NRSG 100 Chapter 13,18, 21, 22, 24, 30, 31, 33
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| Define communication | a dynamic, reciprocal process of sending and receiving messages.
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| Define intrapersonal | conscious internal dialogue. self talk
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| Define interpersonal | communication between two or more people
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| Define group communication | interaction that occurs between several people. e.g. public speaking
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| Define communication process | the act of sending, receiving, interpreting, and reacting to a message
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| List the five elements of communication process | 1. sender 2. message 3. receiver 4. feedback 5. channel
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| Define sender | initiates the conversation to deliver a message (content) using verbal/non-verbal communication to another . the sender is also known as the source or encoder
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| Define encoding | the process of selecting the words, gestures, tone of voice, signs, and symbols used to transmit the message
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| Define message | the verbal/non-verbal information that the sender communicates
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| What makes a message effective? | It's complete, clear, concise, organized, timely, and expressed in a way the receiver can understand
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| The medium used to send the message is called the ____. Give an example. | channel
Face-to-face is a common channel.
Nurses use touch as a non-verbal channel.
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| The observer, listener, and interpreter of the message is called the _____. | receiver
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| This refers to relating the message to one's past experiences to determine the sender's meaning. | decoding
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| _____ validates that the receiver got the message and understood as the sender intended | Feedback
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| What is the difference between denotation, connotation, and intonation? | Denotation: the literal, dictionary meaning
Connotation: implied or emotional meaning of a word
Intonation: reflects the meaning behind the words. "tone of voice"
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| When delivering a verbal message, what factors must be kept in mind? | Vocabulary, denotation, connotative, pacing, intonation, clarity and brevity, timing and relevance, credibility, and humor.
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| Give examples of nonverbal communication. | facial expression, posture and gait, personal appearance, gestures, and touch
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| List major factors that affect communication. | environment, lifespan variations, gender, personal space, territoriality, sociocultural factors, roles and relationships
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| The __________ focuses on improving the health of the client, whether an individual or community. | therapeutic relationship
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| List three characteristics of therapeutic communication. | 1. client-centered 2.goal-directed 3. strengthens therapeutic communication
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| What are the four phases of the therapeutic relationship? | 1. pre-interaction phase 2. orientation phase 3. working phase 4. termination phase
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| What happens in the pre-interation phase of the therapeutic relationship? | This occurs before meeting the client. Information is gathered about the client.
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| What happens in the orientation phase of the therapeutic relationship? | You meet with the client and work on establishing a rapport and trust.
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| During this phase of the therapeutic relationship, mutual respect is obtained and honest verbal/non-verbal expression occurs | working phase
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| Termination phase | the conclusion of the therapeutic relationship. this can be due to the end of the nurse's shift or discharge of the patient.
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| Five Key Characteristics of Therapeutic Communication | 1. empathy 2. respect 3. genuineness 4. concreteness 5. confrontation
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| The inability to receive or interpret verbal/non-verbal message | receptive aphasia
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| the inability to express verbal/non-verbal message | expressive aphasia
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| Barriers to Therapeutic Communication | 1. Too many questions 2. close-ended questions 3. asking "why" 4. changing the subject abruptly 5.failing to listen 6. failing to probe 7. stereotyping 8. using patronizing language
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| Ways to Enhance Therapeutic Communication | 1. interpret body language 2. use open-ended questions 3. use silence 4. share your observations to clarify 5. summarize the conversation
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| If there is a discrepancy between verbal and non-verbal communication, ______. | Ask for clarification
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| Acronym: A Delicious PIE | Assess, Diagnose, Plan, Implement, Evaluate
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| Who do nurses teach? | single clients, families, caregivers, groups of clients, peers, unlicensed assistive personnel (UAP), nursing students, new employees
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| What do nurses teach? | disease information, medication information, procedures, psychomotor skills, health promotion, clinical processes
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| Why do nurses need teaching skills? | Clients/families need information for decision-making, facilitates compliance and shorter hospital stays, and empowers clients and families
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| Four of the eight items that can be used to evaluate learning | 1. checklists 2. direct observation of performance 3. client report 4. client records 5. tests 6. interviews 7. questionnaires 8. oral questions
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| Teaching strategies, content, scheduling and sequencing, and instructional materials are all necessary for a _____ _____. | teaching plan
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| Patients will remember best when... | they are speaking or doing.
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| Three domains of learning | 1. Cognitive 2. Affective (feelings) 3. Psychomotor (hands-on)
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| What are some factors that could affect the way a patient learns? | When the session is scheduled, how complex the task is, developmental stage, culture, literacy, belonging to a special population
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| rest : refreshing :: sleep : _____ | restoration
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| What are four benefits of sleeping? | 1. increases mental performance 2. restores energy 3. improves ability to cope 4. strengthens immune system
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| Internal clock, 24 hour wake/sleep pattern, day/night | circadian rhythm
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| What is NREM? Give another name for it. | Non-Rapid Eye Movement Sleep. There are four stages.
