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Therapeutic relationship - between a nurse and a client

transference - the way a client feels about you


countertransference - the way a nurse feels about a client
superficial involvement - pleasant, casual, saying hello
companionship - sharing common activities
friendship - mutual support and enjoyment of each other
romantic love - friendship with shared sexuality
functional relationship - commitment, marriage, partnership
Hallucinations - respond to senses, inappropriate responses
illusion - misconception of reality
delusion - fixed false belief
Goal of psychotherapy - to help client gain insight
Psychiatric Tech - can only pass meds inPsych
PHD, MD, MFT, NP, LSW - Can conduct therapy
Why - the one question you never ask
Therapeutic boundary - there is no reason to maintain a relationship outside of
the hospital with clients
Pre-interaction phase individual therapy - obtaining info from the chart
Orientation/Introduction phase individual therapy - establish goals, build rapport
and establish a plan
Working Phase Individual therapy - maintain trust promote insight, longest phase
Termination phase of individual therapy - determine progress to goal. plan for
continuation of care and feelings regarding termination
Presenting problem - chief concern, all events up to current encounter
most important parts of medical history - heart, lungs, diabetes, drug withdrawal
3 types of genetic psych diseases - depression, bipolar, schizophrenia
Behavior - hyper/hypo
LOC - should be awake and alert
orientation - name, place, date, situation

memory - 3 unrelated objects


mood - "how are you feeling today?"
affect - appropriate/inappropriate is expression congruent/incongruent
associations - tight/loose going off on a tangent...circumstantial if they come
back to the correct answer
impulse - good, fair, poor
judgement - observe client on unit, what would you do if you found a stamped
envelope
abstract vs concrete - use a proverb to record an answer
triangles - parent ask both parents permission for the same thing
scapegoat - target of projection of blame
family roles - positions defined by the family
power structure - adults usually have the power
pseudomutuality - regard
pseudohostility - conflict
self fulfilling prophecy - an idea or expectation acted out unconciously
life script - decided not by fate but by experiences early in life
schism - each parent underminds the other and children are forced to pick sides
shew - one mate is dysfunctional , lack of partnership
enmeshment - diffuse boundaries, the blending of feelings
disengagement - abandonment, oblivious to effects of their actions on others
reframing - to put problem behavior into positive light
paradoxical intervention - engage in behavior they are trying to change
catharsis - open expression of feelings (beneficial)
high risk patients - one to ones and 15 min checks
assertion - expression of self without fear of disapproval from others, taking care
of oneself but not at the expense of others
passive - avoiding conflict at any cost, even at the expense of one's own
happiness
aggressive - getting what one wants without considering anyone elses feelings

PREINTERACTION PHASE - OCCURS BEFORE MEETING THE PATIENT


ORIENTATION PHASE - WHEN THE NURSE AND THE PATIENT MEET AND GET TO
KNOW EACH OTHER
WORKING PHASE - WHEN THE NURSE AND THE PATIENT WORK TOGETHER TO
SOLVE PROBLEMS AND ACCOMPLISH GOALS.
KINESICS - INVOLVES BODY MOVEMENTS, SUCH AS GESTURES, POSTURE AND
BODY CUES, EYE MOVEMENTS AND FACIAL EXPRESSIONS, AND TONE AND RATE
OF SPEECH. IT REVEALS INNER FEELINGS, SUCH AS HAPPINESS, SADNESS, FEAR,
OR ANGER EXPRESSED THROUGH NON VERBAL LANGUAGE.
PROXEMICS - PHYSICAL CLOSENESS) TOLERATED BY MOST PEOPLE. HOW NEAR
OR FAR WE PLACE OURSELVES FROM OTHERS TRANSMITS STRONG MESSAGES.
EX.MAY BE AFFECTED BY ODORS, SUCH AS POOR PHYSICAL OR DENTAL
HYGEIENE, DECAY. PATIENTS MAY BE UPSET BY SMELLS IN THE MEDICAL SETTING
(DISINFECTANTS & MEDICAL SCENTS).
SYMPATHY - WHEN YOU FEEL PITY AND COMPASSION FOR THE FEELINGS OF
ANOTHER
EMPATHY - IDENTIFYING WITH AND UNDERSTANDING ANOTHER PERSON ON A
DEEPER LEVEL.
THERAPEUTIC TOUCH - USING WARM AND CARING HAND IN HEALTHCARE
SETTING. USING TOUCH MEANS SHOWING CONCERN AND COMPASSION.
CLICHE STATEMENTS - LOOK ON THE BRIGHT SIDE." "IT COULD HAVE BEEN
WORSE."THESE STATEMENTS MAKES PATIENTS FEEL THEY ARE NOT VALUED AS
INDIVIDUALS.
CONTRACTICTING - IT COULD NOT HAVE HAPPENED THAT WAY." "ARE YOU SURE
OF WHAT YOU ARE SAYING?" THIS IMPLIES THAT PATIENT IS NOT BEING
TRUTHFUL.
CRITIZING - YOU KNOW YOU SHOULD HAVE CALLED US AS SOON AS THIS
HAPPENED." MAKES PATIENT FEEL GUILTY AND MAY BUILD A DEFENSIVE BARRIER.
RIDICULING - "THAT WAS A DUMB THING TO DO." THIS STOPS COMMUNICATION
IMMEDIATELY.
SARCASM - "OH, GREAT!" "THIS IS JUST WHAT YOU NEED." THIS STATES ONE
THING BUT IMPLIES THE OPPOSITE
INDIFFERENCE - PATIENTS FEEL THAT YOU DO NOT VALUE THEIR CONCERNS IF
THEY SUSPECT YOU ARE NOT FOCUSED ON COMMUNICATION. WATCH YOUR NON
VERBAL CUES, GLANCING AT YOUR WATCH, YAWNING, OR STARING OFFI IN THE
DISTANCE WHILE THE PATIENT IS TALKING.
LECTURING - "YOU KNOW YOU SHOULDN'T BE SMOKING." "WHY AREN'T YOU
WATCHING YOUR DIET?"

