Communication Exam 4 Flashcards

Question

What is the purpose of documentation in nursing?

Answer 1

Documentation provides a clear, concise, and complete representation of the client’s healthcare experience.

Answer 2

SMART goals are Specific, Measurable, Achievable, Relevant, and Time-bound objectives for patient communication.

Answer 3

intrapersonal- most common interpersonal- exchange of information small group public communication mass communication- social media

Answer 4

you to call. State the following: -Your name -Your unit -The patient’s name and room number -Brief overview of the problem Background: Give other information pertinent to the situation—not the patient’s entire history since admission, but circumstances leading up to the situation. Assessment: State the problem and what you think is causing it. Recommendation: State what you think will correct the problem, or what you need from the provider. Question: Allow an opportunity to ask or answer any questions. Review specific concerns.

Answer 5

Denotative (literal) and connotative (implied) meaning - participants must share meanings when communicating. Different interpretation can cause miscommunication. Clarity and brevity - short and simple is most effective; long and complex may be difficult to understand and follow. Timing and relevance - knowing when to communicate makes it most effective. Most opportune time may not be when the patient is in pain or distracted. Pacing - rate of speech may be interpreted differently than intended. Rapid speech may look as if sender is rushed. Intonation - tone communicates a variety of feelings. “It’s not what you said, but HOW you said it”.

Answer 6

Foundational to the nurse-client relationship Client-centered, not social or reciprocal Purposeful, planned, and goal-directed Expresses empathy and genuine concern for client and family issues May require age-appropriate techniques may need to be used to enhance communication Plan for and allow time to effectively communicate Requires attentive behavior and active listening Must be honest, direct, open, and sincere Demonstrates trustworthiness and acceptance

Answer 7

you understand but have no experience

Answer 8

relate- same experience

Answer 9

pre-interaction phase- report orientation phase- establish report and trust working phase-, the nurse communicates caring, the patient expresses thoughts and feelings, mutual respect is maintained, and honest verbal and nonverbal expression occurs. Key communication goals are to assist the client to clarify feelings and concerns. A professional relationship is courteous, trustworthy, and confidential, and accomplished by active listening. Biggest phase Termination- end of shift/discharge conclusion of relationship

Answer 10

irreverent questions arguing judging stereotyping probing challenging

Answer 11

silence presenting reality touch taking the time provide facts

Answer 12

clarifying "i heard you" reflecting and examine feelings paraphrasing acceptance

Answer 13

clear, respect, professionally round with interdisciplinary teams handoff at bedside CUS words assertive communication

Answer 14

The goal of all nursing documentation is a clear, concise, and complete representation of the client’s healthcare experience that is easily accessible and understood by all members of the healthcare team. Effective documentation allows you to help clients make sound health decisions. It also enables use of current and consistent data, problem statements, diagnoses, goals, and strategies to support continuity of care. Documentation serves as another form of communication between healthcare providers. Charting by exception (CBE) is common and saves the nurse charting time but can omit important information. Focused charting addressing the chief complaint but may miss other problems. Never document an intervention without a response 30-60 minutes later!

Answer 15

Determine impaired communication type and history Consider physical and mental status Medications Substance abuse Developmental status Cultural considerations Determine barriers that may be contributed (as previously discussed) Past medical experiences

Answer 16

Client will use alternative methods of communication effectively by discharge. Client will demonstrate minimal frustration with communication difficulties by the end of shift. Client will effectively communicate via an interpreter AEB relaxation and positive body language by the end of the day. Client will accurately display appropriate verbal and nonverbal communication by the end of shift. Client will actively communicate in healthcare plans and goals with nursing staff by the time of discharge. Client will verbalize understanding of the. healthcare plan by the time of discharge. Client will demonstrate understanding of healthcare plan by the time of discharge.

Answer 17

was the goal successful? what was client response?

Answer 18

Provide time and privacy for communication Provide communication devices or enhancements (glasses, hearing aids, picture boards) Consult interpreter or use organization approved communication tablet Plan communication at a time of day that is most appropriate for client Provide simple instructions Ensure client is provided with educational materials in a format they can understand

Answer 19

cenario: Patient with a New Diabetes Diagnosis Context: A nurse is educating a patient, Mrs. Thompson, who has just been diagnosed with type 2 diabetes. She seems withdrawn and agitated. ⸻ Nurse (therapeutic communication): “Mrs. Thompson, I know this is a lot to take in. I’m here to answer any questions you may have about your diagnosis or the changes ahead.” ⸻ Patient (denotative and connotative response): “Oh, great. So now I’m just a diabetic. Another label. Might as well put me in a box and throw away the key.” ⸻ Interpretation: * Denotative meaning (literal): The patient acknowledges being labeled as “a diabetic.” * Connotative meaning (emotional/figurative): The phrase “put me in a box and throw away the key” implies feelings of hopelessness, loss of identity, and a fear of being defined solely by her illness. The word “label” connotes stigma or judgment. ⸻ Therapeutic response by the nurse: “It sounds like you’re feeling overwhelmed and maybe even boxed in by this diagnosis. You’re not alone, and this doesn’t define who you are. Let’s take this one step at a time together.” ⸻ This approach reflects therapeutic communication by acknowledging both the literal content and the emotional undertone, helping to validate the patient’s feelings while building trust. Would you like a similar example from a nurse’s perspective instead of a patient’s?

