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HEALTH ASSESSMENT > UNIT 2A > Flashcards

UNIT 2A Flashcards

1
Q

a purposeful, time-limited verbal interaction between the nurse and the patient or his/her significant other

A

Nursing interview

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2
Q

nursing interview is done to collect ______ about the patient

A

subjective data

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3
Q

What are the factors influencing the interview

A

Approach
Environment
Confidentiality
Note Taking
Time, Length, Duration
Biases and Preconceptions

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4
Q

gather all appropriate information before approaching the patient

A

approach

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5
Q

How do you begin interviewing the pt?

A

introducing your name and title

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6
Q

Initially, call the patient his or her _____ and ask how the patient prefers to be addressed

A

formal name

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7
Q

has a direct influence on the amt & quality of information gathered

A

environment

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8
Q

What is the ideal setting for interview?

A

private room
less distractions/interruptions
increase comfort level for the patient

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9
Q

essential in developing trust

A

confidentiality

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10
Q

_______ of confidentiality often eases the patient’s concerns

A

verbal assurance

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11
Q

What are the reasons for sharing confidential information?

A

patient poses danger to self or others
institutional policy (inform the patient prior when the info should be shared)

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12
Q

advisable but may cause patient discomfort

A

note taking

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13
Q

explain the necessity of jotting down _____ information

A

pertinent or relevant

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14
Q

pay attention to patient & ______ if patient discusses sensitive issues

A

defer recording

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15
Q

interview times should be least _____ to patient’s _____ & try to accommodate patient’s request

A

Time, Length, Duration
disruptive
daily routine

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16
Q

be sensitive to personal as well as ______ in order to treat all patients fairly & respectfully

A

biases and preconceptions
patient context

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17
Q

avoid faulty assumptions by continually validating information & ______ ( use _______)

A

personal impressions
effective interview techniques

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18
Q

What are the stages of the interview process?

A

Stage 1 (Pre-Introductory Stage)
Stage 2 (Introductory Stage)
Stage 3 (Working Stage)
Stage 4 (Termination Stage)

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19
Q

the nurse reviews patient’s records before
meeting with the patient.

What stage of interview process?

A

Stage 1 (Pre-Introductory Stage)

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20
Q

In stage 2 of the interview process, the nurse and patient _____ and _____

A

establish trust
get to know each other

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21
Q

in this stage, bulk of patient data is collected

A

Stage 3 Working Stage

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22
Q

In Stage 4, information is ____ and _____

A

summarized and validated

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23
Q

during this stage, give the pt an indication of the amt of time left in the interview, & allow pt opportunity to give addt’l info & make comments/statements

A

Termination stage

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24
Q

What are the factors affecting communication?

A

active listening
nonverbal cues
Distance or proxemics
Personal Space

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25
Q

to decode patient messages in order to understand the situation or problem as the other person sees it

A

Active Listening

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26
Q

Nurses should always pay attention and formulate ____

A

Active Listening
appropriate response

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27
Q

communicating a message without words

A

Nonverbal cues

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28
Q

List down the nonverbal cues.

A

body position
nervous repetitive movements of the hands or legs
rapid blinking
lack of eye contact
yawning
fidgeting
excessive smiling or frowning
repetitive clearing of the throat

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29
Q

the amount of space a person considers appropriate for interaction is a significant factor in the interview process and is determined in part by _____

what is this?

A

Distance or Proxemics
cultural influences

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30
Q

What are the four distances?

A

Intimate zone (< 18 in. from pt.)
Personal zone (18 inches to 3 feet)
Social Distance (4 to 12 ft.)
Public Distance (> 12 feet)

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31
Q

the space over which the person claims ownership (e.g. pt’s hospital room & bathroom)

A

Personal Space

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32
Q

pt. may be protective over this space & consider ______ of it as an invasion of privacy

A

unauthorized use

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33
Q

encourages pt. to provide general rather than more focused communication.

A

Using Open-ended Questions

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34
Q

Validating the right patient before giving the drug: “May I know your name sir?”

A

Using Open-ended questions

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35
Q

restrict or regulate patient response to a “yes”, a “no” or a response less than _____

A

Using close-ended questions
3 words

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36
Q

used to focus the interview, pinpoint specific areas of concern, & elicit valuable information quickly & efficiently

A

using close-ended questions

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37
Q

using close-ended questions can ______ if frequently used

A

disrupt communication

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38
Q

encourages patient to continue talking

A

facilitating

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39
Q

coupled with nonverbal cues - eye contact, nodding & leaning slightly forward

A

facilitating

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40
Q

Go on. uh-huh

A

Facilitating

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41
Q

helps structure & pace the interview, convey respect & acceptance, and prompt additional patient data.