IDIOM - A WELL KNOWN PHRASE OR SENtence WITH A MEANING COMPLETELY


DIFFERENT FROM its LITERAL TRANSLATION. THESE INCLUDE SAYINGS SUCH AS,
"LET'S PLAY IT BY EAR", OR "HE WAS BURNING UP WITH FEVER." THESE DON'T
TRANSLATE WELL WITH PATIENTS ESPECIALLY IF ENGLISH IS THEIR SECOND
LANGUAGE.
RAPPORT - A RELATIONSHIP OF TRUST AND DUNDERSTANING FOR FUTURE
INTERACTIONS WITH PATIENTS.
COLLOGQUIALISMS - SLANG (REGIONAL LANGUAGE OR TERMS) ARE IMPROPER
TO USE IN A HEALTH CARE SETTING.
PARALANGUAGE - NON VERBAL QUES, SOUNDS INCLUDE SIGHING, HUMMING,
CHUCKLING, OR LAUGHING.
INCONGURENCE - INCONSISTENT NONVERBAL CUES (BREAKDOWN IN
COMMUNICATION).
MATRIARCHAL - OLDEST FEMALE MAKES ALL DECISIONS
PATRIARCHAL - IT IS THE OLDEST MALE WHO MAKES ALL THE DECISIONS
DYSPHASIA - LOSS OF A FEW WORDS.
APHASIA - TOTAL INABILITY TO SPEAK
AUTONOMY - IS BEING SELF DIRECTED AND INDEPENDENT IN ACCOMPLOSHING
GOALS AND ADVOCATING FOR OTHERS.
CARING - A UNIVERSAL PHENOMENON THAT INFLUENCES THE WAY WE THINK,
FEEL AND BEHAVE.
CHANNELS - ARE MEANS OF CONVEYING AND RECEIVING MESSAGES THROUGH
VISUAL, AUDITORY, AND TACTILE SENSES.
CONDUCTIVE - HARDENED CERUMENT (EAR WAX). OR OSTOSCLEROISIS
(HARDENING OF THE STRUCTURES OF THE EAR). IN MOST CASES IT'S
CORRECTABLE.
SENSORINEURAL - INVOLVES THE OTIC NERVE AND SOUND TRANSMISSION TOE
THE AUDITORY (HEARING) CENTERS OF THE BRAIN. IT'S A NERVE IMPAIRMENT,
CAN USE COCHLEAR IMPLANT THAT TRANSMITS SOUND PAST THE OTIC NERVE
TO THE BRAIN.
MIXED DEAFNESS - HARD TO DIAGNOSE AND TREAT. COMMON IN OLDER
PATIENTS AN IS THEN CALLED PRESBYCUSIS (OLD HEARING). HEARING AIDS MAY
NOT HELP; RAISING VOICE WILL MAKE IT WORSE.
ANACUSIS - TOTAL LOSS OF HEARING.
MADELEINE LEININGER THEORY - STUDIED CARING FROM A TRANSCULTURAL
PERSPECTIVE, CARING IS AN ESSENTIAL HUMAN NEED. CARING HELPS AN

