Exam # 1 (321) Flashcards

Question

Touch

Answer 1

Therapeutic touch can bring a sense of caring and human connection to an interaction with a client. •Feelings and beliefs about touch can vary considerably among individuals, families, and cultures. •The nurse must be sensitive to the differences in attitudes and practices of client and self

Answer 2

Blocking communication with clients •Discouraging the client from expressing emotions openly •Making the client feel defensive or requiring justification of actions •Shifting the focus away from the client’s health concerns and experiences •Belittling the client’s feelings and problems •Avoiding exploration of critical topics •Discouraging effective client decision-making •Focusing on the problem and blaming rather than finding solutions, options, or insight

Answer 3

Using “why” questions •Asking personal questions • Giving personal opinions • Changing the subject • Automatic responses • False reassurance • Sympathy • Asking for explanations • Approval or disapproval • Defensive responses • Passive or aggressive responses • Arguing

Answer 4

Why demands an explanation: “Why did you come home late?” • Why implies wrongdoing •It’s much more useful to ask what is happening rather than why it’s happening

Answer 5

Nurses do not give personal opinions or advice •Why? •It takes the decision making away from the person •Stalls problem solving, and creates doubt •Patients will want to discuss care and options

Answer 6

Sympathy is concern, sorrow, or pity felt for another person. •“You probably feel devasted” •May be compassionate, but not therapeutic. •Sharing empathy •Being emotional may prevent effective problem solving and impair good judgement

Answer 7

You should…” • “You have to…” • “You can’t…” • “If it were me, I’d…” • “Why don’t you…” • “I think you…” • “It’s the policy on this unit…” • “Don’t worry…” • “Everyone…” • “Why…”

Answer 8

Informal interactions among friends, neighbors, and acquaintances

Answer 9

*Usually occurs among people who know each other or are informally getting to know each other * Does not necessarily focus on one person or one topic * May or may not have an equal emphasis on all individuals or topics * Involves mutual sharing of ideas, opinions, judgments, and feelings * May have blurred boundaries at times * Can express appropriate and inappropriate anger and humor * Can have unsolidified (fluid) ethical and legal boundaries, depending on the circumstances * Has little effect on the nurse–patient helping relationship, unless the nurse has a long history with the patient (which may be positive or negative)

Answer 10

Positive, beneficial interactions that focus on the patient

Answer 11

* Usually occurs among the patient, family members, and/or the health care team in a professional manner * Focuses mainly on the patient * Has an emphasis on the patient and health topics * Has sharing but in a limited capacity from the nurse’s point of view * Has clear boundaries on acceptable and unacceptable interactions * unacceptable to express inappropriate anger and humor * Maintains ethical and legal boundaries * Has a positive effect on the nurse–patient helping relationship

Answer 12

Negative, harmful interactions that are not focused on the patient’s needs

Answer 13

* Usually occurs among the patient, family members, and/or health care team in an unprofessional manner * Does not focus on the patient * Does not have an emphasis on the patient or health topics; may have too much inappropriate emphasis on the patient * Has the ability for the nurse to overshare * Usually crosses boundaries of acceptable interactions * Crosses ethical and legal boundaries * Expresses inappropriate behavior, anger, humor, or insensitivity * Has an adverse effect on the nurse–patient helping relationship

Answer 14

No sharing of patient information (not even to family members) unless the patient or guardian has given permission No sharing of patient conversations, except with the health care team when it relates to patient care No talking about patients in public places (e.g., hallways, elevators, cafeteria) No social media postings of patient information or images No talking about patients with the nurse’s own friends, relatives, or neighbors

Answer 15

is an ethical and legal responsibility of nurses in both formal and informal interactions with patients.

Answer 16

Theraupeutic

Answer 17

Assertiveness communication

Answer 18

The nurse is an advocate when defending the rights of patients, especially vulnerable patients, patients who cannot protect their own individual rights (anesthetized, comatose, confused), or those with whom the nurse disagrees philosophically. Assertiveness combined with clear and direct communication enhance advocacy efforts. As resources become increasingly limited, advocacy ensures patient access to needed services/supplies.