Answer 20

Scenario: Emergency Room Triage Context: A nurse is assessing a patient who arrived in the emergency room complaining of chest pain. Time is critical, and communication must be concise and clear. ⸻ Nurse (using clarity and brevity): “Mr. Lee, I need to ask you three quick questions. When did the pain start? Where is it? And how would you rate it from 0 to 10?” ⸻ Patient: “It started about 30 minutes ago. It’s right in the center of my chest, and I’d say it’s an 8 out of 10.” ⸻ Nurse (clear and brief response): “Thank you. I’m alerting the team now. You may need an EKG and blood work right away.” ⸻ Why this works: * Clarity: The nurse asks direct, specific questions to gather vital information efficiently. * Brevity: The nurse avoids unnecessary wording, focusing only on essential information needed for immediate care. * Therapeutic impact: The patient is more likely to cooperate and feel safe due to the nurse’s calm, purposeful communication. ⸻

Answer 21

Absolutely! Here’s a nursing scenario that illustrates the use of timing and relevance, which are also essential components of therapeutic communication. ⸻ Scenario: Preparing a Patient for Surgery Context: A nurse is caring for Mr. Davis, who is scheduled for surgery in 30 minutes. He appears anxious and is reviewing his consent form. ⸻ Patient: “I’m just not sure about this. What if something goes wrong during the surgery?” ⸻ Nurse (using timing and relevance): “I understand you’re feeling nervous. Right now, the surgeon is reviewing your plan, and I’ll stay with you until it’s time to go. After surgery, we’ll monitor you closely, and you’ll have pain relief ready. Do you have a specific concern I can help with before we head in?” ⸻ Why this works: * Timing: The nurse chooses a moment when the patient is receptive and seeking reassurance—right before surgery, not during transport or a rushed procedure. * Relevance: The nurse focuses the response specifically on the patient’s current emotional state and the immediate situation, avoiding unrelated information or deep medical explanations. ⸻ This kind of communication helps reduce anxiety and builds trust at a critical time.

Answer 22

Certainly! Here’s a scenario that demonstrates pacing in therapeutic communication — that is, adjusting the rate, rhythm, and tone of communication to match the patient’s needs. ⸻ Scenario: Elderly Patient with Early Dementia Context: Mrs. Alvarez, a 78-year-old woman with early-stage dementia, is being assessed by a nurse during morning rounds. She seems confused and slow to respond. ⸻ Nurse (using appropriate pacing): (Speaking slowly and calmly, maintaining eye contact) “Good morning, Mrs. Alvarez. My name is Sarah. I’m your nurse today. I’m here to help you get ready for breakfast.” (Pauses, giving Mrs. Alvarez time to process and respond) Mrs. Alvarez: “I… I don’t remember if I ate already…” Nurse: “That’s okay. Breakfast is just starting now. Let’s wash up first, and then I’ll walk with you to the dining room.” ⸻ Why this works: * Pacing: The nurse slows her speech and pauses intentionally, giving the patient time to process and respond without feeling rushed or overwhelmed. * Therapeutic impact: Adjusting communication pace helps reduce anxiety and fosters understanding, especially in cognitively impaired patients. ⸻

Answer 23

Great — here’s a contrasting scenario where the nurse fails to use appropriate pacing, showing how it can negatively impact communication and patient care. ⸻ Scenario: Same Patient – Mrs. Alvarez with Early Dementia Context: Morning rounds again. The nurse is behind schedule and appears rushed. ⸻ Nurse (poor pacing): “Hi Mrs. Alvarez, I’m Sarah, your nurse. We need to get you cleaned up, dressed, and down to the dining room now, okay? Did you eat yet? Let’s go.” (Nurse talks quickly and immediately starts pulling back the bedsheets.) Mrs. Alvarez (confused and anxious): “Wait—who are you? Why are you rushing me? I don’t… I don’t know what’s going on!” ⸻ Why this doesn’t work: * Poor pacing: The nurse speaks rapidly and moves too quickly for a patient with cognitive challenges. * Therapeutic breakdown: The patient becomes more confused and anxious, which could lead to resistance or emotional distress. * Missed opportunity: No pause is given for the patient to process or respond appropriately. ⸻ This contrast highlights how crucial pacing is in building trust and promoting effective communication — especially with vulnerable populations like those with dementia.