INDIVIDUAL OR GROUP IMPROVE A HUMAN CONDITION. CARING HELPS TO


PROTECT, DEVELOP, NUTURE, AND SUSTAIN PEOPLE.
JEAN WATSON THEORY - (TRANSPERSONAL CARING) PROMOTES HEALING AND
WHOLENESS, REJECTS THE DISEASE ORIENTATION TO HEALTH CARE, PLACES
CARE BEFORE CURE. EMPHASIZES THE NURSE-PATIENT RELATIONSHIP.
KRISTEN SWANSON THEORY - A COMPOSITE OF THREE STUDIES IN A PERINATAL
UNIT. DEFINES CARING AS A NURTURING WAY OF RELATING TO A VALUED OTHER,
TOWARD WHOM ONE FEELS A PERSONAL SENSE OF COMMITMENT AND
RESPONSIBILITY.
COMMUNICATION - IS THE MEANS TO ESTABLISH HELPING TRUSTING
RELATIONSHIPS.
INTRAPERSONAL - OCCURS WITHIN AN INDIVIDUAL
INTERPERSONAL - ONE TO ONE INTERACTION BETWEEN TWO PEOPLE.
TRANSPERSONAL - INTERACTION WITHIN A PERSON'S SPIRITUAL DOMAIN.
SMALL GROUP - INTERACTIONS WITHIN A SMALL NUMBER OF PEOPLE.
PUBLIC - INTERACTION WITH AN AUDIENCE
REFERENT - MOTIVATES ONE TO COMMUNICATE WITH ANOTHER
SENDER AND RECEIVER - ONE WHO ENCODES AND ONE WHO DECODES THE
MESSAGE.
MESSAGE - CONTENT OF THE COMMUNICATION
FEEDBACK - INIDICATES WHETHER THE RECEIVER UNDERSTOOD THE MEANING
OF THE SENDER'S MESSAGE.
INTERPERSONAL VARIABLES - FACTORS WITHIN BOTH THE SENDER AND THE
RECEIVER THAT INFLUENCE COMMUNICATION.
ENVIROMENT - THE SETTING FOR SENDER-RECEIVER INTERACTIONS.
VOCABULARY - DENOTATIVE AND CONNOTATIVE MEANING.
INTONATION - TONE OF VOICE
PACING - THINKING BEFORE SPEAKING AND DEVELOPING AWARENESS OF THE
RYTHYM OF YOUR SPEECH.
NON VERBAL COMMUNICATION - PERSONAL APPEARANCE, POSTURE AND GAIT,
FACIAL EXPRESSIONS, EYE CONTACT, GESTURES, SOUNDS.
SYMBOLIC - THE VERBAL AND NONVEWRBAL SYMBOLISM USED BY OTHERS TO
CONVEY MEANING

METACOMMUNICATION - A BROAD TERM THAT REFERS TO ALL FACTORS THAT


INFLUENCE COMMUNICATION.
TERMINATION PHASE - OCCURS AT THE END OF A RELATIONSHIP.
ASSESSMENT - THROUGH THE PATIENT'S EYES GATHER INFORMATION
SYNTHESIZE APPLY CRITICAL THINKING. PHYSICAL
/EMOTIONAL/DEVELOPMENTAL/SOCIOCULTURAL FACTORS
PLANNING - GOALS AND OUTCOMES SPECIFIC AND MEASURABLE, SETTING OF
PRIORITIES/TEAM WORK AND COLLABORATION.
THERAPEUTIC COMMUNICATION - SPECIFIC RESPONES THAT ENCOURAGE THE
EXPRESSION OF FEELINGS AND IDEAS AND CONVEY ACCEPTANCE AND RESPECT.
ACTIVE LISTENING - MEANS BEING ATTENTIVE TO WHAT A PATIENT IS SAYING
BOTH VERBALLY AND NONVERBALLY.
SOLER - SIT FACING THE PATIENT:OBSERVE AN OPEN POSTURE/LEAN TOWARD
PATIENT/ESTABLISH AND MAINTAIN EYE CONTACT/RELAX
EVALUATION - PATIENT OUTCOMES, NURSES AND PATIENTS NEED TO EVALUATE
TO DETERMINE WHICH STRATEGIES OR INTERVENTIONS WERE EFFECTIVE. IF
EXPECTED OUTCOMES ARE NOT MET, THE PLAN OF CARE NEEDS TO BE
MODIFIED.
INTIMATE ZONE - 0-18 INCHES
PERSONAL ZONE - 18 INCHES TO 4 FEET
SOCIAL ZONE - 4 TO 12 FEET
NARRATIVE INTERACTION - WHEN A PATIENT SHARES PERSONAL STORIES.
HANDS OFF - WHEN A PATIENT MOVES FROM ONE NURSING HOME TO ANOTHER
OR IF PATIENT CHANGES FROM ONE DOCTOR TO ANOTHER.
CLARITY AND BREVITY - SIMPLE, BRIEF, AND DIRECT
CONNOTATIVE MEANING - INTERPRETATION OF A WORD'S MEAING INFLUENCED
BY THE THOUGHS AND FELLINGS THAT PEOPLE HAVE ABOUT THE WORD.
TIMING - WHEN A PATIENT EXPRESSES AN INTEREST IN COMMUNICATING.