H&W - Week 5 (Exam 2)
CASE STUDY: Julian returns to the client's room 30 minutes later to find that the client is tearful and states, "I am worried about having this surgery. What if something bad happens? Who will take care of my children?" Which response by Julian is therapeutic?
"This must be a difficult time for you. Would you like to talk more about this?" This is a therapeutic response using empathy and asking relevant questions.
CASE STUDY: Stacy phones the healthcare provider. Which statement represents the recommendation?
"can i have a prescription for a stronger pain medication?"
Which strategies implemented by the nurse would facilitate safe client transfer from the medical-surgical unit to the intensive care unit (ICU)?
1. The nurses from both departments should meet face to face to discuss transition. 2. The nurse should allow time to answer any questions the ICU nurse has before transitioning the client. 3. Use standardized communication tools (such as ISBAR).
A.I.D.E.T.
Acknowledge, Introduce, Duration, Explain, Thank
CASE STUDY: What is the evidence of effective communication between Julian and the client?
As the client leaves the preoperative area to go into the operative room, Julian thanks the client for her trust and cooperation.
CASE STUDY: After receiving the report, Stacy begins to assess the client, who states that pain is 9/10. The client requests additional pain medication, but there are no medications available at this time. Who should Stacy contact for assistance?
Healthcare provider
A standardized communication tool used in healthcare to enhance quality care and client safety uses the acronym ISBAR. What does ISBAR stand for?
Identify, Situation, Background, Assessment, Recommendation
CASE STUDY: Upon entering the exam room, Prisha states, "Hello, Mr. Lang. I saw that today is your birthday. Do you have any plans to celebrate?" This statement begins the orientation phase of the therapeutic relationship. This phase should include:
Informal communication that is friendly
Which statement best describes therapeutic communication?
It is a skill used to meet a client's expressed or unexpressed needs ina timely and respectful manner
CASE STUDY: Review the following interaction, then answer the question. Nurse: It must be frustrating for your TV to not be working when you want to watch the news. Let me see if I can help you. Jeffery is displaying:
Jeffery is displaying empathy toward the client, which is a therapeutic response.
CASE STUDY: Julian communicates with the charge nurse today. Julian: "Hi! I'm ready to receive the report." Charge Nurse: "It would be nice if you could be on time." Julian: "I'm sorry to keep you here longer. It won't happen again." Charge Nurse: "It better not! I have a family too, you know." Julian: "I'm wrong. You are correct."
Julian's responses are passive while the charge nurse is being aggressive.
How does interprofessional collaboration improve health and wellness?
Leverages knowledge from multiple disciplines to improve the care of an individual
Interprofessional collaboration
Match the healthcare professional to the role they play. see photo
What is motivational interviewing?
Motivational interviewing focuses on exploring and resolving ambivalence related to decreased motivation toward changing unhealthy behaviors.
Non-therapeutic communication techniques
Non-therapeutic communication techniques discourage conversation and expression of feelings and causes negative responses or behaviors in others.
What are the reasons for effective communication in healthcare?
Reduce errors meet legal standards meet clinical standards of care, increases client satisfaction improves client outcomes
CASE STUDY: Ms. Simpson's daughter arrives and Rachel prepares to begin teaching. How should Rachel prepare for the education session?f
Secure an authorized translator who can also perform sign language
CASE STUDY: Clara Jones is a nurse in a pediatric unit preparing to interact with four families. Question 1 / 2 Which family may benefit from motivational interviewing?
The family of a child recently diagnosed with diabetes mellitus and the family is concerned about changing their eating habits.
CASE STUDY: How do the phases of the nurse-client relationship compare to the nursing process?
The nurse is performing assessment during he orientation phase
CASE STUDY: Julian enters the client's room to find a nursing assistant helping the older client. Which action by the nursing assistant appears unprofessional?
The nursing assistant is calling the client "honey" instead of by name.
CASE STUDY: After providing education about medication compliance, Prisha thanks Mr. Lang and makes an appointment for him to return to the clinic in one month. What has Prisha accomplished?
The therapeutic relationship has terminated and a plan for the future was established.
CASE STUDY: Rachel
Timing is critical in communication. If your message is poorly timed or irrelevant, communication is ineffective. A client may be unable to focus and retain information when unpleasant physical symptoms are present, such as pain and nausea. The nurse should delay teaching until Ms. Simpson's physical needs are met.
What are the types of therapeutic communication techniques?
Validation, focusing, self-disclosure, clarification, paraphrasing, confrontation, summarizing, asking questions
A nurse is caring for a client who reports difficulty sleeping. Which response by the nurse is most appropriate?
You are having difficulty sleeping?
