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What is the communication process?
An exchange of information, feelings, needs, and preferences between two people.
What is the goal of communication?
To establish a mutual understanding of the meaning of a message, known as shared meaning.
What is verbal communication?
A conscious use of words, either spoken or written.
What factors may influence an individual’s choice of words in verbal communication?
Age
Education
Developmental Level
Culture
How does verbal communication differ from nonverbal communication?
Verbal communication is more direct and often used to give or receive specific information.
How can feelings be expressed verbally?
Through changes in pitch, pace, and tone of voice.
What is nonverbal communication?
Communication conveyed by body language, including facial expressions, posture, and gestures.
Why is nonverbal communication often more significant than verbal communication?
It often conveys more of what a person feels, thinks, and means than what is stated in words.
Why is it important for verbal and nonverbal language to be congruent?
To effectively meet the goal of shared meaning in communication.
What are the different types of personal space in communication?
Intimate
Casual-personal
Social-consultative
Public
Intimate Space
Ranging from physical contact to 18 inches
How should a caregiver communicate when invading a patient’s personal space?
By communicating respect for their personal space while explaining the necessity of closeness for care.
Casual-personal Space
18 inches to 4 feet
Social-consultative Space
4 to 12 feet
Public Space
12 feet if possible
What demonstrates cultural sensitivity in communication?
Refraining from using language that would be deemed offensive or disrespectful by another culture.
How can a nonjudgmental attitude be expressed in communication with patient’s?
Through attentive language and open-focused nonverbal communication.
What characterizes passive or avoidant behavior style?
The desire to avoid confrontation and the inability to share feelings or needs with others; have trouble asking for help and allow others to take advantage of them, resulting in feelings of anger, emotional pain, and anxiety.
What characterizes aggressive behavior style?
Putting one's own needs, rights, and feelings before those of others; exhibit a superior attitude; try to humiliate others and communicate in an angry hostile way; that does not acknowledge the feelings of others.
What characterizes assertive behavior style?
It is the most effective communication style, standing up for one's self without violating the basic rights of others; show respect; express feelings in an honest and direct way; act in consistent manner that enhances self-worth.
Why is assertive communication important for nurses?
It provides self-esteem and self-confidence and allows for higher commitment and respect in patient care.
What does the DESC method promote?
Assertive Communication
What is the goal of therapeutic communication?
To promote a greater understanding of a patient’s needs, concerns, and feelings.
What should be prepared before contacting a healthcare provider?
Quick assessment of the patient
Review of the chart for history and background
Concise statement of the problem
List of points to cover
Current data ( vital signs, lab results, etc.)
What is the ideal method for taking telephone orders in healthcare?
Having a second nurse listen on an extension to verify and co-sign the order.
What is the purpose of shift report in nursing?
To communicate the patient’s condition and required nursing care from the off-going nurse to the oncoming nurse.
What should be the focus of end-of-shift reporting?
To pass along detailed,accurate, current information about the patient and changes in orders or plan of care.
What is patient-centered care communication?
Communication that encourages and empowers patients to participate in their care.
How is health literacy defined?
The ability of an individual to obtain, process, and understand basic health information and services to make appropriate health decisions.
Expressive aphasia (Broca aphasia)
A disturbance in speech planning and production, resulting in “halting” speech.
What are the characteristics of expressive aphasia?
Single-word responses; Inability to produce spontaneous conversation
Slow, monotone utterances
Inappropriate words
Hearing, reading abilities are intact
Receptive aphasia (Wernicke’s aphasia)
A deficit in auditory comprehension, where the patient can hear but cannot understand what is said.
What are characteristics of receptive aphasia?
Abnormal language
Impaired reading and writing skills
Speech with normal rhythm, rate, and fluency
Global aphasia (expressive and receptive)
A deficit of planning, production, and comprehension of language, where patient’s can speak and understand only a few words.
What are the characteristics of global aphasia?
Meaningless speech sounds
Possibly perseveration, or the repetition of one word or thought.
DESC
D stands for “describe the behavior “
E stands for “explain the impact of the behavior”
S stands for “state the desired outcome”
C stands for “consequences “ of not complying”
What are two good communication tools to use in a stressful situation?