Answer 19

Professional boundaries involve ethical and legal responsibilities that delineate the limits and responsibilities of nurses when caring for patients in any setting or facility. If nurses cross these boundaries, legal actions can be taken against the nurse and the nurse’s license. Allowing patients, guardians, or family members to have the nurse’s personal phone number, meeting/dating patients after discharge, and taking money/gifts for care violate professional boundaries. The nurse–patient helping relationship is therapeutic, not social.

Answer 20

Blocking communication with patients Discouraging the patient from expressing emotions openly Making the patient feel defensive or requiring justification of actions Shifting the focus away from the patient’s health concerns and experiences Belittling the patient’s feelings and problems Avoiding exploration of critical topics Discouraging effective patient decision-making Focusing on the problem and blaming rather than finding solutions, options, or insight

Answer 21

Using “why” questions Asking closed-ended questions that can be answered with a “yes” or “no” Changing the subject Giving advice Approving or disapproving Agreeing or disagreeing Offering false reassurance or false hope Offering generalized responses Offering excessive self-disclosure or comparison Comparing patient experiences Using personal terms of endearmen There are several different nontherapeutic communication techniques that should be avoided. Some of these techniques limit the flow of communication and include the following:

Answer 22

Everything will be fine.” “This medicine is nothing to be concerned about.” “Don’t worry.”

Answer 23

It will work out.” “You’re young enough; you can have more children.” “You will be back to normal before long.”

Answer 24

I had the same type of surgery a couple of years ago.” “I have several family members who died of cancer, too.” “I am going through a bad divorce right now.”

Answer 25

The patient in room 22 just had this treatment last week with no problems.” “My aunt had this type of breast cancer and ended up having to remove a breast.” “The patient down the hall has the same thing you do; maybe you will have some experiences in common.”

Answer 26

Honey/sweetheart.” “Sweetie, it is time for your bath.” “Sport, how about we take a stroll down the hall?”

Answer 27

Social communication

Answer 28

Therapeutic communication

Answer 29

Non therapeutic communication

Answer 30

Nurse asks the patient’s name preference during initial contact Respect Nurse defends the rights of others, especially vulnerable patients Advocacy Nurse has confidence and commands respect Assertiveness Nurse keeps the nurse–patient relationship therapeutic, not social Professional boundaries

Answer 31

requires justification of actions from the patient

Answer 32

Establishing trust Exhibiting empathy Setting boundaries Identifying and honoring cultural beliefs and concerns Creating a holistic plan of care

Answer 33

pre orientation orientation/introductory, working termination.

Answer 34

Begins before the interaction Activities include preparing to meet the patient by reading the chart or assessment, thinking about and planning the interaction, and identifying possible areas to address

Answer 35

Begins the nurse–patient relationship Activities include making introductions, setting roles and boundaries, observing/assessing patient, identifying patient’s needs followed by validation from patient, establishing trust, and establishing a tentative timeline

Answer 36

Begins the process of the nurse and patient addressing and solving needs/problems Activities include creating and implementing plan of care, collaborating with others as needed, increasing rapport, using therapeutic communication to allow the patient to reflect on their illness and emotions, and explaining to the patient what is going to occur before and during any procedure or testing

Answer 37

Begins the process of ending the relationship Activities include saying “goodbye,” summarizing and evaluating care and outcomes, and discharging the patient home, to another unit or facility, or to a caregiver

Answer 38

*developmental statege *proxemics *culture *distractions

Answer 39

Interaction spaces and distances Intimate (0 to 1.5 feet) Personal (1.5 to 4 feet) Social (4 to 12 feet) Public (greater than 12 feet)

Answer 40

Some cultures may be comfortable with close proxemics when communicating. Some cultures may require a same-gender caregiver or want the family to help. Some cultures may be uncomfortable with direct eye contact. Some cultures do not want the top of the head touched.

Answer 41

Too many visitors and/or family members can sometimes make communicating difficult. The nurse has the right to ask the visitors/family members to leave because of confidentiality issues. However, if the patient wants the family members present, they can be allowed to stay. Turning off the television and other electronic devices (cell phones, tablets, laptops) that are not essential for patient monitoring can help the nurse interact with the patient.

