Week 4: Therapeutic Communication, Interviewing and Nursing Health History

Question 1

Therapeutic communication

Answer 1

techniques involve knowledge of verbal and nonverbal communication patterns

build relationship with patient and family members

Question 2

Therapeutic interviewing

Answer 2

Purpose:

Obtain health history

Identify health needs and risk factors

Determine changes in level of wellness and patterns of living

To help clients interpret and understand their condition

Question 3

Active listening

Answer 3

Show the person they are being heard

Search for meanings behind subtleties
Words -what the client says
Feeling -behind the words
Essence -real meaning

Involves:
Vocabulary  
Denotative and connotative meaning  
Pacing  
Intonation  
Volume 
Pitch  
Clarity and brevity  
Timing and relevance

Question 4

nonverbal communication

Answer 4

Personal appearance  
Posture and gait  
Facial expressions  
Eye contact  
Gestures  
Sounds  
Personal space

Question 5

special situation examples

Answer 5

Patients in health care settings

Hearing impaired

Altered level of consciousness

Cognitive Impairment

Mental Health illness

Under the influence of alcohol or drugs

Patients who are crying

Patients who are angry

Language barrier

Sexually inappropriate

Intercultural communication/interpreters

Lifespan considerations

Question 6

gathering data

Answer 6

SUBJECTIVE DATA: stated by the client/family (symptom)

OBJECTIVE DATA: observed by the nurse (signs)

Question 7

primary and secondary sources

Answer 7

Primary – patient

Secondary – charts, family members

Question 8

types of health histories

Answer 8

Comprehensive

Focused

Emergent

Question 9

Phases of the interview process

Answer 9

Preinteractive phase 
(Info from charts, etc.) 

Beginning phase
(Setting the tone)

Working phase
(Interviewing)

Closing phase
(Next steps )

Question 10

health history 101

Answer 10

Demographics

Reasons for seeking care (presenting illness next slide)

Past health history

Family history

Current medications and indications

Allergies

Lifestyle

Functional symptoms

Review of systems (associated symptoms)

Social, Cultural and spiritual considerations

Human violence (use discretion)

Sexual history and orientation (use discretion)

OLD CARTSS – for presenting illness ie. PAIN

Onset – when did it start?

Location – Where is it located?

Duration – How long have you had it?

Character – can your describe it?

Aggravating/alleviating factors – what makes it better, what makes it worse?

Radiation – does it (ie pain) radiate to any other location?

Timing – when does your pain happen? Is it constant? Come and go? Morning versus night?

Severity – How bad would your rate it on a scale of 0-10?

Self-perception – Do you have any idea what’s causing this? What do you think is going on?