Unit 2

Question 1

Therapeutic Relationship

Answer 1

1.The therapeutic relationship is a professional one

2. Relationship is focused solely on helping the patient meet healthcare goals
3. It is time limited.
4. Another difference in the therapeutic relationship is sympathy and empathy. Sympathy means a relationship or an affinity between people or things in which whatever affects one correspondingly affects the other.Empathy is the action of understanding, being aware of, being sensitive to, and vicariously experiencing the feelings, thoughts,

Question 2

Therapeutic Barriers

Answer 2

1. Your personal biases
2. enmeshment. To become enmeshed means to be ensnared or tangled. When this term is used in the context of the nurse patient relationship, it refers to the nurse who becomes overly involved with a patient.
3. Social stigma refers to “the extreme disapproval of (or discontent with) a person on socially characteristic grounds that are perceived, and serve to distinguish them, from other members of a society.
4. environment will greatly affect your ability to develop the nurse-patient relationship. Examples are if the environment is too noisy, if there is no private place to talk, or if the nurse’s workload doesn’t allow adequate time for a 1:1.

Question 3

Stages of nurse patient relationship

Answer 3

1. pre-orientation.
2. orientation phase
3. working,
4. termination.

Question 4

pre-orientation

Answer 4

During this phase, the nurse gathers patient history and examines his or her own feelings or biases concerning the patient information.

Question 5

orientation phase

Answer 5

the nurse get to know the patient. Rapport, or the ability to talk with that patient, is established. The nurse attempts to gain the patient’s trust. The nurse-completes a thorough assessment, establishes nursing diagnoses and sets treatment goals with the patient.

Question 6

working,

Answer 6

nurse and patient do the therapeutic work. Together they problem solve and try to increase the patient’s insight. The nurse will encourage this work through teaching and 1:1s.

Question 7

termination.

Answer 7

During this phase the nurse and patient evaluate progress on treatment goals, problem solve follow-up care, and allow the patient to discuss feelings regarding the termination of the relationship.

Question 8

non-verbal communication

estimate that approximately 70-90% of communication is nonverbal and

Answer 8

1. Vocal Cues-volume, the speed, the tone
2. Affect-behavioral expression of emotion. Most nurses use the patient’s facial expression as the biggest indicator of a patient’s affect.
3. Spatial distance-refers to how close the patient stands to the nurse and may be referred to as personal space. Some patients, particularly those suffering from paranoia, may require extra personal space whereas others, like manic patients may be intrusive often inappropriately touching others.
4. Eye contact-Eye contact should be direct. Lack of contact, staring or indirect contact, which is looking at you through bang, from behind a book, or through their fingers, are all significant and should be noted.
5. movements, gestures, and posture can also reveal information and can be included in the description of the affect.
6. patient’s dress grooming and hygiene as communication. For example, the patient who takes time to complete grooming may be feeling better about him or herself.

Question 9

communication style

Answer 9

1. Assertive behavior
2. Aggressive
3. Passive
4. Passive-aggressive

Question 10

Aggressive

Answer 10

Aggressive individuals defend their own rights by violating the basic rights of others. An example of this behavior would be threatening a patient or raising your voice at a patient in anger

Question 11

Passive

Answer 11

Passive individuals seek to please others at the expense of denying their own basic human rights. An example of this would be not setting appropriate limits or withholding information, like an upcoming probate hearing for fear the patient may become upset.

Question 12

Passive-aggressive

Answer 12

Passive-aggressive individuals defend their own rights by expressing resistance to social and occupational demands. An example of this would be complaining to other staff about a patient or being purposefully slow to respond to the patient’s needs.

Question 13

Assertive

Answer 13

Assertive behavior increases self-esteem and the ability to develop satisfying interpersonal relationships. This is accomplished through honesty, directness, appropriateness and respecting one’s own rights and the rights of others. An example of assertiveness frequently used by the mental health nurse is setting limits when a patient is disruptive, disrespectful, or breaking rules.