ISBARR
ISBARQ
ISBARR
Introduction
Situation
Background
Assessment of the situation
Recommendation
Reedback
ISBARQ
Introduction
Situation
Background
Assessment
Recommendation
Questions
Six factors that affect communication
Personal space
Body position
Language
Culture
Attitude
Emotions
Barriers to communication
Asking questions with yes or no
Giving false reassurances
Asking too many personal questions
Giving advice
Belittling a patient's feelings
Expressing disapproval
Styles of communication
Passive or avoidance
Aggressive
Assertive
Proxemics
The distance, or personal space, that people place between themselves and others.
Required Data for a Telephone or Verbal Order
Patient's first and last name
Date order received
Time order received
What needs to be done
When it should be done
Indicate whether the order is a telephone order (T.O.) or verbal order (V.O.)
Provide your name and credentials
Name of health-care provider giving the order
Documentation that the order was read back to the prescriber for verification & validation
Name the 4 quadrants that describe a person's condition based on the influences of wellness or illness and a favorable or unfavorable environment.
Protected Poor Health
Poor Health
Emergent High-Level Wellness
High-Level Wellness
Protected Poor Health
The environment is favorable, but health is not.
Poor Health
Both health and environment are not favorable.
Emergent High-Level Wellness
The environment is not favorable, but health is favorable.
High-Level Wellness
Both the environment and health are favorable.
How many quadrants does the environmental axis have?
4
H.L. Dunn's Theory of High-Level Wellness 1959
There is not only a continuum of health and wellness, referred to as the health axis, but also a vertical axis to represent the person's environment.
The goals of Healthy People 2030
Attain healthy, thriving lives and well-being, free of preventable disease, disability, injury, and premature death.
Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all.
Create social, physical, and economic environments that promote attaining full potential for health and well-being for all.
Promote healthy development, healthy behaviors, and well-being across all life stages.
Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all.
How often are Healthy people 2030 revising goals and objectives?
Every 10 years
Healthy People 2030
Healthy People provides science-based health goals and objectives to improve national health and prevent disease in the United States.
Examples of how location and social situations can affect health include whether:
Safe housing and neighborhoods are available.
Racism and discrimination are present.
Ongoing violence is an issue.
Opportunities for people to get an education are available so they can obtain skilled jobs that pay a living wage
Food is available at grocery stores near the neighborhood or whether only unhealthy snacks and fast food are accessible
Air and water are clean and safe
There are opportunities to improve language and literacy skills, especially if an individual's first language is different than that of the neighborhood or surrounding areas
“newest vital sign” (NVS)
Assessing health literacy
Acute Illness
Strikes suddenly and lasts for a limited time.
Examples of an acute illness
Food poisoning: You become very ill a few hours after ingesting contaminated food. You experience severe symptoms of nausea, vomiting, and diarrhea for 24 to 48 hours. Once your body rids itself of the offensive contaminants, you begin to feel better.
Acute illness also can occur in situations in which hospitalization is required
Acute appendicitis: A patient is admitted with acute appendicitis and has an emergency appendectomy, or removal of the appendix. After surgery, the incision gradually heals, and the patient eventually returns to normal activities.
Chronic Illness
Lasts for 6 months or longer and is characterized by intensifying or improving symptoms.
A patient who has been diagnosed with rheumatoid arthritis tells you that she has not had any joint pain or swelling for 3 months. She is hoping it has "gone away for good." What is probably happening with this patient?
a. She is probably right and the acute phase of the illness is over.
b. Because this is chronic illness, she is probably in remission for now
c. She is now in the prodromal phase of illness and no longer in the symptomatic phase.
d. She is in the recovery phase of illness and will no longer experience those symptoms
b. Because this is chronic illness, she is probably in remission for now
Which are modifiable risk factors for diseases?
a. Smoking
b. Diet high in fat
c. Genetic makeup
d. Age and gender
a. Smoking
b. Diet high in fat
Remissions
Periods of either minimal symptoms or a complete absence of symptoms
Exacerbations
Periods of worsening symptoms
5 phases of illness
Prodromal
Symptomatic
Seeking help
Dependency
Recovery
Prodromal phase
Before symptoms of a specific illness develop, a person may simply "not feel good," with generalized body aches and fatigue.
