Ch 7 Caring in Nursing Practice
Which would be an appropriate response to the nurse who states that there is no place in nursing for spiritual caring?
"Spiritual, mind, and body connections can affect health."
Watson's theory of caring comprises 10 carative factors:
1) expressing all positive and negative feelings, 2) instilling faith and hope, 3) developing a trusting relationship between the nurse and the patient, 4) forming a human value system, 5) cultivating sensitivity to others, 6) using creative problem-solving processes, 7) promoting transpersonal teaching-learning, 8) providing for a supportive and spiritual environment, 9) meeting human needs, and 10) allowing for existential spiritual forces.
A patient is disabled due to cancer-related pain. Which nonpharmacological intervention can help enhance the patient's comfort, dignity, and peace?
A clean and pleasant environment
Which best describes presence?
A person-to-person encounter that conveys closeness and a sense of caring.
Which type of intervention is the best way to know the patient?
Active listening
A patient is talking to the nurse about being upset after receiving a cancer diagnosis. The nurse attentively listens and touches the patient gently. Which component of Swanson's theory does this action fulfill?
BEING WITH Touch signifies that the nurse understands the patient's concerns. It means being with the patient and listening to the patient whenever needed
The nurse is interacting with a patient who is experiencing depression and reassures the patient by saying, "I know you are feeling sad; please speak up and do not keep your feelings to yourself. It will help you feel better." Which caring process of Swanson's theory is the nurse following in this situation?
Being with The nurse is trying to reassure the depressed patient by encouraging the patient to express feelings. Thus, the nurse is following the process of being with the patient, according to Swanson's theory of caring. Being with refers to maintaining emotional contact with others.
The nurse applies Swanson's theory of BEING WITH
Being with refers to being emotionally present for the patient.
The nurse gently touches the shoulder of a patient lying with eyes closed. When the patient opens his eyes, the nurse smiles and asks how he is feeling. Which kind of touch is this?
Caring
Watson's carative factor of providing for existential-phenomenological-spiritual forces.
Caring for the patient from a spiritual aspect would address
The hospice nurse sits at the bedside of a male patient in the final stages of cancer. He and his parents made the decision that he would move home and they would help him in the final stages of his disease. The family participates in his care, but lately the nurse has increased the amount of time she spends with the family. Whenever she enters the room or approaches the patient to give care, she touches his shoulder and tells him that she is present. Which type of touch is this?
Caring touch
Which is a strategy for creating work environments that enable nurses to demonstrate more caring behaviors?
Creating a setting that allows flexibility and autonomy for staff
Which factor in Watson's carative theory could the nurse utilize in any setting? Select all that apply.
Cultivating sensitivity to others Instilling faith and hope Instilling faith and hope
The nurse visits the patient for a chat every morning and evening. Which carative factor does this illustrate, according to Watson's theory of care?
Developing a human caring relationship
While inserting a catheter, the nurse drapes the patient with a cloth and instructs the patient to take deep breaths. Which caring process of Swanson's theory does the nurse address in this situation?
Doing for
increases nursing satisfaction
Encouraging flexibility and autonomy When nurses' job satisfaction is high, they have a greater connectedness with their patients and believe that caring practices are part of the nursing culture.
Of the five caring processes described by Swanson, which describes knowing the patient?
Establishing an understanding of a specific patient Knowing the context of a patient's illness helps the nurse choose and individualize interventions that will actually help the patient. The nurse should strive to understand an event as it has meaning in the life of the other. Knowing the patient is essential when providing patient-centered care.
A patient is admitted to the hospital for treatment of breast cancer. The nurse assigned to this patient decides to practice implementing Watson's caring theory. Which are carative factors of this theory?
Expressing feelings Instilling faith and hope Developing a trusting relationship
A patient is admitted to a hospital after a miscarriage. The nurse offers the patient realistic optimism. Which process of care is this?
Giving optimistic advice is an example of maintaining belief. It is one of the components of Swanson's theory, which focuses on sustaining faith in the other's capacity to get through an event or transition
The nurse enters the patient's room to find the patient worried and depressed. According to the caring principles, what should the nurse do?
Greet the patient and gently touch the patient's shoulder. Make good eye contact and sit next to the patient. Ask the patient about any concerns and listen to complaints patiently.
While attending to a patient, the nurse finds that the patient is having difficulty in getting up to a sitting position. The nurse cares for this patient by applying the process of doing for. Which is the most appropriate action the nurse can take?
Help the patient move into the sitting position. NOT : Help the patient by raising the head end of the bed. (this would be enabling ) Encouraging the pt to move independently indicates the proces of MAINTAINING BELIEF
Which nursing intervention indicates a protective touch for a patient with a major injury after an accident?
Holding the patient while assisting with walking
A patient is depressed due to chronic illness and disability and reports being unable to sleep. The nurse uses caring touch. Which is an example of caring touch?
Holding the patient's hand
task-oriented touch
Holding the patient's hand while completing a procedure indicates a
Which factors enhance patient-centered care? Select all that apply.
