nurse client relationship

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Process of motivational interviewing

1. Engaging: to establish rapport 2. Focusing: offers alternatives for current behavior by analyzing patient 3. Evoking: covering the clients own motivation for change 4. Planning

Dynamicity

Adapting to culture change

Open ended statements

Allow for clients to elaborate what's important in their own words

Congruence

Body matches words and expressions

Maintenance

Change comes naturally and wants to prevent relapse

A nurse is reviewing the plan of care for a client. Which statement would the nurse identify as an appropriate outcome?

Client will identify one coping strategy to try by end of week."

Orientation

Collect data, assess knowledge, establish mutual goals, set boundaries, set the tone

Contemplation

Contemplate change but would rather stick to toxic tendencies

Preparation

Demonstrating minor changes to current habit and has difficulties overcoming barriers

Affirmations

Empower client behavior and decision making by giving positive words for their actions

Action

Experiencing changed behaviors

Active listening

Look interested, stay involved, stay on task, test, evaluate message, neutralize feelings

Precontemplation

Not intending to make changes within the next 6 months. Has no insight on issue

Transcultural nursing theory

Nursing care through Social, spiritual, psychological, and physiological perspectives

Fundamental therapeutic communication techniques

OARS (open ended, affirmations, reflect, summarize)

OARS in therapeutic communication

Open-ended questions Affirmations Reflective listening Summaries

Phases of Nurse-Patient Relationship

Orientation: The introduction phase is not a valid phase, yet the nurse introduces oneself during the orientation phase. identification: During the orientation phase, the nurse and client establish the tone and guidelines for the relationship working/exploitation: defines characteristics of the working phase, during which the nurse and client work together to meet the client's physical and psychosocial needs. . resolution/termination :The termination phase occurs when the nurse and client acknowledge that they have met the goals of the initial agreement or that the client would be better served by another nurse or health care provider.

Preorientation

Recognize needs of client by self evaluating

Summarize

Restate key concept about change

SMART goals

Specific, Measurable, Attainable, Realistic, Timely

identification (nurse client relationship phase)

Stage in which issues are identified

A dialysis nurse is educating a client on caring for the dialysis access that was inserted into the client's right arm. The nurse assesses the client's fears and concerns related to dialysis, the dialysis access, and care of the access. This information is taught over several sessions during the course of the client's hospitalization. Which phase of the working relationship is best described in this scenario?

The working phase

Care provided to a client following surgery and until discharge represents which phase of the nurse-client relationship?

Working phase

nurse-client relationship forms of communication

auditory non-verbal energetic emotional

closed-ended (0ARS)

can be answered with a yes or no

ATI question A client asked for their last rites before they die. What factor is influencing the clients request?

cultural

resolution (nurse client relationship phase)

end of the client-nurse relationship.

motivational questions (OARS)

example of a open- ended question requires more than a yes or no answer

exploitation (nurse-client relationship phase)

nurse is actively coaching the client towards a healthier lifestyle

nurse needs a interpreter when client speaks another language

nurse must use a facility interpreter or they are violating HIPPA

Schramm's Model of Communication

sender: sender is the nurse and the client is giving feedback channel: transmission of message feedback: letting the messenger(nurse) know that the message was properly received(client) receiver: the person receiving the message

Working phase

when the nurse and the patient work together to solve problems and accomplish goals. There is an established trust

orientation ( nurse client relationship phase)

when they first meet


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