Unit II Flashcards
1
Q
confidentiality
A
- keeping information private
- privacy standards
- HIPAA
2
Q
process of communication, communication flow: sender
A
- 2
- person who conveys message
3
Q
process of communication, communication flow: message
A
- 3
- information sent
4
Q
process of communication, communication flow: channel
A
- 4
- the way it is sent
- visual, audio, tactile
5
Q
process of communication, communication flow: receiver
A
- 5
- person to whom message is sent
6
Q
process of communication, communication flow: feedback
A
- 6
- receiver shares perception of meaning of message
- allows for correction
7
Q
elements of verbal communication
A
- spoken/written
- vocabulary
- pacing
- tone
- clarity
- time
- relevance
8
Q
elements of non-verbal communication
A
- facial expressions
- voice cues
- eye contact
- gestures
- posture
- touch
- odor
- physical appearance
- silence
- time
9
Q
elements of therapeutic communication
A
- improves relationship between nurse and client
- professional
- courtesy
- confidential
- trusting
- acceptance/respect
10
Q
non-therapeutic communication
A
- hinders the nurse/client relationship
- judgmental
- accusatory
- inflammatory
- self-servicing
11
Q
therapeutic communication
A
communication between client and nurse to enhance the health status and improve health of the client
12
Q
social communication
A
communication that is personal and has no relevance to health status of the client and does not improve health of the client
13
Q
factors that hinder communication
A
- inattentive listening
- poor listener
- using terms unfamiliar to client/family
- prying/personal questioning
- approval/disapproval
- changing the subject
- automatic responses
- think before you speak
- false reassurance
- don’t tell patient everything will be ok
- asking for explanations
- don’t ask “why” questions
- arguing with client/family
- being defensive
- sympathy
14
Q
implement therapeutic communication
A
- sharing empathy
- active listening
- no yes or no questions
- sharing observations
- using silence
- providing accurate information
- clarifying
- focusing
- only on patient
- paraphrasing
- summarizing
- self-disclosure
- sharing
- hope
15
Q
phases of caring nurse/client relationship
A
- pre-interaction phase
* prior to meeting - orientation phase
* meet and introduce - working phase
* working together to solve problems and accomplish goals - termination phase
* ending of relationship
16
Q
communication skills to enhance patient/client relationship
A
- professionalism
- courtesy
- conveys respect, begins with introduction
- confidentiality
- HIPAA
- empathy
- active listening
- eye contact
- acknowledge patients
17
Q
professional nursing values
A
- strong commitment to service
- belief in the dignity and worth of each person
- commitment to education: lifelong learning
- autonomy
* free to make decisions - altruism
* always promote good
* always to do good with the patient - freedom
- truth
* varisity
18
Q
autonomy
A
- free to make decisions
- independence
- self-determination
- self-reliance
19
Q
altruism
A
- always promote good
- always to do good with the patient
20
Q
truth
A
varisity
21
Q
ethics
A
- principles and standards governing proper conduct as applied to an issue
- what one ought to do in a situation
- format for making logical and consistent decisions based upon moral beliefs
22
Q
professional code of ethics guides practice
A
- individuals agree to follow these rules and to codes of conduct by accepting the professional credential
- members agree to monitor others in the profession
- allows people outside the profession to be assured that a member of the profession will consistently act in a certain way
23
Q
ethical issues
A
- arise when there is more than the one way to proceed with care
- neither way is clearly right or wrong
- conflicting moral claims
- conflicting wishes
24
Q
determine if an issue is an ethical issue
A
- it cannot be resolved by scientific data alone
- is it perplexing?
- do others disagree about the best course of action?
- will the answer to the question have a profound relevance for several areas of human concern?
* will it affect the patient in a positive way?