Increasing the number of staff members Allowing autonomy over nursing practices
Which carative factor does the nurse illustrate when helping a patient find the meaning of cancer by supporting beliefs about life?
Instilling hope and faith Instilling hope and faith helps to increase an individual's capacity to get through an event or transition and to face the future with meaning.
If the nurse only practices the curative regimen prescribed by the health care provider while dealing with patients, which aspect of Watson's transpersonal caring theory does the nurse fail to apply?
Intention to care Watson's transpersonal caring theory emphasizes care over cure. The nurse is not compliant with this aspect because the nurse is more inclined towards curing rather than caring.
Listening is multifaceted. Besides taking in what a patient says, what else does listening include?
Interpreting and understanding what the patient means NOT : incorporating the views of Dr correcting any errors in Pt's understanding injecting the Rn's personal views and statements
The nurse holds the hands of a patient when talking to the patient during rounds. Which is a likely impact of the nurse's behavior?
It enhances the self-esteem and mental health of the patient
The nurse has long conversations with a patient about the patient's health, family, religious, and cultural practices. What impact will such a conversation likely have on the healing relationship?
It will help to assist the patient in using social resources.
A patient is admitted to a hospital following severe pain in the abdomen. The nurse obtains the patient's complete history and assesses the patient thoroughly. Which process of Swanson's theory is the nurse using?
Knowing
The nurse decides to use Swanson's theory of caring in clinical practice. Which caring processes are included in this theory? Select all that apply.
Knowing doing for being with
A 60-year-old patient is undergoing treatment for a brain tumor. The patient is depressed due to the diagnosis. The nurse enters the room and finds that the patient is weeping. On inquiring, the patient starts speaking about the disease and the related problems. To be a good listener, what should the nurse do?
Maintain good eye contact. Give complete attention to the patient. Be silent and listen to the patient carefully. (The nurse should not interrupt or give opinions. It is easy for the nurse to get distracted by tasks on hand and workload, but the nurse should listen to the patient first and then complete the tasks. )
A patient is suffering from a hormonal disorder. The nurse tries to retain a hope-filled positive attitude for this patient. The nurse also offers realistic optimism to the patient. Which component of Swanson's caring theory is the nurse applying?
Maintaining belief
The nurse is teaching a physically handicapped patient to acquire self-care skills and to perform basic care. Which of Watson's carative factors does this illustrate?
Promoting transpersonal learning
A patient loses balance, and the nurse holds the patient to avoid a fall. Which kind of touch is this?
Protective
The nurse needs to insert an intravenous (IV) line and measure urine output for a patient. The nurse enters the patient's room and finds the patient weeping. What should the nurse do first?
Sit down beside the patient and ask what's wrong. Similarly, leaving the room or asking somebody else to comfort the patient signifies the nurse's indifference.
The nurse applies Swanson's theory of CARING while attending to patients. Which definition best describes the KNOWING component of Swanson's theory of caring?
Striving to understand an event as it has meaning in the life of the patient
The nurse enters a patient's room, arranges the supplies for a Foley catheter insertion, explains the procedure to the patient, and tells the patient what to expect. Just before inserting the catheter, the nurse tells the patient to relax and says that, once the catheter is in place, the patient will not feel the bladder pressure. The nurse then proceeds to skillfully insert the Foley catheter. Which type of touch is this?
Task-oriented touch
A patient is admitted to the psychiatric unit for major depressive disorder and suicidal thoughts. The nurse decides to explore healing through spiritual health. Which statements are true of spiritual caring? Select all that apply.
The approach mobilizes hope for the patient and the nurse. The approach helps to recognize that caring relationships connect humans to each other. The approach helps the patient understand the illness, symptoms, or emotions.
his indicates that the nurse is doing for, according to the Swanson's theory.
The nurse is skillfully performing catheterization while maintaining the patient's dignity and helping to reduce the patient's pain.
The nurse is caring for an older adult who needs to enter an assisted-living facility following discharge from the hospital. Which is an example of listening that displays caring?
The nurse listens to the patient's story while sitting on the side of the bed and then summarizes the story.
Which actions demonstrate a caring touch? Select all that apply.
The nurse positions the patient comfortably. The nurse comforts the patient and holds the patient's hands. The nurse engages in a conversation with the patient.
A patient admitted to a hospital is very depressed. The patient wants to share personal concerns with the nurse. Which should the nurse do to be a good listener? Select all that apply.
The nurse should pay attention to the patient's concerns. The nurse should make good eye contact, which signifies that the nurse is interested in the patient's problems. The nurse should listen to the patient with openness, keep silent, and let the patient speak. It is easy for the nurse to get distracted by tasks and workload, but the nurse should listen to the patient first and then complete the tasks.
The nurse has to insert a nasogastric tube in a patient. The nurse explains the procedure to the patient and uses task-oriented touch. Which action by the nurse would be considered task-oriented touch?
The nurse skillfully inserts the tube and positions it.
interpersonal touch.