Answer 42

Use eye contact intermittently Maintain eye level with patient Use open posturing Face the patient, if possible Lean toward the speaking person Avoid body movements that are distracting Expresses interest and concern for the patient’s needs Offers undivided attention to the patient

Answer 43

Use of no words Be present for the patient without verbal communication Shows concern and caring for the patient in difficult or challenging situations Gives the patient time to think and reflec

Answer 44

Use discriminately in certain circumstances Hold patient’s hand Lightly touch patient’s arm, shoulder, or feet Demonstrates empathy Offers emotional supp

Answer 45

Offering shelf Calling patient by name Sharing observations Giving information Open ended questions

Answer 46

You look worried.” “You seem upset.” “You are frowning.”

Answer 47

It is time for your medication.” “My name is Samuel, and I will be the nurse taking care of you until 7 p.m.” “Your test is scheduled for 8:30 a.m. tomorrow.”

Answer 48

What are your biggest concerns at this time?” “How would you describe your general health status?” “Tell me about some of the feelings you had after being diagnosed with cancer.”

Answer 49

Restating/paraphrasing Seeking clarification Summarizing Validating

Answer 50

Patient: “I couldn’t eat supper last night.” Nurse: “You couldn’t eat supper last night?” (restating) Nurse: “You had trouble eating supper last night?” (paraphrasing)

Answer 51

I don’t quite understand what you are saying.” “What did you mean by your last comment?”

Answer 52

There are three things that are bothering you: your weight, job, and finances.” “We have covered some things that you are angry about, including…”

Answer 53

Do I have this right that you…?” “Do you mean that…?”

Answer 54

Allowing the patient to explore problems/issues in-depth Gaining insight into a problem or issue Producing emotional growth Identifying progress Increasing self-awareness

Answer 55

Using focused questions or comments Providing general leads Conveying acceptance Reflecting feelings Using humor Verbalizing the implied

Answer 56

Collaborating among the nurse, patient, and others Working Transitioning to another caregiver Termination Predetermining topics of interaction Preorientation Observing, interviewing, and assessing patients Orientation

Answer 57

Maintaining eye level with the patient Keeping arms uncrossed Facing the patient Leaning toward the patient

Answer 58

I’ll sit with you for a while.” Offering self “You seem frustrated.” Sharing observations “Tell me about some of your concerns.” Using open-ended comments “It is time for physical therapy.” Giving information

Answer 59

Conveying acceptance Using focused comments Using humor

Answer 60

Hearing impairments Visual impairments Physical impairments Cognitive impairments

Answer 61

Determine whether the patient uses a hearing aid, and check that the hearing aid, if used, is being used properly and that the batteries are charged. Minimize background noise as much as possible. Make sure that the area is well lit to improve the patient’s ability to read lips. Speak as clearly as possible. Raise normal voice level only slightly, using low tones (not high tones). Stay within 3 to 6 feet of the patient to allow for observation of nonverbal cues. Avoid turning away from the patient while talking; facing the patient allows the mouth and facial expressions to be seen and interpreted correctly. Use a writing board, whiteboard, or computer as needed.

Answer 62

Describing the location of objects or potential hazards in the room Using analog clock descriptors to specify location (“The phone is at 9 o’clock on the table.”) and for eating (“The meatloaf is in the 6 o’clock position, and your mashed potatoes are at 9 o’clock.”) Using available tools for communication, such as large print, Braille, audio, and e-books to facilitate patient education Speaking before touching or providing care to alert a blind patient to the nurse’s presence Explaining in more detail about the procedure or assessment as it is taking place Keeping eyeglasses available at all times for patients who wear them

Answer 63

eye blinking, hand squeezing or head nodding, or written communication tools such as a whiteboard, tablet, or laptop.

Answer 64

Continue to use physical touch. Continue to communicate and teach the patient as though the patient can hear. Allow friends and family to stay and talk to the patient. Always speak before touching or providing care. Observe for nonverbal signs of pain (grimacing) or restlessness (constant movement). Use nonverbal signals, such as hand squeezes or eye movements, if the patient is able to provide them.

Answer 65

Use gestures, such as nods, shrugs, or eye movements, that communicate meaning (e.g., one blink for “yes” and two blinks for “no”). If the patient is completely paralyzed, do not use hand squeezes (patient will not be physically able to perform). Use assistive/electronic devices that can interpret gestures and eye movements and connect to computers.