25
ethical/issue dilemma
- good people can disagree about the correct course of action without any malice or ill being present
- health care agencies have ethics committees to help treatment teams deal with these tough issues
- you are not on your own
26
teaching process
interactive process that promotes learning, consisting of a conscious and deliberate set of actions that helps an individual gain new knowledge, change attitudes, adopt new behaviors, or perform new skills
27
learning process
acquisition of new knowledge, attitudes, behaviors, or skills through reinforced practice and experience
28
process of communication, communication flow: referent
- 1
| - reason that communication is occurring
29
```
cognitive domain
(understanding/thinking)
```
1. knowledge
* acquire facts or information and recall it
2. comprehension
* ability to understand the meaning
3. application
* applying newly learned abstract ideas in concrete ways
4. analysis
* organize ideas according to degree of importance
5. synthesis
* ability to recognize parts of information as a whole
6. evaluation
* ability to judge the worth of information, for a given purpose
30
knowledge
acquire facts or information and recall it
31
comprehension
ability to understand the meaning
32
application
applying newly learned abstract ideas in concrete ways
33
analysis
organize ideas according to degree of importance
34
synthesis
ability to recognize parts of information as a whole
35
evaluation
ability to judge the worth of information, for a given purpose
36
```
affective domain
(attitudes)
```
1. receiving
* attend to another's words
2. responding
* reacting verbally and nonverbally to the other's words
3. valuing
* attaching worth to an object
4. organizing
* developing a value system by identifying and organizing values and resolving conflicts
5. characterizing
* acting and responding with a consistent value system
37
receiving
attend to another's words
38
responding
reacting verbally and nonverbally to the other's words
39
valuing
attaching worth to an object
40
organizing
developing a value system by identifying and organizing values and resolving conflicts
41
characterizing
acting and responding with a consistent value system
42
```
psychomotor domain
(motor skills)
```
1. perception
* awareness of objects or qualities through the use of senses. associating sensory cue with action
2. set
* readiness to take a particular action. know exactly what to do, be committed
3. guided response
* performance of an act under guidance of another
4. mechanism
* higher level behavior when a person has gained confidence and skill in performing the behavior
5. complex overt response
* performing a motor skill involving a complex movement pattern
6. adaptation
* person is able to change a motor response when problems arise
7. origination
* highly complex. creating a new movement pattern based on existing skills and abilities
8. give access to reading materials before teaching
9. if you can't answer a question, say so and offer to help find an answer. don't bluff
10. if teaching a new skill, demonstrate and allow return demonstration after practice
43
perception
awareness of objects or qualities through the use of senses. associating sensory cue with action
44
set
- readiness to take a particular action
* know exactly what to do
* be committed
45
guided response
performance of an act under guidance of another
46
mechanism
higher level behavior when a person has gained confidence and skill in performing the behavior
47
complex overt response
performing a motor skill involving a complex movement pattern
48
adaptation
person is able to change a motor response when problems arise
49
origination
highly complex. creating a new movement pattern based on existing skills and abilities
50
principles of teaching-learning
1. know the subject, present information and answer questions
2. know what language your client uses
3. know your audience
* teach according to assessment of client
4. match your methods to client needs
* cognitive: lecture
* affective: discussion
* psychomotor: demonstrarion
5. know yourself
* use strategies and styles you are comfortable with
6. don't overwhelm with too much information. expose gradually, over time
51
principles of learning
1. motivation to learn
- attentional set
* mental state that allows learner to focus and comprehend
- motivation
* internal impulse that causes a person to take action
- psychosocial adaptation to illness
- active participation
2. ability to learn
- developmental capability
* reading
- age group
- physical capacity
3. learning environment
- milieu
* environment: lighting, noise, temperature
52
attentional set
mental state that allows learner to focus and comprehend
53
motivation
internal impulse that causes a person to take action
54
milieu
- environment
* lighting
* noise
* temperature
55
assessing learning needs
- questions raised by client/family
- client's level of understanding of current health status, treatment, etc.
- information or skills needed to care for themselves or family
- experiences that influence client/family
- necessary information needed
56
incorporating teaching with routine nursing care
- informal
* during ADLs
* during feeding
* whenever client/family ask questions
- formal
* set up time with client when they will be at optimal learning
* organize teaching, including items needed
- cover required information before addressing other topics
57
teaching: informal
- during ADLs
- during feeding
- whenever client/family ask questions
58
teaching: formal
- set up time with client when they will be optimal at learning
- organize teaching, including items needed
- cover addressing other topics
59
assess client
1. learning needs
2. motivation to learn
3. ability to learn
4. teaching environment
5. resources for learning
60
identify client's learning needs in three domains
1. cognitive
- what the patient knows
2. psychomotor
- skills
3. affective
- attitude
- beliefs
- values
61
establish learning objective
1. set priorities
2. write teaching plan
- what do you want them to do?
- how will you know they have done it?
- when will you know?