A

Using silence

42
Q

using silence on the part of the patient, may convey

A

anxiety, confusion or embarrassment

43
Q

the nurse verbalizes perceptions about the patient’s behavior, then shares them with the patient

A

making observations

44
Q

Speaking about those symptoms seems to make you tense. I notice that you are clenching your fists and grimacing.”

A

making observations

45
Q

involves repeating or rephrasing the main idea expressed by the patient & lets the patient know that you are paying attention

A

restating

46
Q

the nurse directs the pt’s own questions, feelings & ideas back to the patient & provides opportunity for the patient to _____ &/or expand on what was said.

A

reflecting

reconsider

47
Q

used by the nurse to make clear something the patient says or to pinpoint something in the message when the patient’s words & nonverbal cues do not agree.

A

clarifying

48
Q

enables the nurse to link events that perhaps the patient was not able to piece together

A

interpreting

49
Q

involves asking the patient to place a symptom, a problem, or an event in its proper sequence.

A

sequencing

50
Q

facilitating the conversation such that occurrence of symptoms/events are pieced together ______ by pt.

A

sequencing
chronologically

51
Q

helps the patient to deal more effectively with unfamiliar situations by placing the symptoms or problems in the context of something else that is familiar

A

Encouraging comparison

52
Q

In what way was this allergy attack different from or the same as your previous ones?”

A

encouraging comparison

53
Q

especially useful at the end of the health assessment interview

A

summarizing

54
Q

also provides a means of smoothly transitioning to a new topic or section of the health assessment.

A

summarizing

55
Q

allows the nurse to concentrate on or “track” a specific point the patient has made

A

focusing

56
Q

Focusing is useful to patients with ?

A

heightened anxiety
altered concentration
jumping from topic to topic

57
Q

enables the nurse to develop, in more detail, a specific area of content or patient concern.

A

exploring

58
Q

helps the nurse identify ______ in symptom presentation or in the way patients handle problems or health concerns

A

exploring
patterns or themes

59
Q

typically used with psychiatric or confused patients, or to patients who exaggerate or make grandiose statements.

A

presenting reality

60
Q

presenting reality should be done in a ?

A

non-argumentative way

61
Q

a verbal response that the nurse makes to some perceived discrepancy or incongruency in the pt’s thoughts, feelings, or behaviors.

A

confronting

62
Q

can be used to focus the patient’s attention on some aspect of behavior that, if changed, could lead to more effective functioning

A

confronting

63
Q

confronting is done in a caring, empathetic manner, rather than a ______

A

critical or accusatory

64
Q

Providing the patient with needed information, such as explaining the nature and/or the reasons for any necessary tests or procedures.

A

informing

65
Q

allows the nurse to help patients become aware of possible choices & then evaluate those choices correctly.

A

informing

66
Q

the nurse & patient work together, rather than the nurse taking control of the interaction

A

collaborating

67
Q

conveys the message that the patient has important knowledge and information to share & encourages
1. active involvement of patient in their own health care
2. in setting goal
3. in gathering information
4. in problem solving.

A

collaborating

68
Q

setting specific limits on inappropriate patient behavior

A

limit setting

69
Q

What scenarios do you set specific limits?

A

sexually aggressive patients
hostile patients
talkative patients

70
Q

provide guidance by calmly, clearly, and respectfully telling the patient what behavior is expected

A

limit setting

71
Q

____ only the behavior that is ______ to the purpose of the interview and avoid making a “big issue” of whatever it is that the patient is doing

A

limit
problematic or detrimental

72
Q

allows the nurse to offer appropriate reassurance that the pt.’s response may be quite common for the situation and helps decrease patient’s anxiety and fear of being misunderstood.

A

Normalizing

73
Q

Enumerate the different therapeutic or effective interview techniques

A

using open-ended questions
using close-ended questions
facilitating
using sulience
making observations
restating
reflecting
clarifying
interpreting
sequencing
encouraging comparisons
summarizing
focusing
exploring
presenting reality
confronting
informing
collaborating
limit setting
normalizing

74
Q

What are the different non-therapeutic interview techniques?