Question 14

interdisciplinary communication

Answer 14

The Ohio Department of Mental Health dictates that the healthcare team should meet as a group every 72hours of the patient’s stay to discuss progress in treatment and to plan patient care. Communication with team members should be assertive and professional in nature.
team members include the:
psychiatrist. This is the medical doctor. He is responsible for admitting the patient to the unit and decides when the patient will be discharged. The psychiatrist assigns the medical diagnosis and is responsible for medication management. The ultimate responsibility for patient care falls on the doctor, therefore, he or she is the leader of the healthcare team.

Question 15

Milieu

Answer 15

The word for the environment on the mental health floor

Question 16

Goal of the Milieu

Answer 16

healthy environment that promotes positive behavioral changes. The therapeutic milieu also increases the patient’s functional level and increases the responsibility in his or her care. The therapeutic milieu may also be referred to as milieu therapy, the therapeutic community, or the therapeutic environment. To provide milieu therapy, the nurse must work to manipulate the environment so that all aspects of the patient’s hospital experience are considered therapeutic. The goal of the therapeutic milieu is for the patient to learn adaptive coping , interaction, and relationships skills that can be generalized to other aspects of his or her life.

Question 17

Assumptions of the Milieu

Answer 17

Assumptions of the milieu are that:
The health in each individual is to be realized and encouraged to grow
Every interaction is an opportunity for therapeutic intervention
The patient owns his environment
Each pt. owns own behavior
Peer pressure is a useful and powerful tool
Inappropriate behaviors are dealt with as they occur
Restrictions and punishments are avoided

Question 18

Criteria of the Therapeutic Milieu

Answer 18

Basic physiologic needs are fulfilled – The nurse must consider the patient’s Maslow needs, including food, fluids, pain management, etc.
The physical facilities are conducive to achievement of the goals of therapy. There should be space for privacy, space for groups, etc.
A democratic form of self-government exists – Community meetings
Responsibilities are assigned according to pt. capabilities – Patients may be responsible for cleaning their own room, putting meal trays up, etc.
A structured program of groups and activities is scheduled
Community and family are included in the program of therapy in an effort to facilitate discharge from treatment

Question 19

boundaries

Answer 19

guidelines, rules or limits that a person creates to identify for themselves what are reasonable, safe and permissible ways for other people to behave around him or her and how they will respond when someone steps outside those limits.[1] They are built out of a mix of beliefs, opinions, attitudes, past experiences and social learning.[2][unreliable source?

Question 20

formal teaching

Answer 20

Organized, guided by a formal curriculum, leads to a formally recognized credential such as a high school completion diploma or a degree, and is often guided and recognized by government at some level. Teachers are usually trained as professionals in some way.

Question 21

informal teaching

Answer 21

Informal learning occurs in a variety of places, such as at home, work, and through daily interactions and shared relationships among members of society. For many learners this includes language acquisition, cultural norms and manners.

Question 22

self awareness

Answer 22

Aware of oneself, including one’s traits, feelings, and behaviors

Question 23

teaching

Answer 23

The act, practice, occupation, or profession of a teacher.

2. a. Something taught.

b. A precept or doctrine. Often used in the plural: the teachings of Buddha.

adj.
1. Of, involving, or used for teaching:

Question 24

learning

Answer 24

the activity or process of gaining knowledge or skill by studying, practicing, being taught, or experiencing something : the activity of someone who learns

Question 25

Types of Learning

Answer 25

Cognitive learning
Affective learning
Psychomotor learning

Question 26

Learning Styles

Answer 26

Visual
Auditory
Verbal
Physical
Logical
Social
Solitary

Question 27

Learning Barriers

Answer 27

Physical ability
Strength, endurance, movement, dexterity, coordination
Reading level/ability
Sensory deficits
Developmental level
Cognitive functioning
Memory, knowledge, association, and judgment.
Physical/Mental status
Pain, fatigue, anxiety, severely depressed, extremely psychotic

Question 28

Diagnostic Tests

Answer 28

Personality testing
IQ testing
Learning disability testing
Vision/hearing screening

Question 29

Teaching Interventions

Answer 29

Select the appropriate teaching approach
Telling
Participating
Entrusting
Reinforcing
Positive reinforcers
Social
Material
Activity
Consequences