation-allows increased oxygen intake
3- increase cellular metabolism
4- Increased blood clotting
5- Increased fat mobilization to provide energy into synthesize other compounds
Principal effect of norepinephrine
Decreased blood to the kidneys and increased secretion of renin.
Stage of resistance (stage 2 of GAS)
Body’s adaptation takes place
Body attempts to cope with stressor and limit it to the smallest area of body to deal with it
Stage of exhaustion
3rd stage of GAS
Adaptation cant be maintained
NANDA -I approved nsg dx that address therapeutic communication: (4)
1- readiness for enhanced communication
2-impaired verbal communication,
3- impaired social interaction,
4-ineffective health maintenance
Identify NANDA - I approved nursing diagnoses that address stress and anxiety (6)
1- Anxiety, 2-ineffective coping, 3-ineffective denial, 4-defensive coping, 5-compromised family coping, 6-decisional conflict
Identify NANDA-I approved Nursing diagnoses that address teaching and learning (3)
1-Readiness for enhanced coping,
2-ineffective health maintenance, 3-readiness for enhanced Health management
Which phase of nursing interview (therapeutic relationship) does the nurse gather all info for the subjective database?
Working phase
Which phase of nursing interview does the nurse prepare the patient and environment for interview?
Preparatory phase
Which phase of nursing interview sets tone for the rest of the interview?
Introductory phase
Which phase of patient interview does the nurse read past and current records?
Preparatory
Which phase of patient interview does the nurse gather all info needed to form the subjective database?
Working phase
Which phase of patient interview does the nurse assess the patient’s comfort and ability to participate in interview?
Introductory phase
Identifies patient weaknesses and strengths, potential and actual health problems, and health risks.
Nursing history
Meaning of “adaptability” as used in communication.
Adjusting tone and speech to match facial expression.
Zones of proximity and their distances. (Proxemics)
Intimate- body contact. Used for procedures.
Personal- 1.5-4 feet. Used to converse with patient
Social- 4-12 feet
Public-12-15 feet.requires loud voice.
What is a process recording?
Word for word accounting of conversation.
Appropriate for evaluating effectiveness of a teaching session.
Bandura’s theory
Imitation
Bandura claims that most learning comes from observation and instruction.
Lewin’s theory of cognitivism
What is it and what are the four types of changes involved?
Theory of learning
1-Cognitive structure
2-Sense of belonging to the group
3-Motivation
4-voluntary muscle control
What is the most negative factor affecting a nurse his credibility?
Communication breakdown
The best communicator is the nurse who:
Thinks critically
Difference between types of communication: intrapersonal interpersonal transpersonal nonverbal
intrapersonal :self instructions, mental rehearsal
interpersonal: face to face with someone else
transpersonal: occurs within spiritual practice (prayer)
nonverbal: all five senses, but not spoken or written