Answer 66

Ask family members or other caregivers about effective strategies they have used to increase cooperation from the patient. Gain as much insight into the lifelong habits of the patient to prevent disruption of familiar routines. Do not confront or continually reorient the patient because this can increase agitation. Reminisce with the patient. When the patient is refusing all requests, distract the patient with an activity, such as walking or folding clothes, and then reintroduce the request. Accept the patient’s erroneous thought processes rather than continually correcting the errors because the patient’s brain deterioration cannot process this information, leading to more confusion and agitation.

Answer 67

Using individual abilities or strengths to overcome feelings of inadequacy

Answer 68

Refusing to admit the reality of a situation or feeling

Answer 69

Transferring emotional energy away from an actual source of stress to an unrelated person or object

Answer 70

Taking on certain characteristics of another individual’s personality

Answer 71

Attributing undesirable feelings to another person

Answer 72

Denying true motives for an action by identifying a more socially acceptable explanation

Answer 73

Reverting to behaviors consistent with earlier stages of development

Answer 74

Storing painful or hostile feelings in the unconscious, causing them to be “forgotte

Answer 75

Rechanneling unacceptable impulses into socially acceptable activities

Answer 76

Choosing not to think consciously about unpleasant feelings (this is the only defense mechanism that is not unconscious)

Answer 77

Obtain an interpreter. Use face-to-face, phone, or video platforms for the interpreter. Do not use family members because it breaches confidentiality and may lead to misinterpretation of medical information. Follow the facility’s policies and procedures for this situation.

Answer 78

Use pronouns (he, she) that the patient has identified as rather than those reflective of sex at birth. Be nonjudgmental and respectful. Continue to use appropriate touch for comfort.

Answer 79

Use short and direct sentences, questions, or instructions. Avoid teaching during these times (learning does not occur). Do not leave severely anxious patients alone because it will make the anxiety worse.

Answer 80

Family or supportive relationship dynamics Effects of illness on the patient’s family or members of the patient’s supportive relationships Presence and availability of support systems

Answer 81

Refusing to admit the reality of a situation Denial Using personal strengths to overcome feelings of inadequacy Compensation Choosing not to think consciously about unpleasant feelings Suppression Taking on certain characteristics of another Introjection

Answer 82

recognizing the existence of support systems

Answer 83

The joint commission standards

Answer 84

Patient/health care provider communication (information related to medical terms/health condition) Medication labels and medication instructions Informed consent for treatment Medical and insurance forms Personal health history and reporting of symptoms Written educational materials, such as handouts or pamphlets

Answer 85

Increased rates of hospitalization Poor adherence to treatment plans, a situation that results in higher health care costs Lower usage of preventive health care services Medication and treatment errors Poor adherence to outpatient appointments and follow-up care

Answer 86

Greater understanding and perception of the patient’s chronic illness and of related health care decisions Better self-management, which leads to better health outcomes Lower emotional stress associated with unknowns about the illness and care

Answer 87

Older adults Those who speak English as a second language Immigrants Members of lower socioeconomic class Homeless individuals Prison population People with limited formal education

Answer 88

based on their ability to understand medical concepts required for personal decision-making. People with low health literacy are unable to comprehend health-related terminology and understand written health care instructions. They have difficulty understanding medical concepts necessary for informed decision-making.

Answer 89

Communication Reading comprehension Numeracy Technology

Answer 90

Oral communication is the ability to send and receive information. Does the patient have any impairments such as vision or hearing difficulties? Does the patient speak English, or is English a second language? Would an interpreter be beneficial? Should educational material be presented in a verbal, visual, or written form, or in all three forms?

Answer 91

Written material is presented with the assumption that the patient not only can read the material but also can understand what is written. Most preprinted health-related information is designed for comprehension at the fifth-grade reading level. It is important to recognize that some patients may require simpler written instructions.

Answer 92

Numeracy is the ability to understand numeric data and to use the data to make health-related decisions. Numeric data could include statistical information, information in a graph, or test results indicating low blood sugar. Numeric information may also require the ability to tell time and to know when to take medication.

Answer 93

Educational material is now delivered electronically and digitally. The patient must know how to navigate technological devices, such as a cell phone used for text messaging or a computer used to visit a website. Electronic health materials can impact low-literacy patients in a positive way with audiovisual presentations.

