Therapeutic Communication & Therapeutic Relationships: Exam 1 Flashcards

1
Q

Trust associated behaviors include:

A

-caring
-honesty
-keeping promises
-listening

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2
Q

Trust builds when…

A

-client is confident in the nurse
-nurses presence conveys integrity and reliability

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3
Q

when words and actions match. the nurse needs to exhibit congruent behaviors to build trust with the client. (ex: im really glad you’re taking part today!) seeing is believing!

A

Congruence

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4
Q

mentally ill clients can detect when someone is exhibiting dishonesty or artificial behavior. (ex. talking over him/her, assuring them that everything will be alright.)

A

Genuine interest

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5
Q

perceive the meaning or feelings of the pt and to communicate that understanding to the client. considered an essential skill a nurse must develop to provide high-quality, compassionate care. (ex: empathy- I see you are sad, how can I help. sympathy- I feel so sorry for you)

A

Empathy

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6
Q

Not becoming upset or responding negatively to a clients behavior. NOT acceptance of the negative behavior, but acceptance of the person as worthy.

A

Acceptance

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7
Q

unconditional, non-judgement attitude. Appreciate the patient as a unique worthwhile human being. Can respect them no matter their behavior, background, or life-style. (Ex: you are awesome.)

A

Positive regard

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8
Q

Developing an understanding of ones own values, belief, thoughts, feelings, attitude, motivations, prejudices, strengths, and limitations and how these qualities affect others is __________________________.

A

self-awareness

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9
Q

As you learn self-awareness, you as the nurse can begin to use aspect of their personality, experiences, values, feelings, intelligence, needs, coping skills, and perceptions to establish relationships with the client. This is called ______________________.

A

therapeutic use of self

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10
Q

The Johari Window: 1-4

A

1 = OPEN
2 = BLIND
3 = HIDDEN
4=UNKNOWN

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11
Q

known to self and to others

A

The Johari Window: OPEN

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12
Q

not known to self but known to others

A

The Johari Window: BLIND

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13
Q

known to self but not others

A

The Johari Window: HIDDEN

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14
Q

not known to self or others

A

The Johari Window: UNKNOWN

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15
Q

The Johari Window: GOAL?

A

to moves from quadrants 2, 3, & 4 to quadrant 1

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16
Q

ways one person expects another to behave as a roadblock to the formation of an authentic relationship.

A

Perceptions

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17
Q

Patterns of Knowing:

A

empirical, personal, ethical, aesthetic

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18
Q

derived from the science of nursing

A

Empirical Knowing

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19
Q

derived from life experiences

A

Personal Knowing

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20
Q

derived from the moral nursing knowledge

A

Ethical Knowing

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21
Q

derived from the art of nursing

A

Aesthetic Knowing

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22
Q

Munhall’s pattern of unknowing

A

The nurse admits to not knowing the patients or patients subjective world.

-opens the way for authentic encounters
-psych nurses, negative preconceptions can adversely affect the therapeutic relationship.

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23
Q

Fundamental Patterns of Knowing

A

-Empiric
-Personal
-aesthetic
-Ethical
-Emancipatory (center)