3. select teaching methods
62
do the teaching
1. select a good time
2. organize your material
- start simple then go to complex
3. approaches
63
approaches
- telling
* only in emergencies
- selling
- participating
* set your learning objective
- entrusting
* trusting what the patient says
- reinforcing
* need a stimulus
* helps respond
* activities
* pamphlets, hand-outs
64
effectiveness of the teaching plan
1. evaluate outcome of teaching
- teaching is not complete until outcomes are evaluated
- evaluation methods
* client can answer questions
* return demonstration
* discussion
- if new learning needs are identified during evaluation, may need to do more teaching
2. document the teaching
- be specific
- document evidence of learning
- describe method(s) used
65
evaluation methods
- client can answer questions
- return demonstration
- discussion
66
process of communication, communication flow: referent
- 1
| - reason that communication is occurring
67
document teaching
- be specific
- document evidence
- describe method(s) used
68
telling
only in emergencies
69
participating
set your learning objective
70
entrusting
trusting what the patient says
71
reinforcing
- need a stimulus
- jelps respond
- activities
- pamphlets, hand-outs
72
cognitive: discussion
- one-on-one or group
- involves nurse and patient or nurse with several patients
- promotes active participation and focuses on topics of interest to patient
- allows peer support
- enhances application and analysis of new information
73
cognitive: lecture
- more formal method of instruction because teacher controls it
- helps learner acquire new knowledge and gain comprehension
74
cognitive: question-and-answer session
- designated specifically to address patient's concerns
| - assists patients in applying knowledge
75
cognitive: role-play, discovery
allows patient to actively apply knowledge in controlled situation
-promotes synthesis of information and problem solving
76
cognitive: independent project (computer-assisted instruction), field experience
- allows patient to assume responsibility for completing learning activities at own pace
- promotes analysis, synthesis, and evaluation of new information and skills
77
affective: role play
allows expression of values, feelings, and attitudes
78
affective: discussion (group)
- allows patient to acquire support from others in group
- permits patient to learn from others' experiences
- promotes responding, valuing, and organization
79
affective: discussion (one-on-one)
allows discussion of personal, sensitive topics of interest or concern
80
psychomotor: demonstration
- provides presentation of procedures or skills by nurse
- permits patient to incorporate modeling of nurse's behavior
- allows nurse to control questioning during demonstration
81
psychomotor: practice
- gives patient opportunity to perform skills using equipment
- provides repetition
82
psychomotor: return demonstration
- permits patient to perform skills as nurse observes
| - is excellence source of feedback and reinforcement
83
psychomotor: independent project, game
- requires teaching method that promotes adaptation and origination of psychomotor learning
- permits learner to use new skills
84
patient's behavior: denial or disbelief
- patient avoids discussion of illness ("there's nothing wrong with me") and disregards physical restrictions
- patient suppresses and distorts information that has not been presented clearly
85
learning implications: denial or disbelief
- provide support, empathy, and careful explanations of all procedures while they are being done
- let patient know you are available for discussion
- explain situation to family
- teach in present tense (explain current therapy)
86
rationale: denial or disbelief
- patient is not prepared to deal with problem
- any attempt to convince or tell patient about illness will result in further anger or withdrawal
- provide only information patient pursues or absolutely requires
87
patient's behavior: anger
patient blames and complains and often directs anger at nurse
88
learning complications: anger
- do not argue with patient, but listen to concerns
- teach in pressent tense
- reassure family of patient's normality
- continue to introduce only reality
- teach only in present tense
- reassure family of patient's normality
89
rationale: anger
- patient need opportunity to express feelings and anger
| - patient is still not prepared to face future
90
patient's behavior: bargaining
patient offers to live better life in exchange for promises of better health ("if God lets me live, I promise to be more careful")
91
learning implications: bargaining
- continue to introduce only in reality
| - teach only in present tense
92
rationale: bargaining
patient is still unwilling to accept limitations
93
patient's behavior: resolution
patient begins to express emotions openly, realizes that illness has created changes, and begins to ask questions
94
learning implications: resolution
- encourage expression of feelings
| - begin to share information needed for future, and set aside formal times for discussion
95
rationale: resolution
patient begins to perceive need for assistance and is ready to accept responsibility for learning
96
patient's behavior: acceptance
patient recognizes reality of condition, actively pursues information, and strives for independence
97
learning implications: acceptance
- focus teaching on future skills and knowledge required
- continue to teach about present occurrences
- involve family in teaching information for discharge
98
rationale: acceptance
- patient is more easily motivated to learn
| - acceptance of illness reflects willingness to deal with its implications
99
health care ethics: justice
fairness or equity
100
health care ethics: fidelity
- faithfulness
| - striving to keep promises
101
health care ethics: beneficence
- actively seeking benefits
| - promotion of good
102
health care ethics: nonmaleficence
actively seeking to do no harm