Slow Wave Sleep (SWS)
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| What is REM? | Rapid Eye Movement. Stage V of sleeping. Dreaming takes place in REM.
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| Age, exercise, foods, meds, illness, temperature, and noise all affect _____. | Sleep
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| The inability to fall asleep, stay asleep, or return to sleep | insomnia
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| Sylvia traveled from Indiana to China. What circadian disorder is she likely to be suffering from? | Jet lag
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| Agnes' mother is concerned for her daughter because she sleeps over 18 hours a day. What sleeping condition may her daughter be suffering from? | hypersomnia
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| Jackie noticed that her husband occasionally stopped breathing during the night. After participating in a sleep study, it was discovered that her spouse had _____ _____. | sleep apnea
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| Lydia has to sleep with a mouth guard because she has this parasomnia condition. | Bruxism
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| A graduate nurse comes to asking for advice on how to help her patients get enough sleep while at the hospital. What advice would you give? | Schedule care to avoid interrupting pt sleep, create a restful environment, promote comfort/relaxation, support bedtime routines/rituals, offer foods to help promote sleep,teach sleep hygiene, administer/complete client teaching about sleep-inducing meds
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| Five characteristics of culture | 1. learned 2. taught 3. shared by its members 4. dynamic and adaptive 5. complex 6. diverse 7. provides identity 8. has common beliefs and practices
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| John is a young, homeless man who suffers from schizophrenia. What type of subculture does he fit in? | vulnerable population
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| Lack of knowledge, emotional responses, ethnocentrism, cultural stereotypes, language, and prejudice are examples of | barriers to culturally competent care
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| Nurses can culturally competent care by | developing cultural self-awareness and knowledge, accommodating cultural practices, avoiding mandating change, and being respectful to culturally based family roles
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| Take a trip to BALI | Be aware of your own cultural heritage. Appreciate that the pt is unique. Learn about the pt group. Incorporate the pt cultural values/behavior into the care plan.
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| Define superficial | skin or subcutaneous
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| a sunburn is an example of a ____ wound | superficial
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| stimulates deep internal pain receptors | visceral
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| pain in the ligaments, tendons, bone | somatic
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| classification of pain by origin (3) | superficial, visceral, somatic
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| classification of pain by cause (2) | nociceptive, neuropathic
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| classification of pain by duration (3) | acute, chronic, intractable
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| Define transduction | activation of pain receptors
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| Define modulation | initiation of the protective response. process where the sensation of pain is inhibited or modified
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| Define perception of pain | awareness of the characteristics of pain
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| If you barely touch Renee on the back, she howls with pain. What condition may she have? | Hyperalgesia- extreme sensitivity to pain
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| The three endogenous opioids | enkephalins, dynorphins, beta endorphins
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| What are endogenous opioids? | naturally occurring analgesic neurotransmitters that inhibit the transmission of pain impulses and the release of substance P.
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| Physiologic responses to pain | inc BP, pulse, and resp rate; muscle tension
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| Behavioral responses to pain | moving away from painful stimuli, moaning, crying
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| Affective (emotional) responses to pain | fear, anger, anxiety, withdrawal
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| TENS | transcutaneous electrical nerve stimulation. used to reduce pain
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| PENS | percutaneous electrical nerve stimulation. combines TENS with a percutaneous needle that stimulates the peripheral sensory nerves
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| Nonopiod analgesics | NSAIDS, Acetaminophen
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| Agnes has lower back pain that goes down her leg. This is an example of _____ _____. | radiating pain
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| Sylvia says she occasionally feels pain where her leg used to be. She is experiencing _____ _____. | phantom pain
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| The doctors have run several tests on Larry. They have come back negative. Larry insists that he is having pain. Larry's pain may be categorized as _____. | psychogenic
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| Parents of small children who are orally fixated would benefit from knowing maneuver | Heimlich
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| Florence is a 78 year old white female. She is using seven medications daily, has slowed reaction time, impaired vision, and often confused. She is at prime risk for _____. | falling
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| Nonskid shoes, tidy clothes, proper lighting, grab bars, no scatter rugs are | fall preventions
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| It is mandatory for a nurse to complete an incident report if | a patient falls while in the hospital
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| Physical examination includes | assessing mobility status, ability to communicate, level of awareness or orientation, sensory perception, identify potential safety hazards, recognize manifestations of domestic abuse or neglect
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| Types of restraints | side rails, lap trays, extremity restraints, vests
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| alternatives to restraints | bed alarms, sitters, frequent orientation
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| List physiologic hazards associated with restraints | suffocation, impaired circulation, pressure ulcers, atrophy, fractures, altered nutrition and hydration, aspiration and breathing problems, incontinence, changes in mental status
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| How can poisoning be prevented? | cabinet locks, store poison high, keep Poison Control number available
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| What's the best way to prevent CO poisoning? | CO detector
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| What is RACE? | RESCUE anyone in immediate danger.