Answer 94

Read and identify credible health information: Written materials and websites from well-known professional organizations versus websites that may promote unorthodox or harmful solutions for diseases and conditions. Understand numbers in the context of their health care: Dosages on medication labels or calculations, if required. Make appointments: Contact the correct health care provider or facility. Fill out forms and obtain health records: Involves reading forms and entering correct information. Asking appropriate questions of health care providers. Advocate for appropriate care: Involves knowing what appropriate care includes, whom to contact for that care, and how to get that care. Navigate complex insurance programs, Medicare or Medicaid, and other financial assistance programs: Involves understanding of these programs, how to access agency representatives, and how to complete any necessary forms. Use technology to access information and services (DHHS, 2010): Involves assessing use of programs required to access needed services

Answer 95

The first objective stresses the need for an increase in the proportion of patients who report that their health care providers always provide easy-to-understand guidance about their health and illness concerns The second objective states that health care providers and organizations need to demonstrate an increase in the number of patients reporting that their health care providers always confirm that they understand and are capable of following the information that was presented. The third objective states that there must be an increase in the number of patients who report that the offices of their health care providers always offer to help fill out necessary medical paperwork (Ling, 2021).

Answer 96

It involves explaining how the medication works, why it is necessary, and what may occur if the patient is nonadherent

Answer 97

teaches the patient how to make changes and why the changes are necessary, and it gives the patient the skills needed to implement changes

Answer 98

Decreased lengths of stays (shorter amounts of time to teach) Limited time during outpatient clinic visits Limited or lack of teaching materials/supplies Conflicting information received by patients who seek information from the Internet, other primary health care providers, or other health care disciplines Complex patient care needs and a nurse who may have limited training/skills to provide the necessary education Low patient health literacy and/or low patient literacy Anxiety, stress, or medications affecting mental capacity Patient’s lack of readiness to learn

Answer 99

A nurse’s lack of awareness about a patient’s level of health literacy Lack of time to answer questions or to repeat complicated material Inaccurate simplification of complex information Concerns about offending the learner due to culture/race Staff turnover, which leads to inadequate educational training of new nurses A nurse’s belief that particular information is not vital and does not need to be taught

Answer 100

Taking prescribed medications incorrectly Missing follow-up appointments Higher health care costs Poor adherence with treatment plans

Answer 101

25-year-old undocumented migrant worker

Answer 102

Understanding which websites are appropriate to use for health information Understanding benefits of Medicare programs Being able to call and schedule follow-up appointments Navigating a smartphone to input a medication list into an app

Answer 103

Behavioral, cognitive, change and humanist theories

Answer 104

Some of the most common theories believe learning should focus on observable behaviors.

Answer 105

These theories believe that internal processes must occur for the learner to begin understanding presented information.

Answer 106

Learners must be assessed for readiness to learn before presentation of the educational material so that behavioral changes may be implemented.

Answer 107

The learner must be self-motivated in addition to being able to self-evaluate with clear-cut goals and outcomes (Stephens, 2016).

Answer 108

Childbirth classes for a group of expectant mothers Class for nursing students on the proper methods of obtaining vital signs Demonstration for patient on caring for a surgical incision before discharge CPR classes for other health care employees

Answer 109

The patient or caregiver might ask a question about a procedure, medication, or treatment while the nurse is at the bedside. The nurse uses the question as an informal teaching opportunity. In this case, there is no specific structure and there are no preset goals for the teaching session. The patient is free to continue asking questions that direct the teaching session. Informal teaching is particularly effective because it is based on learner need. It indicates that the patient or caregiver is motivated and ready to learn. Patient questions that might prompt informal teaching sessions include, but are not limited to: What does this medication do? How long will the procedure take? What happens during this test? Does this medication cause side effects? Will the procedure hurt?

Answer 110

"Teach-Back" to Assess for Understanding Goal: Effective child and family self-management • Teach new concept or skill Repeat new learning in own words or demonstrate new skill ("teach-back") @ Clarify or correct misunderstood information — Repeat corrected information • "What questions do you have?" • Continue process until concept or skill is understood

Answer 111

when individuals seek the information themselves instead of waiting for the information to be taught.