Touch can enhance interpersonal relationships, but there is no category of touch labeled interpersonal touch.
Forming a human-altruistic value system promotes
a therapeutic relationship between the nurse and patient.
Healing touch is
a type of energy therapy used for healing certain diseases.
Behavioral therapy and psychiatric counseling
are not helpful for relieving physical pain due to cancer. They are used when the illness has a psychological cause.
swansons 4 BEING WITH
being emotionally present for the pt
Two elements that facilitate knowing are
continuity of care and clinical expertise.
Preserving and protecting the patient are components of
doing for
A patient who is quadriplegic complains of being cold and asks for an extra blanket. The nurse covers the patient and draws the room's curtains. Which process did the nurse follow?
doing for the nurse carries out tasks for patients as they would do for themselves, if possible
Noncontact touch mainly involves
eye contact, not physical touch.
swansons 5 ENABLING
facilitating the pt's passage through changes of life
Swanson's theory of caring is comprised of
five processes of nursing.
An example of the caring process of knowing would be when the nurse
follows the patient's cues and assesses the patient thoroughly while providing care.
Caring touch
form of nonverbal communication. It helps to improve a patient's comfort and security, enhances self-esteem, increases confidence in the caregivers, and improves mental well-being.
Which intervention uses Watson's carative factor of the scientific problem-solving process while caring for a patient?
he nurse explains the details of the prescribed pain medication to the patient before administration.
An example of the carative factor of creative problem solving would be to
help the patient with decision making.
Caring touch is
holding a patient's hand, giving a back massage, gently positioning a patient, or participating in a conversation to enhance a patient's comfort and security, self-esteem, confidence in the caregivers, and mental well-being.
Spiritual health occurs when
individuals find a balance between their own life values, goals, and belief systems and those of others, especially as research shows a link between spirit, mind, and body. The approach helps in mobilizing hope for the nurse and the patient in a caring relationship. The patient and the nurse realize that caring relationships connect humans. The spiritual approach also helps establish an understanding of illness, symptoms, or emotions that is acceptable to the patient. The approach helps the nurse to look beyond the conventional methods of treatment, and helps the patient in getting cured by using social, emotional, and spiritual resources.
there is no category of touch called
interpersonal touch
The nurse applies Swanson's theory of DOING FOR
is caring for another person as that person would have done if it were possible.
The nurse applies Swanson's theory of ENABLING
is facilitating the patient's passage through changes in life.
The nurse applies Swanson's theory of MAINTAINING BELIEF
is sustaining faith in the other person's ability to get through an event.
A patient is undergoing treatment for lung cancer and is depressed due to the diagnosis. The nurse tries to understand the patient's feelings without making any assumptions. Which caring process is this, according to Swanson's theory?
knowing
Attentive listening
lets the nurse hear the patient's story and then correctly summarize it. Attentive listening does not occur when the nurse is distracted by equipment or other personnel. The importance of listening is not to distract the patient or solve the problem but rather to hear what the patient has to say and understand what the situation means to the patient.
Maintaining a hope-filled approach is part of
maintaining belief.
Watson's 10 carative factors focus
on the relationship between the nurse and the patient. The factors include expressing all positive and negative feelings. Watson's theory of caring also includes instilling faith and hope. This provides a direction to the patient when trying to find the meaning of the illness. The theory also includes developing a trusting relationship between the nurse and the patient. Suppressing negative feelings and denying that a problem exists may lead to undertreatment and complications.
Watson's carative factor of using the scientific problem-solving process enables
patient-centered care. Explaining the medication to the patient before administering it indicates that the nurse is involving the patient in the decision-making processes related to the care.
swansons 3 DOING FOR
performing for others as the pt would have done for herslef it were possible
Protective touch protects the nurse and/or the patient to prevent
physical or EMOTIONAL harm
Protective touch
protects the nurse and/or the patient to prevent physical or emotional harm.
swansons 2 KNOWING
striving to understand an event as it has meaning in the life of the other
Swansons 1 MAINTAINING BELIEF
sustaining faith in orther person's ability to get through an event
Touching the back to give a massage is
task-oriented.
An example of the carative factor of promoting transpersonal teaching and learning would be to
teach the patient proper skills for self-care
An example of the caring process of enabling would be when
the nurse generates alternatives and supports the patient during unfamiliar events.
Knowing the patient is a process by which
the nurse understands the patient, the patient's disorder, and the individual's background. The nurse should be unprejudiced and avoid any assumptions. The nurse performs a thorough assessment and takes a complete health history in order to better know the patient.
Protective touch is used to protect
the patient or the nurse
Task-oriented touch is
the touch that takes place while the nurse is performing a nursing task or procedure.
Protective touch is
used to protect the patient from any harm.
Task-oriented touch
when performing a task or procedure. An expert nurse learns that any procedure is more effective when administered carefully and in consideration of any patient concern.
An example of being with would be
when the nurse encourages the patient to respond and share feelings.
Task-oriented touch occurs
when the nurse is performing nursing duties.