John is talking to Tim and states, "Tim, you should quit your job if you are so unhappy." This is an example of giving:
a personal opinion
When caring for a client who is hearing-impaired, which techniques may improve communication?
allow the client time to respond, keep communication short and simple, assess adaptive (hearing) equipment
CASE STUDY: When Stacy returns to the nurses' station, she overhears the night shift nurse mention that Stacy is a new graduate and probably not capable of caring for such a complicated client. When the nurse sees that Stacy has overheard the comment, the nurse groans and walks away. What action should Stacy take first?
approach the nurse privately and ask to speak about the comment
A nurse is counseling a client about weight loss and suggests eliminating certain foods from the diet. The client refuses this advice stating, "But those are some of my favorite foods. I will not cut out those foods!" The nurse responds with, "You must cut out those foods or your health will continue to decline." This is an example of:
arguing
CASE STUDY: Review the following interaction, then answer the question. Nurse: What is wrong with you today? Client: I messed up the TV in my room. What non-therapeutic communication technique is Jeffrey using with this client?
asking for an explanation
CASE STUDY: Review the following interaction, then answer the question. Client: Yes, I've actually had to turn away customers. My schedule is so overbooked. Nurse: Thank you for making time to see us today. Tell me how it makes you feel to turn away customers. What therapeutic communication technique is Iryna using with this client?
asking relevant questions
What are elements of professional appearance?
avoid strong perfume follow uniform clean and well groomed
CASE STUDY: Review the following interaction, then answer the question. Client: Can you call someone to fix my TV? Nurse: Let's go and see what the cafeteria is serving for lunch. What non-therapeutic communication technique(s) is/are Jeffrey using with this client?
changing the subject
CASE STUDY: Review the following interaction, then answer the question. Nurse: How are you today? Client: I'm doing good, but it has been very busy at work lately. Nurse: You've been busy at work? What therapeutic communication technique is Iryna using with this client?
clarifying
The nurse is educating a client and at the end of each sentence asks, "Okay?" The nurse's speech is rapid and explanations are lengthy. Which aspect of verbal communication is the nurse breaching?
clarity
A father is playing catch with his son. His son throws the ball high. The father says, "Come on son, that was a terrible throw." This is an example of:
disapproval
Which communication techniques are considered non-therapeutic?
disapproving false reassurance
CASE STUDY: Prisha remembers her late grandfather who refused to take his medication and how her grandmother struggled to watch his health decline. She notices that Mr. Lang's partner is very concerned, so Prisha provides reassurance by touching Mr. Lang's partner's hand. Which characteristic of the therapeutic relationship is Prisha displaying?
empathy
CASE STUDY: Rachel finishes the teaching session and asks Ms. Simpson to repeat back how to care for her surgical site. Which part of the nursing process is Rachel performing?
evaluation
Which are aspects of nonverbal communication?
eye contact personal space posture/gait appearance facial expression gestures sounds
CASE STUDY: Review the following interaction, then answer the question. Client: I need it fixed now. I can't watch the news. Nurse: I'm sure it is just the batteries in the remote. Don't worry about it. What non-therapeutic communication technique is Jeffery using with this client?
false reassurance
What are the characteristics of a therapeutic nurse-client relationship?
goal-directed purposeful contain boundaries
rapport definition
harmony and mutual fondness between people in a relationshiop
CASE STUDY: Review the following interaction, then answer the question. (Nurse makes eye contact with the client.) Nurse: Your hair looks very pretty today. Client: Thank you! I just got it cut last week. (A few minutes of silence passes while the client looks at herself in the mirror.) Client: I would love to do your hair for you one day. Nurse: If my hair gets any grayer, I may take you up on that offer. What therapeutic communication technique is Iryna using with this client? Select all that apply.
humor active listening using silence observations
CASE STUDY: Where is the best location for the hand-off report to occur
inside the clients room
what is aphasia?
loss of ability to understand or express speech, caused by brain damage.
CASE STUDY: Click to select the cues that Prisha may need to establish a therapeutic relationship with Mr. Lang. Prisha Patel Prisha Patel is a nurse working in a medical clinic. Mr. Lang, age 78, presents to the clinic with his partner for laboratory testing to make sure his medication is working properly. After reviewing the results, Prisha determines that Mr. Lang may be taking his medication inconsistently.
not taking his medication inconsistently
CASE STUDY: As Rachel prepares to provide discharge teaching, which level of communication is most appropriate?
one on one
What is the most important characteristic of small group communication?
organized and concise
CASE STUDY: Iryna Davis is a registered nurse working in an outpatient mental health clinic. Today, she is caring for a new client and is working to establish rapport. In which phase of the therapeutic relationship does building rapport occur?
orientation
Which communication technique involves repeating the client's exact statements word for word?
parroting
CASE STUDY: Review the following interaction, then answer the question. Client: Seriously! I need the TV fixed. Nurse: What did you do to it? Client: I did not do anything to it. Nurse: You did not do anything to it. Client: Why do you not believe me? Nurse: Of course, I believe you. Why wouldn't I believe you? What non-therapeutic communication techniques is Jeffery using with this client?