Answer 112

over time through multiple interactions with others such as nurses, respiratory therapists, and primary health care providers.

Answer 113

through mistakes and motivates the learner to engage in finding more information about why the mistake happened.

Answer 114

they usually obtain a greater amount of knowledge. This is the basis behind support groups, such as weight-loss groups, bereavement groups, and addiction groups.

Answer 115

Negative Effects on Motivation to Learn Cognitive Ability Cultural Influences Emotional Barriers Ineffective Communication

Answer 116

Belief that goals are unattainable Lack of trust in the nurse–patient relationship Denial of current illness Too many distractions Feeling overwhelmed by too much information

Answer 117

Age Brain injury Developmental delay Medication side effects Low literacy

Answer 118

Lack of a support system Cultural influences that do not support wellness Religious or spiritual influences Individual cultural beliefs about wellness

Answer 119

Stress about finances, health Anxiety about new diagnosis Anxiety about loss of independence Recent loss—divorce, death of family member Depression

Answer 120

Language barrier Hearing impairment Vision impairment Speech impairment (jaw wired shut, history of stroke)

Answer 121

Questioning Lecture Demonstration Group Discussion Role-Playing

Answer 122

The questioning technique requires the teacher to present information in a way that promotes critical thinking. Clearly phrased questions enhance the learner’s ability to put pieces of information together and arrive at an “aha” moment. “Have you noticed an increase in your child’s asthma exacerbations when she is around her grandparents who smoke?” The teacher then continues to ask direct questions that further the learner’s ability to make the connection.

Answer 123

In the lecture style of teaching, the information is usually presented to individuals who already have a basis of knowledge about the topic. Printed material is often given to supplement the formal lecture.

Answer 124

With the demonstration teaching technique, the teacher performs a task for an individual or a group of individuals. The hands-on demonstration may occur in a live session, or it may be prerecorded for learners to view individually. With video-recorded demonstrations, learning is enhanced if the teacher is available for interactive questions after the video has been watched. Additionally, because video-recorded demonstrations can often fail to engage the learner, humor or other stimulating tactics are necessary to make the video-recorded teaching style successful.

Answer 125

Group discussions allow the educator to lead a purposeful conversation among individuals engaged and interested in the same topic or idea. The group discussion technique is great for allowing the learner to share individual opinions and experiences, a situation that encourages the participant to take an active role in the learning process.

Answer 126

Role-playing requires participants to recreate an environment similar to a real-life situation. It allows the learner to have an up-close and personal experience and engages the learner in the teachable moment.

Answer 127

cognitive, psychomotor, and affective.

Answer 128

The cognitive domain requires memorization and recollection of presented material to understand, apply, analyze, and evaluate the information. A patient who learns in the cognitive domain remembers educational information that was taught, can repeat the information, and ask follow-up questions about the presented material. Examples: Teaching carbohydrate counting to a new diabetic Knowing the signs of infection with a ventricular assist device (VAD) Knowing signs and symptoms of heart failure

Answer 129

Learners who gain knowledge in the psychomotor domain use physical movement or motor skills during the teachable moment. Examples: Learning to check a blood glucose level for a new diabetic Learning to change a VAD dressing Obtaining accurate daily weight for the patient with heart failure

Answer 130

The affective domain recognizes the importance of the emotions involved when learning new material. Successful teaching in this domain requires the teacher to understand a learner’s emotions, motivation, and attitude as well as their effects on the value of the presented material. Examples: Exploring the feelings associated with self-administering insulin Discussing importance of VAD dressing changes in the prevention of infections Discussing patient’s feelings about the need to significantly change diet to maintain better health

Answer 131

visual learning; auditory learning; reading/writing; and kinesthetic, or tactile, learning.

Answer 132

Encourage patients and their families to participate actively as part of patient-centered care. Ensure that patients and their families understand the information presented to them. Provide patients and their families with materials aligned with their learning styles, reading levels, and preferred languages. Speak in a clear, distinct voice, and use understandable terminology when teaching patients and their families. Use multiple teaching methods to accommodate learning styles of all learners. Stop after covering two to three key points to ensure that the patient is still engaged and able to process more information. Reassess knowledge of the patient and/or family members after each teaching session to determine if learning has occurred or if teaching needs to be repeated. Review information taught at previous sessions before proceeding with new material. Ask questions that indicate comprehension (e.g., the teach-back method) to determine whether patients and/or family understood the material.

