N 321 - Sleep and Communication Study Guide

Intrapersonal communication is…..

self talk

Interpersonal communication is…

one to one

small group communication is…

a few people all communicating (generally goal driven)

public communication is…

Interaction with an audience

Referent element of communication is

the motivation for communication (the stimulus)

Sender element of communication

encodes and delivers the message

The receiver element of communication

receives and decodes the message

The messages element of communication

is the content of the communication (can be verbal or non-verbal)

The channels element of communication

is how the message is conveyed

the feedback element of communication

is the message returned by the receiver

The interpersonal variables element of communication

is the factors that influence communication

the environment element of communication

is the setting

What is vocabulary in verbal communication

words and phrases (don’t use medical talk)

What is denotative in verbal communication

what is actually said - what it actually means by definition

What is connotative in verbal communication

interpretation of the words

What is pacing in verbal communication

speed of speaking

What is intonation in verbal communication

the tone of voice

Clarity vs Brevity

Clarity - speak slow and clear, repeat if needed

Brevity - use shorter sentences or words

Name some elements of non-verbal communication

personal appearance, posture and gait, facial expressions, eye contact, gestures, sounds, personal space & zones of touch

Passive vs Aggressive

Passive- lack outward communication, often indifferent or avoidant, lack eye contact, poor posture, not saying no, but easy to get along with

Aggressive- Bullying, loud, demanding, intense eye contact, dominate and control, with blame or criticism, very selfish

Passive Agressive vs Assertive

Passive Aggressive - muttering under breath, silent treatment, moody, may appear surface level cooperative,

Assertive - GOOD! EFFECTIVE COMMUNICATION! focuses on effective communication with others and is appropriate with boundaries. “I statement”

Rules of Assertive communication

• takes practice

• be willing to take risks

• be willing to make mistakes

• have good self esteem

Therapeutic communication techniques

Active listening, empathy, sharing humor, summarizing, focusing,

Non-Therapeutic communication

DONT - ask personal questions, give personal opinions, change the subject, falsely reassure, passive or aggressive responses “you cant win emm all”

4 main elements of special communication approaches

• don’t change tone or volume of voice

• face the individual

• calm environment

• Actively listen

What considerations are there for patients who don’t speak English

Use a trained medical interpreter not a family member. Also use communication boards, pictures, or cards

What considerations are there for patients who are hearing impaired

Limit environmental noise, get their attention before communicating, ensure your mouth is visible, don’t chew gum, do NOT YELL, rephrase instead of repeating, Sign language interpreter

What considerations are there for patients who are visually impaired

Check for glasses, identify yourself and notify the individual when you leave the room, do not rely on gestures or nonverbal communication, use large print when appropriate

What considerations are there for patients who cannot speak clearly

listen attentively, be patient, do not interrupt, ask yes/no questions, use visual cues when possible, use communication aids

What considerations are there for patients who are cognitively impaired

use simple sentences - keep it short and sweet, ask one thing at a time, be attentive and patient, include family and friends in conversations, use a picture or gestures that mimic the action desired

What is the key with unresponsive patients

TREAT THEM LIKE THEY ARE RESPONSIVE

Restorative sleep is important for (3)…

Tissue repair, energy restoration, and immune function

Practical sleep hygiene components…

Light exposure, consistency/routine, and stimulation

THE BED IS FOR (these 3 things)….

Sleep, $ex, and Sickness

What is light therapy..

use for 15-20 mins, 2,500-10,000 lux, 16-24 inches away

What is EMDR?

Eye movement desensitization and reprocessing, it can reduce anxiety and improve sleep

What is REM sleep?

Rapid Eye Movement sleep, it has a role in emotional processing and memory consolidation.

What is CBT-i?

CBT-i is cognitive behavioral therapy for insomnia, it involves cognitive restructuring, sleep restriction, and stimulation control

Manifestations of Insomnia

Difficulty falling asleep, early morning awakening, nonrestorative sleep, daytime fatigue

Common causes of insomnia

Psychological stress, psychiatric conditions, medication side effects, and chronic illness

Diagnosing insomnia

comprehensive sleep history, two-week sleep diary, and exclusion of other disorders

Insomnia treatment

CBT-i, sleep restriction, stimulus control, cognitive restructuring, pharmacotherapy for refractory cases only (short term, and risk benefit profile)

What airway is more dilated UARS or OSA?

OSA

What are the manifestations of (OSA) Obstructive Sleep Apnea?

loud disruptive snoring

if the tounge is touching the uvula it is a class..

2

if there is almost no window it is a class…

3

OSA polysomnography (AHI> …. events per hour)

5

Stop Bang Questionnaire (sensitivity >….% for moderate to severe OSA)

90

What is the first-line treatment for OSA

CPAP

What is used to diagnose restless leg syndrome?

(IRLSSG), serum ferritin levels, exclude mimicking conditions

What is used to treat restless leg syndrome?

Iron supplementation (for low ferritin), dopamine agonists (first - line)