Answer 24

Certainly! Here’s a therapeutic communication scenario that focuses on intonation — the tone, pitch, and inflection used when speaking — which can greatly affect how a message is perceived. ⸻ Scenario: Teen Patient in a Pediatric Unit Context: Jordan, a 16-year-old recovering from an appendectomy, hasn’t been engaging much. The nurse notices he’s withdrawn and offers to check in. ⸻ Two versions showing the impact of intonation: ⸻ 1. Ineffective Intonation (Flat, Disinterested Tone): Nurse: “Hey Jordan. Just checking how you’re doing. Pain okay? Want anything?” (Tone is flat and rushed, lacking warmth or sincerity.) Jordan (shrugging): “No. I’m fine.” (Tone mirrors the nurse’s disinterest.) ⸻ 2. Effective Intonation (Warm, Supportive Tone): Nurse: (Gently, with a calm and encouraging tone) “Hi Jordan. I just wanted to see how you’re feeling. Is your pain a little better today? I’m here if you need anything.” Jordan (softening): “It still hurts a little… but I guess it’s better than yesterday.” ⸻ Why this works: * Effective intonation conveys empathy, attentiveness, and support — key to therapeutic communication, especially with adolescents who are sensitive to tone. * Poor intonation can make a message sound dismissive or insincere, even if the words are appropriate. ⸻

Answer 25

Certainly! Here’s a scenario that demonstrates therapeutic communication through restating — a technique where the nurse repeats the patient’s words in a slightly different way to show understanding and encourage further expression. ⸻ Scenario: Hospitalized Adult Expressing Frustration Context: Mr. Collins is recovering from a stroke and is struggling with mobility. He’s visibly frustrated during a physical therapy session. ⸻ Mr. Collins: “I can’t even walk to the bathroom without help. I feel useless.” ⸻ Nurse (restating): “You’re feeling frustrated because you need assistance with something that used to be easy for you.” ⸻ Mr. Collins: “Exactly. I was always independent. Now I have to ask for help just to stand up.” ⸻ Why this works: * Restating shows that the nurse is actively listening and understands the emotional content of the patient’s message. * It encourages the patient to elaborate, helping build trust and emotional validation. * It avoids judgment or advice, focusing instead on empathy and presence. ⸻ Would you like a variation that uses reflection or paraphrasing as a follow-up technique?

Answer 26

Absolutely! Here’s a therapeutic communication scenario using the technique of reflecting, where the nurse focuses the conversation back to the patient’s feelings or concerns, encouraging them to explore more deeply. ⸻ Scenario: Young Adult with New Diagnosis of Depression Context: Sara, a 22-year-old patient, has just been diagnosed with clinical depression. She’s speaking with a nurse during a follow-up visit. ⸻ Sara: “I just don’t see the point in trying anymore. Nothing I do seems to matter.” ⸻ Nurse (reflecting): “It sounds like you’re feeling hopeless and questioning your worth right now.” ⸻ Sara: “Yeah… I guess I feel like I’m invisible. Like I could disappear and no one would notice.” ⸻ Why this works: * Reflecting focuses on the emotional tone of what the patient says, rather than just the content. * It validates the patient’s feelings and encourages deeper self-expression without pushing advice or solutions. * It helps the nurse assess the patient’s emotional state and potential risk (e.g., suicidal ideation). ⸻ Would you like an example that shows how to follow reflection with a supportive intervention?

Answer 27

Of course! Here’s a therapeutic communication scenario that demonstrates paraphrasing — a technique where the nurse restates the patient’s message using different words to clarify meaning and show understanding. ⸻ Scenario: Middle-Aged Patient Facing Surgery Context: Mr. Daniels is scheduled for heart bypass surgery next week. He’s talking with the nurse during pre-op education and seems uneasy. ⸻ Mr. Daniels: “I know the doctors say it’s routine, but I can’t stop thinking about what could go wrong. I’m not ready for something to happen to me.” ⸻ Nurse (paraphrasing): “You’re worried about the risks of surgery and feeling unprepared for what might happen.” ⸻ Mr. Daniels: “Exactly. Everyone keeps acting like it’s no big deal, but to me it is.” ⸻ Why this works: * Paraphrasing allows the nurse to check understanding while showing that they are actively listening. * It helps the patient feel heard and respected, often prompting them to open up further. * It also clarifies vague or emotionally loaded statements in a neutral, supportive way. ⸻ Would you like a quick chart summarizing the differences between paraphrasing, restating, and reflecting?

Answer 28

What makes you think point A leads to Point B...

Communication Exam 4 Flashcards

(52 cards)