Answer 133

Address the patient and family by name and maintain good eye contact (if culturally appropriate). Pick a quiet setting with limited interruptions. Confirm the goal(s) of the teachable moment (desired outcome). Ensure the patient’s readiness to learn (free of pain and stress). Avoid conducting education sessions immediately after surgery or delivery of a difficult diagnosis. Encourage questions even if the same questions are repeated. Keep the patient/family engaged in the presented material. Keep the teachable moment brief and focused. Give positive reinforcement.

Answer 134

Use plain language and simple terms. Teach only the necessary information. Teach the most important information first. Condense information to avoid overwhelming a patient. Confirm that written material is at an appropriate grade level. Use multiple formats to present the information.

Answer 135

Involve family members in the teaching process. Cover only two to three key points at a time. Review previous information before starting new material. Encourage the patient to ask questions.

Answer 136

When teaching, I will include the three distinct styles of learning: visual, auditory, and reading and writing.”

Answer 137

Lack of patient readiness to learn Sedation related to medications Lack of skill required for patient teaching

Answer 138

A patient with low health literacy is unable to understand the medical information necessary for health care decision-making

Answer 139

CPR certification taught to a pediatrician’s office staff Infant parenting class at the local hospital Teaching the patient and family signs of a wound infection during the discharge process

Answer 140

Improved health outcomes Increased clarity about future decisions related to illness Improved medication adherence Increased adherence to treatment plan

Answer 141

Filling out a health questionnaire Solving simple mathematical equations Reading discharge instructions Following medication instructions

Answer 142

Have the patient perform the step-by-step instructions with guidance from the nurse.

Answer 143

In addition to a medical translator, I want to make sure at least one family member or caregiver is present when I am teaching the patient.

Answer 144

Psychomotor

Answer 145

Word recognition tests are literacy tests that give a patient an allotted amount of time to read health-related terminology.

Answer 146

socioeconomic characteristics that can be associated with low health literacy, directly asking the patient about ability to understand oral and written health-related information. A common occurrence when assessing a patient’s literacy is assuming that wealth or formal education equates with higher health literacy levels. It is important to remember that socioeconomic status and educational level do not always correlate with the ability to understand and process medical terminology and health-related information.

Answer 147

Current level of knowledge Age/developmental level Preferred language Preferred style of learning Readiness to learn/motivation level Current anxiety or stress level Current overall health/well-being Current beliefs associated with wellness

Answer 148

What is your preferred language?” “Do you like to read books, magazines, or newspapers?” “Do you have any family members or caregivers we should include in the education process?” “Do you have access to the Internet?” “How do you learn best—watching videos, reading information, or using a hands-on approach?”

Answer 149

Open-ended questions such as “Can you tell me about your medications?” will help the nurse determine whether the patient knows the names of current medications and the conditions that the medications treat or the patient is just taking a blue pill every morning. Open-ended questions will also allow the patient to talk about the illness and identify additional information that should be presented to increase the patient’s health literacy level.

Answer 150

Makes excuses: “I forgot my glasses.” “I want my daughter to be present to read it with me.” “I would rather take it home to read it.” Points to text as they read Mouths words as they read Refers to medications by description of the pill instead of the name Opens the medication bottle to show the pill instead of naming the medication Watches for others’ behavior or responses before talking Does not complete forms or has family members fill out necessary information Pretends to read the information (acts as if reading/eyes wander over a page) Will not sign consent forms for treatment/postpones decision-making until family can be present Seems noncompliant (does not follow up with scheduled appointments or take medications correctly) Has laboratory results that do not correlate with expectations if patient is adhering to the treatment plan as stated

Answer 151

Age, developmental level, and cognitive ability Physical limitations (visual, auditory, language skills/speech impediments) Educational background Cultural experiences (home environment, spiritual beliefs, occupation) Finances and insurance coverage Social support (family, friends, church) Emotional issues (pain, anxiety, stress, depression) Readiness to learn

Answer 152

Did not graduate high school Could not name his medications Refuses to read educational material left at the bedside

