Fundamentals - Test 1

Communication
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Purpose: establish nurse-client relationship
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- express concern/interest for patient/family
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- provide health care info
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SEND and RECEIVE verbal and non-verbal messages

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- channel = means of communication

- feedback = message understood by patient

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Sender = nurse
Receiver = patient

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Levels: Intrapersonal = people talk to themselves by forming thoughts that

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influence perceptions
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Interpersonal = occurs 2 people or groups
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Public = one person with a crowd of people (conference)
Non-verbal Communication= 85% of communication
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- use of gestures, expressions, behaviors (body language)
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ex: personal appearance
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- posture and gait
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- facial expression
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- eye contact
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- gestures
- territorially and space

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Zones of Touch
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- Social zone
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- Consent zone (permission needed)
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- Vulnerable zone (special care needed)
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- Intimate zone (great sensitivity needed)
Communication within Caring Patients
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- Professionalism
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- Courtesy
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- Confidentiality
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- Trust
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- Acceptance and respect
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- Availability
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- Socializing
Therapeutic Communication
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= PURPOSEFUL & GOAL-ORIENTED
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= Creates a beneficial outcome for the client
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Goals: obtain and provide information

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- develop trust
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- show caring
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- explore feelings

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- Use: attentive listening = use of all senses; receives total messages

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- help patient express thoughts and feelings
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- encourage conversation and elaboration

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Techniques: Empathy
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- Active listening
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- Use of touch
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- Use of humor

Communication Techniques
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- Clarifying/validating
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- Asking open-ended questions
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- Using indirect statements
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- Reflecting
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- Paraphrasing
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- Summarizing
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- Focusing
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- Silence
NO-NOs of Communication
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- Closed questions
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- False reassurance
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- Judgemental responses
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- Defensive reflex
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- Agree/disagreeing or approving/disapproving
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- NEVER Give ADVICE
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- Request an explanation
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- Changing the subject
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- Talking to much
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- Interrupting
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- NOT LISTENING = MOST HARMFUL
Gestures = must be sensitive to cultural variances
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Time = important in the US
Cultural Values = important to know when assessing patients
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- be aware
Determinant Factors
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=Social Factors
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- Religion
- Family Situation
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- Level of Consciousness
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- Stage of Illness
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- Visual, hearing, and speech ability
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- language proficiency
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Ways of Communication: 1) Oral
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2) Written
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3) Self-reflection

Keep Communication Clear

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- Ask for clarification
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- Restate
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- Seek validation
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- Place events in chronological order
Ethics = the principles of right and wrong, virtue vs. vice, good vs. evil, etc.
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Identify =own personal values and morality
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- professional values and ethics
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- Know institutional policies
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- know legal guidelines of healthcare
Professional Values
- Altruism = the belief in concern for the well-being of others.
- Autonomy = self- values (independence)
- Human dignity = dignity for every human being
- Integrity = the quality of being honest and having strong moral principles
- Social Justice
Principles of Healthcare Ethics
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- Beneficence = doing good
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- Nonmaleficence = we should act in ways that do not inflict evil or cause harm to
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others
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- Respect of Autonomy
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- Justice
Ethical Rules in Professional-Client relationship
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- Fidelity = loyalty
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- Veracity = telling the truth
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- Privacy
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- Confidentiality
To practice ethically, the nurse should FOLLOW the American Nurses Association
Code of Ethics for Nurses
Patients Bill of Rights
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1) High-quality hospital care
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2) Clean and safe enviornment
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3) Involvement in care
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4) Protection of your privacy
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5) Help prepare you for discharge
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6) Help with billing and insurance claims
Nurses Bill of Rights

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1) Practice in a manner that fulfills their obligation to society and patients

2) Work in environments supportive of ethical practice
3) Advocate (self and patient)
4) Fair compensation
5) A safe environment (self and patient)
6) Negotiate conditions of employment

Law = standard or rule of conduct established and enforced by government

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- Federal Law = regulates relationships between individuals and government
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- Private Law = regulates relationships among people through court decisions
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- Criminal Law = state and federal criminal statuses
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Crime - wrong against a person or property
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Tort - a wrong committed by a person against another person or property
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(un/intentional)
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Intentional ! !
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Unintentional
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-Assault/battery ! !
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- Negligence
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- defamation of character!!
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- Malpractice
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- Invasion of privacy
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- False imprisonment
Teaching = interactive process consisting of actions that help a learner gain new
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knowledge, behaviors, attitudes or skills
Learning = attainment of new knowledge, attitudes, behaviors or skills
Domains of Learning
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Cognitive = Intellectual behaviors that require thinking
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Affective = expressing feelings and accepting attitudes, opinions and values
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Psychomotor = attaining skills that require brain and muscles to work together
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Purpose of patient education:
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- Health promotion and illness prevention
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- Restoration of health
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- Coping with impaired function
What percentage of elders on their own consume less than 1000 calories per day?
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= 16%
How many elders in the US are estimated to be mistreated every year?
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- 700,000-1.2 millions cases/yr.
Which group of individual in the elderly population are more likely to be widowed?
- Elderly women

Signs of Depression with elders

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- Persistent depressed mood every day for 2 weeks
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- loss of interest
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- Significant change in weight or appetite
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- problems sleeping
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- suicidal ideation
Dementia (signs and Symptoms)
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- Irreversible confusion
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- Delirium (acute confusion)
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- Language deficits
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- Impaired communication
When youre doing an assessment on a Alzheimers patient, which type of health
promotion would you be giving?
- Validation therapy
If the physician has ordered a high does of medication, and you need to be safe, what
do you do?
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- You verify the medication
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- Are you sure you want to give 10x the dose to the patient?
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= due to your ethics, you know that you should not do this.
What is a living will?
- a written statement detailing a person's desires regarding their medical
treatment in circumstances in which they are no longer able to express
informed consent, especially an advance directive.
A primary health maintenance concern for adolescences is: LIVER
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- due to alcohol consumption = educate them about the liver
What topic of education would you focus on to an elder?
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- Exercise: this can prevent a lot of potential problems