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24
Q

initiate for the purpose of friendship, socializations, and enjoyment

A

Social Relationship

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25
2 people who are emotionally committed to each other
Intimate Relationship
26
communication skills, understand human behavior and personal strength to enhance pt growth.
Therapeutic Relationships
27
Nursing Theory:
Nursing Theory: 1. assessment 2. diagnose 3. implement 4. evaluate
28
Peplau Theory:
1. orientation 2. identification 3. exploration 4. resolution
29
Orientation Phase:
-meet -establish roles -discuss purpose and parameters of future meetings -Nurse-Client contracts, confidentiality, and self-disclosure -clarify expectations -Identify clients problems
30
Working Phase:
-problems identification: pt identifies issue or concerns -Exploration: examination of feelings/responses and develops better coping skills. (more positive self image, behavior changes, and independence)
31
Blurring of Boundaries:
-When relationship slips into social context -When nurse's needs are met at expense of patient's needs
32
Termination/resolution Phase:
begins when problems are resolved, and ends when relationship has ended.
33
Nurse-Client relationships must remain ...
THERAPERUTIC
34
the process that people use to exchange information
communication
35
consists of words a person uses to speak to one or more listeners
Verbal Communication
36
the behavior that accompanies verbal content
Non-verbal Communication
37
In verbal communication you have...
content context includes: time and physical, social, emotional, and cultural environments
38
the literal words that a person speaks
Verbal Communication: Content
39
the environment in which communication occurs
Verbal Communication: Context
40
in non-verbal communication you have...
process
41
all nonverbal messages that the speaker uses to give meaning and context to the message
Non-Verbal Communication: Process
42
Types of Non-Verbal Communication:
posture body language eye contact blinking tone of voice facial expressions smell time personal presentation gestures pitch of voice
43
verbal and nonverbal signals endorses each other (ex: somebody who says that he is unhappy and weeps)
Congruent Message
44
verbal and non-verbal expressed are contradictory (ex: somebody who says that he is happy and weeps)
Incongruent Message
45
_______________ signals have a stronger impact than _________ signals
non-verbal verbal
46
An interpersonal interaction between the nurse and the client Focuses on client specific needs Helps the nurse understand and empathize with the client's experiences Encompasses goals that facilitate the nursing process Is needed to effectively meet the standards of client care
Therapeutic Communication
47
Goals of Therapeutic Communication:
-Establish therapeutic relationship -Identify patient's most important concerns -Assess patient's perceptions -Facilitate patient's expression of emotions -Teach patient, family necessary self-care skills -Recognize patient's needs; -Implement interventions to address patient's needs -Guide patient toward acceptable solutions
48
concentrating exclusively on what the patient says
Active Listening
49
watching non-verbal actions as the patient communicates
Active Observation
50
Active Listening and Active Observations: This helps the nurse...
-recognize the most important issue -know what questions to ask -use therapeutic communication techniques -prevent jumping to conclusions -objectively respond
51
the words are explicit and need no interpretation
Concrete Message
52
unclear patterns of words that often contain figures of speech that are difficult to interpret
Abstract Message
53
Concrete Language has meaning that comes _______________________________________________. It portrays things we can picture, feel, smell, and hear. The words "perfume", "spiciness" and "noisy" are all examples of concrete words.
directly from our senses
54
Abstract language on the other has is language that can't be deciphered directly through a sensory pathway. It includes words like "elite" "irony" "symbolism" and "sportsmanship." - term _______________________________.
resistant to instant visualization
55
Effective Communication Techniques:
L-istening B-road openings R-estating C-larification R-eflection F-ocusing S-haring perceptions S-ilence H-umor I-nforming S-uggesting
56
may discourage client from further expression of feelings if client believes the feelings will only be downplayed or ridiculed
Giving Reassurance
57
refusing to consider client's ideas or behavior
Rejecting
58
implies that the nurse has the right to pass judgment on the "goodness" or "badness" of client's behavior
Approving or Disapproving
59
implies that the nurse has the right to pass judgment on whether client's ideas or opinions are "right" or "wrong"
Agreeing or Disagreeing
60
implies that the nurse knows what is best for client and that client is incapable of any self-direction
Giving Advice
61
verbal or nonverbal messages that signal key words or issues for the client
Cues
62
Types of Cues:
Overt Covert
63
clear, direct statements of intent, such as "I want to die"
Overt
64
Vague or indirect messages that need interpretation, such as, "Nothing can help me"
Convert
65
Types of Cues: NOTE... if the nurse suspects ______________ _________ or _________________, use a yes, no question to elicit a clear response.
Self-harm Suicide
66
Facial Expressions:
Expressive Impassive Confusing
67
portrays the person's moment-by-moment thoughts, feelings, and needs
Expressive
68
face is emotionless deadpan expression like a mask
Impassive
69
expression is opposite of what the person wants to convey (feeling angry but smiling)
Confusing
70
Body Language:
Open and Closed Posture
71
sit facing the client with both feet on the floor, knees parallel, hands at the sides and legs uncrossed, demonstrates unconditional positive regard, trust, care, and acceptance
Open-Posture
72
crossed legs or arms folded across the chest, indicates that the interaction might threaten the listener who is defensive or not accepting
Closed-Posture
73
Factors that can Impede Communication:
Internal Factors Sensory/Emotional Factors Verbal Expressions Non-verbal Expressions
74
Factors that can Impede Communication: Sensory/Emotional Factors
-fear -stress, anxiety -pain -mental acuity, brain damage, hypoxia -sight, hearing, speech impairment
75
Factors that can Impede Communication: Environmental Factors
lighting noise privacy distance temperature
76
Factors that can Impede Communication: Verbal Expression
-language barrier -jargon -choice of words/questions -feedback, voice tone
77
Factors that can Impede Communication: Non-verbal Expression
body movement facial expression dress professionalism warmth interest
78
Factors that can Impede Communication: Internal Factors
previous experiences attitudes values cultural heritage religious beliefs self-concept listening habits preoccupations feelings illness
79
_____________________ is desirable but not always possible in therapeutic communication
Privacy The nurse needs to evaluate locations that are most therapeutic for nurse-client interactions
80
the study of distance zones between people during communication
Proxemics
81
Distance Zones:
Intimate (0-18 inch) Personal (18-36 inch) Social (4-12 feet) Public (12-25 feet)
82
5 Types of Touch:
functional/professional social/polite friendship/warmth love/intimacy sexual arousal Comforting and supportive when welcome and permitted Can be possible invasion of intimate and personal space The nurse must evaluate use of touch based on the client's preferences, history, and needs
83
messages often contain more meaning than just spoken words
Meaning
84
Validate with findings from the client's verbal and non-verbal information Assessment focuses on who, what, when, how, and why
Contest
85
Nurse must be aware of their own spiritual beliefs Need to objectivity and non-judgmental attitudes about clients beliefs
Spirituality