Answer 153

Financial stress: chose work over outpatient follow-up appointment and chooses fast food over vegetables due to cost Denial related to new diagnosis: does not believe he will need a heart transplant Lack of family or social support: lives with grandparents and was discharged home from his previous admission without social support Seems withdrawn: does not interact with nursing staff and is always on his phone

Answer 154

TOFHLA score of 50. A score less than 53 indicates low health literacy Did not keep follow-up appointment because he was feeling good at the time Lack of understanding about his grandfather’s heart condition and his own diagnosis Does not think he will need a heart transplant No dietary changes made after discharge Could not verbalize which medication treated which symptom or give the names of his medications

Answer 155

During each patient interaction

Answer 156

Wants to wait for family before signing consent form Has laboratory results that do not support the patient’s prescribed treatment plan Refers to medications by the color of the pill Frequently misses follow-up appointments

Answer 157

Which medications do you take for your high blood pressure?”

Answer 158

Telling Participating Entrusting Reinforcing

Answer 159

Telling is the approach used during the moments when there is limited time available for teaching. The nurse needs to be direct and to the point and to make sure the patient understands the information. The material should be clear and precise because there is limited opportunity for the patient to engage in the teachable moment. For example, an emergency department nurse would use telling to explain the need for a nonrebreather oxygen mask to a patient having a severe asthma exacerbation.

Answer 160

Participating is the approach used when both the patient and the nurse are involved in the learning process. This type of approach is most common when providing important medical education. An example of the participating approach would be teaching the mother of a child with hypoplastic left heart syndrome the signs and symptoms of heart failure.

Answer 161

The entrusting approach is seen when the patient is given the opportunity to manage personal care. The nurse is available for teaching, if needed, but trusts that the patient has the knowledge to manage care independently. This might be seen in the patient who has a known history of asthma and receives a new maintenance medication to add to his or her current medications. The nurse may need to give initial instructions but knows the patient is competent and able to use a metered-dose inhaler independently.

Answer 162

Reinforcing is the positive (or negative) stimulus that produces a desired response. An example of reinforcing is smiling or giving an encouraging nod when the patient does well learning a new skill.

Answer 163

The three components that are necessary when creating patient education goals are identifying who will accomplish the goal, which action will be accomplished, and what final outcome is to be evaluated. The verb should be measurable, concrete, and clearly stated so that the desired outcome can be evaluated for completeness of the task. By keeping it simple and concrete, it easily allows for the patient to understand what is expected. Goals can be related to behavioral lifestyle changes, increased knowledge, or psychomotor skills to be learned.

Answer 164

Lack of Knowledge and Interventions Attitude Skill Level Physical Impairments Native Language Previous

Answer 165

Specific Patient-centered Measurable Individualized

Answer 166

Patient is given opportunity to manage personal care Entrusting Patient and nurse are both involved in the learning process Participating Nurse presents direct, clear, and precise information to the patient Telling Nurse provides a stimulus that produces a desired response Reinforcing

Answer 167

Determine who will be the learner (patient, family member, caregiver). Assess motivation and willingness to learn. Assess ability to learn. Identify priority of learning needs. Identify any existing misconceptions. Determine patient’s learning style. Provide quiet learning environment. Establish objectives and goals of learning at each teaching session. Allow learner to identify what they most want to learn.

Answer 168

Quiet and free from distractions Private Comfortable with appropriate furniture Adequately lit Adequately ventilated, neither too hot nor too cold Roomy with ample space, especially for teaching skills or providing demonstrations

Answer 169

Providing the best way to deliver the educational information is important. Identifying how the patient learns best can be key for patient retention and understanding. As discussed earlier, patients can learn from reading, watching videos, doing hands-on demonstrations, and having informal discussions

Answer 170

Using short sentences Using simple words (“breathing fast” instead of “tachypnea”) Using bullet points Limiting written information to most important points Dividing the document into manageable chunks of information Being specific by focusing on two to three key pieces of information at a time Using simple pictures and drawings Showing relationships through pictures, if applicable

Answer 171

New concept Nurse explanation Patient verbalizes what was hear Nurse clarify any miss information Nurse clarifies patient’s understanding: can you tell me in your own words Patient verbalizes understanding and remember clinical information

Exam # 1 (321) Flashcards

(198 cards)