Nurs-335: Exam 2

Who do nurse communicate with?

patients, families, community partners, other nurses, physicians

What are components in the process of communication?

Auditory, visual, kinesthetic

What is auditory in the process of communication?

spoken words and cues

What is visual in the process of communication?

sight, observations, and perception

What is kinesthetic in the process of communication?

touch

What are the three levels of communication?

intrapersonal, interpersonal, group

What is intrapersonal communication?

self talk; communication within a person

What is interpersonal communication?

occurs between two or more people with a goal to exchange messages

What is group communication?

small group, organizational communication, group dynamics

What are the three different forms of communication?

verbal, nonverbal, electronic

What is verbal communication?

language; an exchange of information using words, including both the spoken and written word

What is nonverbal communication?

body language; the transmission of information without the use of words

What are some factors influencing communication?

developmental level, gender, cultural differences, roles/responsibilities, physical, mental, emotional state, values

What is personal reflection?

requires taking time to focus on own thoughts, feelings, actions, and beliefs; can cause discomfort

What are different attitudes to be aware of when interacting with patients?

desensitization to the needs of the patient, time constraint issues, need for emotional space, dislike for a particular event

What is therapeutic communication?

purposeful use of communication to build a therapeutic nurse-patient relationship, essential to effective nursing care

What are some therapeutic interviewing skills?

therapeutic silence, reflect patient feelings, encourage expression of thoughts/emotions, focus/guide conversation, understand importance of authenticity

What are ways of therapeutic communication?

control tone of voice, knowledgable on conversation topic, be flexible, open-ended questions, clear and concise, be truthful, keep open mind, thin before responding

What are things not to do in therapeutic communication?

false assurance, using cliches, closed questions, giving advice, judgmental comments, changing subject

What is the purpose of humor in nursing?

building rapports, eases anxiety, facilitates difficult conversations

What are humor guidelines for nurses?

appropriateness, patient-centered, observe reactions

What are some pitfalls of humor in nursing?

misinterpretation, overuse, sensitivity

What are some listening skills?

sit when communicating with patient, be alert and relaxed, maintain eye contact, keep conversation natural, use appropriate facial expressions/bod gestures, listen for themes in patients comments, use silence, therapeutic touch, humor appropriately

What are reasons why nurses may have trouble listening?

time restraints on being a good listener, distracted by colleagues, phone, or other patient, own personal/professional problems

What are difficult emotions patients may experience?

anger, anxiety, depression, demanding behavior

What causes patients difficult emotions?

loss of control, frustration, fear, defense mechanism

How do you deal with angry patients?

stay calm, keep tone of voice low/controlled, avoid defensiveness, listen, reflect/restate, acknowledge their emotions, pause after emotional outburst, assistance if needed

How can we communicate with patients dealing with anxiety?

speak slowly/concisely, help pt verbalize feelings/find source of anxiety, assess pt support system, coping mechanisms, offer explanations/info

What are depression warning signs?

increasingly withdrawn, agitated, restless, talk about suicide

How do we use therapeutic communication for a pt with depression?

initiate conversation, show understanding/caring/acceptance, encourage simple activities, take suicidal ideation seriously

What are phases of the helping relationship?

orientation phase, working phase, termination phase

What are goals of the orientation phase?

pt will call nurse by name, pt will accurately describe roles of participants in relationship, pt and nurse will reach an agreement

What type of agreement will patient and nurse establish during the orientation phase?

goals of the relationship, location, frequency, and length of contacts, duration of relationship

What are goals of the working phase?

the pt will actively participate in the relationship, the pt will cooperate in activities that work toward achieving mutually acceptable goals, the pt will express feelings and concerns to nurse

What are goals of the termination phase?

the pt will participate in identifying goals accomplished/progress made toward goals, pt will verbalize feelings about termination of relationship

What are three professional boundaries in nursing?

under-involvement, zone of helpfulness, over-involvement

What is under-involvement?

distancing, disinterest, neglect

What is zone of helpfulness?

the ideal space

What is over-involvement?

excessive personal disclosure by the nurse, secrecy, role reversal, touching, gestures, money/gifts, special attention, social contact, involved in personal affairs, sexual misconduct

How do infants (0-12 months) communicate and what is appropriate communication to them?

communicate by crying; comforting/feeding can help develop a relationship

How do toddlers (12-36 months) communicate and how should you appropriately communicate with them?

communicate with words, phrases, sentences; attention span is short

How should you appropriately communicate with school age children (6-12 yrs) ?

answer all questions directly, with diagrams, illustrations, books, video materials