A

Requesting an Explanation
Probing
Offering false reassurance
giving approval or disapproval
advising
using problematic questioning techniques

75
Q

such questions ask the patient to provide a reason or justification for personal beliefs, feelings, thoughts, and behaviors and imply criticism and may make the patient feel inadequate, defensive, or angry

A

requesting an explanation

76
Q

using “why” in the question

A

requesting an explanation

77
Q

repeated or persistent questioning of the patient about a statement or behavior

A

probing

78
Q

What are the useful responses to prevent probing

A

going on to the next part of interview
asking permission to get back to the subject later
just sitting quietly until patient begins to speak

79
Q

giving vague, simplistic responses that question the patient’s judgment, devalue and block patient feelings, and communicate a lack of understanding and sensitivity on the part of the nurse w/c often increases pt. anxiety

A

Offering false reassurance

80
Q

telling a patient what is right or wrong is demoralizing and may limit patient’s freedom to verbalize or behave in certain ways and hinder the nurse’s attempts to establish rapport.

A

giving approval or disapproval

81
Q

What should be the appropriate response instead of giving approval or disapproval?

A

What do you think the consequences ______

82
Q

What non therapeutic interview does consistently telling a patient what to do?

A

advising

83
Q

advising does not foster ______

A

competence

84
Q

nurses should not reinforce ______ because some patients may resort to _____ passive behavior when faced with illness

A

dependence

85
Q

What are the different problematic questioning techniques?

A

Posing leading questions
interrupting the patient
engaging in talkativeness
using multiple questions
using medical jargon
being authoritative
having hidden agendas

86
Q

What should you do with patient who is hearing impaired?

A

Often lip-read; remain within the sight of the patient & face the patient when talking.
• Ensure that the hearing aid is in working order and turned on.
• Minimize background noise.
• Always face the patient and direct all communication to the patient
Avoid speaking loudly and slowly
• Use nonverbal cues such as facial expression and body movements to convey the meaning
• May also have speech difficulty; allow additional time and use a written form of gathering data.

87
Q

What should you do with patient who is speech impaired?

A

Ask simple questions that requires yes and no answers (closed-ended questions);

Allow additional time for patient responses
• Repeat or rephrase the question if the patient did not understand
If unable to understand the patient’s responses, use a written interview format, letter boards, or yes/no cards.
• When someone else is speaking for the patient, the nurse should speak and direct questions to the patient, not to the intermediary

88
Q

What should you do with patient who is non-english speaking?

A

Have an interpreter/translator if possible • Nurse should not assume that the interpreter can answer questions for the patient.
• Direct the questions to the patient and NOT to the interpreter

89
Q

What should you do with patient who has low level of understanding?

A

Requires time and patience;
Hurrying may cause confusion, lose of concentration or refusal to answer the question.

If necessary, interview the patient’s family or caregiver for supplemental information.

Always direct the questions to the patient and allow assistance from family members or the caregiver.

Observe nonverbal communication between patient and family to gather information about patient’s health/illness state as well as relationships between them

90
Q

How should you interview patient who is under the influence of alcohol or drugs?

A

-security personnel should be alerted and stationed nearby
-place yourself at a safe distance
-remain calm
-provide care in a non-threatening manner

91
Q

How should you interview patient who is visually-impaired?

A

-look directly at the patient as if the patient were sighted
- avoid soeaking loudly
- touch is very important
-advise the patient when you are entering or leaving the room
-use clock hours to indicate position of items
-offer assistance to partially sighted

92
Q

When using clock hours
12 is
3 is
6 is
9 is

A

12 is ahead
3 is right
6 is behind
9 is left

93
Q

How should you interview patient who is crying?

A

-show empathy and allow patient to cry
-offering of tissues

94
Q

In dealing or interviewing patient who is anxious or angry avoid statements such as?

A

Take a moment to get hold of yourself

95
Q

______ tends to be contagious. Don’t reciprocate with anger and ____

A

hostility

96
Q

Minimize aggression through

A

limit-setting and refocusing

97
Q

When dealing with patient who is hostile, position yourself near an easily accessible ___

A

exit

98
Q

How should you deal with patient who is sexually aggressive?

A

define appropriate boundaries
sharing personal reactions
refocusing the patient

99
Q

When you interview patient who is very ill, you should collect ____ from the patient first and defer remainder of the interview later

A

pertinent

100
Q

When interviewing patient who is older adult, what should be assessed first?

A

hearing acuity

101
Q

When dealing with older patient, avoid?

A

Elderspeak

because it gives message of dependence and incompetence

HEALTH ASSESSMENT (16 decks)

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