ACTIVATE the fire code and notify appropriate person
CONFINE the fire by closing doors and windows
EVACUATE patients and other people to safe area (ambulatory pts first)
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| Give 2 examples of take-home toxins. | asbestos, lead, mercury, arsenic, pathogenic microorganisms
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| What are some preventions for take-home toxins? | be aware of workplace preventative measures, remove work clothing, shower if appropriate, gloves
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| What is a help bath? | The nurse helps to bathe areas that are difficult for the patient to reach.
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| What is a partial bath? | The nurse bathes only the areas that are necessary (underarms, genitals etc)
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| Before shaving a patient, what do you need to check/ask about? | Are they on an anticoagulant
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| Flexion | bending parts of the joint so that the angle between them decreases and the parts come closer together (bending at the knee)
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| extension | straightening parts at a joint so that the angle between them increases and the parts move farther apart (straightening the knee)
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| hyperextension | excess extension of the parts at a joint, beyond the anatomical position (bending the head back beyond the upright position)
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| abduction | moving a part away from the midline (lifting the arms forming a right angle to the body)
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| adduction | moving a part toward the midline (bringing the arm back toward the body)
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| rotation | moving a part around an axis (twisting the head from side to side)
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| supination | turning the hand so the palm is upward or facing anteriorly
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| pronation | turning the hand so the palm is downward or facing posteriorly
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| eversion | turning the foot so the plantar surface faces laterally
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| inversion | turning the foot so the plantar surface faces medially
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| lateral | means toward the side with respect to the imaginary midline
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| medial | relates to an imaginary midline dividing the body into equal right and left halves
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| circumduction | moving a part so that its end follows a circular path (moving the finger in a circular path without moving the hand)
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| How often should an immobile patient be repositioned? | At least every two hours to prevent skin breakdown
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| List six pressure points | coccyx, hips, scapula, heels, ears, sacrum
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| Fowler's position | semisitting position. head of bed is elevated 45-60 degrees. Promotes respiratory function by lowering the diaphragm and allowing the greatest chest expansion
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| semi-Fowler's position | head of the bed is elevated only 30 degrees
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| high-Fowler's position | head of the bed is elevated 90 degrees
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| orthopneic position | Head of the bed is elevated 90 degrees and an overbed table with a pillow on top is positioned in front of the patient. The patient rests arms and head on the pillow. This is helpful for those with shortness of breath.
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| Lateral position | side lying position with top hip and knee flexed and placed in front of the rest of the body. causes pressure on lower scapula, ilium, and trochanter but relieves pressure from heels and sacrum
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| Lateral recumbent position | side-lying with legs in straight line
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| oblique position | an alternative to lateral position. places less pressure on trochanter. pt lays on the side with the top hip and knee flexed but the top leg is placed behind the body
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| prone position | the pt lies on stomach with the head turned to a side. only position to allow full extension of the hips and knees. creates significant lordosis and rotation of the neck. Not for pts with cervical or lumbar spine problems. Meant for short periods of time
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| Sim's position | semiprone position. the lower arm is positioned behind the patient, and the upper arm is flexed. upper leg is more flexed than lower leg. ideal position for administering enema or a perineal procedure
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| Supine position | also called dorsal recumbent position. pt lies on back with head and shoulders elevated on a small pillow. spine is aligned and the arms and hands comfortable rest at the side
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| How does exercise effect the cardiovascular system? | decreases HR & BP, increased blood flow to body and increasing efficiency of the heart
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| How does exercise effect the respiratory system? | increased depth of resp, resp rate, and excretion of CO2
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| How can muscle atrophy be prevented? | exercise
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| Always use a ____ ____ when transferring an ambulatory pt. | gait belt
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| Range of Motion: passive | pt is unable to move joints independently
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| Range of Motion: active | pt is able to move joints independently through full ROM
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| Range of Motion: both | improve joint mobiity, increase circulation to affected part, and help prevent contractures
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| Only exercise joint to point of resistance not _____ | pain
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| How is the urinary system effected by lack of exercise? | urinary stasis causes infection, urinary retention, and incontinence from decreased muscle tone
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