Symptomatic phase
Observable symptoms develop (sore throat, cough, congestion)
Seeking help phase
Reaching out for help in the medical community. (Doctors, healers)
Dependency phase
Relies on help from other sources for diagnosis and treatment.
Recovery phase
When the patient is slowly able to resume independence and regain health.
Risk factors for some illnesses that contribute to the development of an illness or disease?
Physiological
Psychological
Genetic elements
Environmental elements
Non-modifiable risk factors
heredity, age, and gender assigned at birth
Modifiable risk factors
Alterations in lifestyle and nutrition
An increasingly common modifiable risk factor for many illnesses is?
Overwhelming stress and a lifestyle that lacks balance among work, play, and rest.
Stress
Nonspecific response of the body to any demand made on it.
Stressor
Any stress inducing event
Adaptation
The ability to positively adjust to changes that occur in an individual's world.
The Seven Warning Signs of Cancer
CAUTION
Change in bowel or bladder habits
Any sore that does not heal
Unusual bleeding or discharge
Thickening or lump in breast or indigestion
Obvious change in wart or mole
Nagging cough or hoarseness
Risk factor: obesity = which diseases?
diabetes
heart disease
breast cancer
colon cancer
Risk factor: diet high in trans-fatty acids, cholesterol & triglycerides = which diseases?
diabetes
stroke
heart disease
Risk factor: hypertension = Which diseases?
stroke
heart disease
kidney disease
Risk factor: smoking = which disease?
heart disease
bronchitis
breast cancer
colon cancer
What stimulates fight or flight response?
sympathetic nervous system
One action of the flight or fight response is to convert glycogen to glucose. What is the purpose of this action?
To increase energy.
The Fight-or-Flight Response
When your brain perceives a threat to your well-being, it sends messages to the body to prepare to either stay and fight or run away.
What causes a physiological reaction in the body called the fight-or-flight response?
Stress
What is one of the main objectives of the body fight or flight response?
To get more oxygen to certain organs and muscles
What effect does the fight or flight response have on the cardiovascular system?
Increases pumping of the heart, constricts peripheral blood vessels, and dilates central blood vessels.
What happens to the nervous system once the threat is removed and the fight or flight response is no longer needed?
The parasympathetic nervous system reverses fight or flight response.
3 stages of General Adaptation Syndrome (GAS)
The three stages of the body's physiological reaction to stress, including alarm, resistance, and exhaustion.
Alarm phase
Stressor triggers fight-or-flight response
Resistance phase
The body tries to resist stress and keep working to prevent illness. Can go on for weeks, months, years.
Exhaustion phase
The bodies resources are depleted most vulnerable to psychological and physical disease.
If you don't change outlook/ adapt/avoid the stressor
it can lead to disease or illness
Examples of positive coping strategies for the body include the following:
Eating regular meals with lower levels of fat and sugar
Exercising regularly
Sleeping an adequate number of hours every night
Using deep-breathing exercises to relax and relieve stress
Listening to your body and giving it what it needs, such as extra rest when you are ill
Symptoms of Stress
Frequent feelings of anger, helplessness, or hopelessness.
Headaches, back pain, and insomnia.
Hiding real feelings from family and friends.
Hurting loved ones with words or physical harm.
Constant worry, memory loss, and trouble thinking clearly.
Panic attacks with rapid heart rate, shortness of breath, and dizziness.
Isolation from friends and family.
Inability to make decisions.
Overuse of alcohol, drugs, or food to feel better.
Individuals adapt to stress by using coping strategies?
TRUE/FALSE
TRUE
Coping strategies
the actions people use to combat stress.
Defense mechanisms
ways we manage our fears and anxieties
Patient teaching to decrease stress
ask questions if they are unsure of treatment
discuss feelings with others
ask for assistance if they are unable to sleep
laugh at movies or stories
To determine a persons health literacy the nurse asks the person to?
Answer six question about a specific ice cream label.