parroting defensive response asking for explanation
Tom says to Sally, "I'm not angry with you." Then Tom ignores Sally for the rest of the night. This is an example of:
passive response
CASE STUDY: Before assuming care, Julian receives a report of information from the nurse who is leaving the unit. Which phase of the therapeutic relationship is Julian entering with the client?
preinteraction
CASE STUDY: Clara reviews the client's medical record. Clara specifically wants to review the client's ethnicity and family form to determine any cultural needs to be addressed as part of dietary teaching. Additionally, Clara consults with the facility dietician for strategies to encourage family diet change. Which phase of the therapeutic relationship do Clara's actions demonstrate?
preinteraction
CASE STUDY: Prisha speaks to the healthcare provider and learns that Mr. Lang was recently diagnosed with a heart condition that requires daily medication. The provider explains that Mr. Lang was hesitant to take the drug and did not want to return to the clinic for monthly laboratory testing. Which phase of the therapeutic relationship does this represent?
preinteraction
what are the stages of the therapeutic relationship?
preinteraction orientation working termination
CASE STUDY: Click to specify if each action by the nurse indicates impaired verbal or impaired nonverbal communication.
see photo
CASE STUDY: Match the ISBAR
see photo
Phases of a therapeutic relationship
see photo
S.U.R.E.T.Y.
see photo
Which clients may benefit from motivational interviewing?
see photo
adaptations for communication
see photo
difference between verbal and non-verbal
see photo
elements of professionalism
see photo
professional vs unprofessional examples
see photo
zone of personal space
see photo
Place these in order according to the nursing plan
see photo Assess diagnose/analyze plan implement evaluation
Xavier Jones is talking with a family whose grandfather has just passed away. While answering questions and providing information, Xavier shares a story about his experience of losing his grandmother last year. What communication technique is Xavier using?
self disclosure
What are the levels of communication?
self-talk, one on one, electronics, public, small group
CASE STUDY: Review the following interaction, then answer the question. Nurse: What exactly do you do for work? Client: I cut and style hair, mostly for brides and bridesmaids. Nurse: That sounds fun! Client: It is fun. I love my job, but yesterday I worked from 6 a.m. until 6 p.m. Nurse: That must have been an exhausting day. What therapeutic communication technique is Iryna using with this client?
sharing empathy
CASE STUDY: Nurse: As a hair stylist, how do you avoid exposure to COVID-19? Client: I wear a mask and gloves at work. I wash my hands all the time. Nurse: You work with customers all day and you wear gloves and a mask. You wash your hands very frequently. Client: Yes, I wash my hands so much that the skin peels. Nurse: That sounds painful. Client: It is. I have tried different soaps, but nothing helps. Nurse: I have such dry skin on my hands from all the hand washing. I find that lotion helps. What therapeutic communication technique is Iryna using with this client?
sharing empathy paraphrasing asking relevant Q's self -disclosure
CASE STUDY: Rachel Montgomery a nurse in an inpatient rehabilitation unit, is caring for Ms. Simpson, aged 69 years, who speaks Polish. Ms. Simpson understands some English but speaks very little. Ms. Simpson is recovering from a broken hip and has been deaf since childhood. Her vision has deteriorated some with age. Today, Rachel is preparing to discharge Ms. Simpson to home, whose daughter will be arriving soon. Click to select all the cues that alert the nurse to be aware of communication needs.
speaks polish, understands some english but speaks little, deaf, vision
A student says to another student, "I'm sorry that you did poorly on the exam. I'm so worried that you won't pass this class." This is an example of:
sympathy
CASE STUDY: While Stacy is receiving the hand-off report, the physical therapist enters the room. What role does the physical therapist play in the client's recovery?
teaching the client how to use a mobility device
empathy definition
the ability to understand another's feelings without losing personal identity and perspective
purpose definition
the nurse focuses on communication toward a specific client-centered goal.
What is the purpose of active listening?
to convey trust and respect to the client
The nurse is caring for a client who only speaks and reads Spanish. What action should the nurse take when communicating with this client?
use an authorized interpretor
what are the most important aspects of verbal communication?
vocabulary, meaning, pacing, intonation, clarity and brevity, and timing and relevance.
What are elements of professional demeanor?
warm and friendly confident clear voice good listener
Case study: Jeffery Phillips a registered nurse working in an assisted living facility. Today, he is caring for a resident that he has known for several months who seems agitated and angry. Question 1 / 6 In which phase of the therapeutic relationship does this occur?
working
In which phase of the therapeutic relationship, does the nurse encourage the client through self-exploration and use therapeutic communication to facilitate successful interactions?
working phase