How should you communicate appropriately with adolescents (12-18 years)?

include adolescents in decision making and planning as much as possible

How should you appropriately communicate with preschoolers (3-5 y/o)?

use play, stories, books; give choices where appropriate

What is aphasia?

absence or impairment of the ability to communicate through speech, writing, or signs because of brain dysfunction

What are three types of aphasia?

expressive, receptive, global

What is expressive aphasia?

motor; words cannot be expressed or formed

What is receptive aphasia?

sensory; language is not understood

What is global aphasia?

includes both expressive and receptive deficits

What must the nurse assess when it comes to aphasia?

type of aphasia, methods that the patient uses to communicate

What are examples of patient communication impairment?

aphasia, visual impairment, hearing impairment, intensive care environment

How do you speak to a patient with hearing loss?

get pt’s attention, face pt directly, speak clearly/moderate pace, use short/simple sentences, confirm comprehension, write key points, encourage pt to indicate their preferred communication method

Should you shout when speaking to a patient with hearing loss?

No, shouting distorts lip movements

Where should you write key points when communicating with a patient who has hearing loss?

on a notepad, tablet, whiteboard if speech is unclear

How do you communicate with a patient who has vision loss?

announce yourself when entering/leave room, address pt by name to avoid confusion, warn of obstacles when ambulating, use consistent placement of personal items so pt can find them independently

How do you electronically communicate with a patient?

social media, e-mail and text message

When did the US found WHO?

1948

What is WHO?

World Health Organization

What is the purpose of WHO?

all people achieve highest possible level of health

The US withdrew from __ in 2025

WHO

What federal department in the US is the principal agency for protecting health?

Department of Health and Human Services (DHHS)

What federal department in the US is the principal agency for protecting health?

FDA, centers for Medicare and Medicaid services, national Institute of health, substance abuse and mental health services administration, CDC

How many operating agencies is under the Department of health and human services?

11

What is the annual budget of the health and human services department?

$525 billion

What is a government health agency?

Agency funded by tax dollars

What is top down funding?

money comes from the federal or state level to the local level

Do all 50 states have their own state health departments?

yes

What is the purpose of state health agencies?

to promote, protect and maintain the health and welfare of their citizens

What are state mandated services provided locally?

restaurants, public buildings, public transportation inspections, detection and reporting of certain diseases, collection of vital statistics

What are Quasi-governmental health organizations?

operate more like voluntary health organizations, operate independently of government supervision, some funding and work from the government

What are non-governmental health agencies?

funded by private donations or membership dues, arose due to unmet health need, operate free from governmental interference, meet specific IRS guidelines with tax status

What are some types of non-governmental health agencies?

voluntary, professional, religious, social, philanthropic, corporate, service

What are four basic objectives of voluntary health agencies?

raise money, provide education to public and professionals, provide service to those afflicted, advocacy

What is the primary activity of voluntary health agencies?

fundraising and supporting organization mission and programs

What are some examples of voluntary health agencies?

AHA, March of dimes

What are some things service, social, and religious organizations do?

food banks, shelters, donate space

What is community?

a group of people who share common interests, needs, resources, and or environment

What are the four types of communities?

geopolitical, phenomenological, communities of solution, societal/global

What is a geopolitical community?

geography/political boundaries

What is a phenomenological community?

shared beliefs, values, and interests

What are communities of solution?

formed to address specific issues

What are societal/global communities?

nations or large populations

What type of community is this: new mom's social group

Phenomenological

Which type of community is this: Opioid overdose prevention coalition (EMT, hospital staff, law enforcement, etc.

Community of Solution

Which type of community is this: Veterans

Phenomenological

What type of community is this: Jefferson County residents

Geopolitical

What type of community is this: support groups

phenomenological

What type of community is this: immigrant community

phenomenological

What type of community is this: residents of the US

Societal/global

What type of community is this: violence prevention partnerships

community of solution

What is community assessment?

The comprehensive evaluation of the status of a community, based on the interactions between people, health, and the environment

What are community assessments used for?

to assess a geopolitical community

What does a community assessment include?

problems, strengths, assets

Why are community assessments done?

to identify priority health problems so health programming can meet the needs of the community

Who does community assessments?

non-profit hospitals, local/state health departments, community health centers, nonprofits and social service agencies, city/county governments and planners, researchers/consultants

What does data tell us?

WHAT is happening

Community voice helps us understand __

WHY

What does data and community together help us decide?

What to do

What do demographic factors tell us ?

who lives here

What do biological factors tell us?

what health conditions or biologic risk factors are present