Fundamentals of Nursing - Communication, Organizations, Theorists, and Vital Signs

Group 7: Elements of Communication

Introduction to Communication Elements As defined in Taylor (p. 173-175), communication consists of several distinct elements that facilitate the exchange of information between a source and a receiver.

  • 1. Stimulus : The origin of the message, which can prompt a response and initiate the communication process.

    • Definition: Any factor that can impact or cause a reaction in a patient. The stimulus can lead to changes in thoughts, actions, feelings, or emotions.

    • Source: MedlinePlus

    • Example: Breaking eye contact while relaying crucial information to a patient can serve as a communication stimulus that alters the patient's reaction or perception of the message.

  • 2. Sender

    • Definition: The source of the message; the individuals who initiate the communication process.

    • Citation: (Taylor p. 173)

    • Example: A patient who is experiencing discomfort becomes the sender when they communicate their problem or symptoms to a nurse.

  • 3. Message

    • Definition: Communication derived directly from the source that is clearly spoken or written.

    • Citation: {Taylor pg 175-176}

    • Example: A charting note, a spoken speech, a physical gesture, or a formal interview. Specifically, a patient telling the nurse all the symptoms they are currently experiencing.

  • 4. Channel

    • Definition: The medium or way in which a message is sent to a patient. There are three primary channels: auditory, visual, and kinesthetic.

    • Citation: (Taylor pg 175)

    • Example: For a non-verbal patient, the auditory channel can still be utilized by asking the patient "yes" or "no" questions. The patient can then use a blinking system as their response method.

  • 5. Receiver

    • Definition: The person who decodes and translates the received information to provide an appropriate response.

    • Citation: (Lippincott pg. 173)

    • Example: A nurse maintaining composure while responding to a person in immense pain (e.g., from a motor vehicle accident). The receiver asks questions pertaining to identity and the event to gather vital information before the patient reaches a state where they cannot respond (such as after receiving pain medication).

  • 6. Feedback

    • Definition: Once a message is received from the sender, it must be confirmed, reiterated, and evaluated.

    • Citation: (Taylor pg. 174)

    • The Closed Feedback Loop: This involves repeating instructions back to the sender to acknowledge receipt and ensure understanding.

    • Example: A supervisor instructs you to obtain vital signs for room 200200. You repeat back, "Got it, I’ll grab vital signs for room 200200."

    • Professional Guidance: Ensure the patient understands; never direct the patient; prioritize collaboration and flexibility.

Group 8 & 3: Professional Nursing Organizations

  • 1. State Board of Nursing / NCSBN (Presented by Brandon)

    • Organization: The National Council of State Boards of Nursing (NCSBN) is a non-profit organization.

    • Role: It regulates nursing policies and state licensure exams across all 5050 states. They develop the NCLEX (National Council Licensure Examination).

    • NCLEX Necessity: Every nursing graduate must take and pass this exam to become a Registered Nurse (RN).

    • Nursing Impact: They maintain education standards for future nurses and keep the nursing curriculum updated over time.

    • Students' Role: To become familiar with the standards put forth by the NCSBN and learn from their policies/practices to pass the NCLEX.

  • 2. ANA and NSNA are two key professional organizations that support nursing education and practice. The American Nurses Association (ANA) advocates for the profession and provides resources for ongoing education, while the National Student Nurses' Association (NSNA) focuses on empowering nursing students through leadership development and professional preparation.

    • ANA (American Nurses Association):

      • Goal: To expand the nursing profession and improve public health.

      • Role: Sets the standards that RNs must meet and teaches professional ethics (creating the "laws" of the profession).

    • NSNA (National Student Nurses Association):

      • Goal: To support nursing students on their path to becoming RNs.

      • Role: Helps students build professionalism and prepares them for careers in patient care and peer support.

    • Relationship and Role: The associations support one another and help professionals grow regardless of their career stage. As students (NSNA), we help each other learn; as future nurses (ANA), we utilize these standards to grow and provide better care.

    • Citation: (Lippincott - Fundamentals of Nursing: Pages 19-20)

Group 9: Nursing Theorists and Influencers

  • 1. Florence Nightingale

    • Background: Began as a battlefield nurse during the Crimean War.

    • Contribution: Established concepts of wellness and disease prevention. She was the first to connect poor sanitation to negative impacts on patient well-being.

  • 2. Clara Barton

    • Background: Served as a battlefield nurse in the American Civil War, earned the nickname "Angel of the Battlefield."

    • Contribution: One of the first women and nurses to become a federal employee during wartime. She is most remembered for importing the Red Cross to America after a trip to Europe. The American Red Cross has provided community health care, humanitarian aid, and medical education for over 150150 years.

  • 3. Abraham Maslow

    • Note: Maslow is an American Psychologist, not a nursing theorist.

    • Contribution: Developed the Hierarchy of Needs. This hierarchy explains which human needs are most foundational/important, allowing nurses to prioritize assessment and care.

Group 10: Principles of Thermoregulation

  • 1. Conduction

    • Definition: The transfer of heat to another object during direct contact.

    • Example: The body transferring heat to an iced drink while holding it, causing the ice to melt.

  • 2. Convection

    • Definition: The dissemination of heat by motion between areas of unequal density.

    • Example: An electric fan blowing cool air across a warm surface, causing the heat to disseminate.

  • 3. Evaporation

    • Definition: The conversion of a liquid into a vapor.

    • Example: Body heat/water boiling in a pot until the pot is empty.

  • 4. Radiation

    • Definition: The diffusion or dissemination of heat by electromagnetic waves.

    • Example: Exposure to the sun or UV light.

Group 11: Hypothermia and Hyperthermia

Hypothermia (Sub-normal Body Temperature)

  • Risk Factors: Excessive exposure to cold air or water, advanced age (elderly), exhaustion, the perioperative period, newborn status, and chronic conditions like malnutrition.

  • Signs/Symptoms: Shivering, clumsiness, confusion, fatigue, trouble speaking correctly, and increased urination. Physiological changes include weakened/irregular respirations and pulse, and lowered blood pressure.

  • Nursing Interventions (General): Move the patient to a warmer environment, remove wet clothing, provide warm blankets, and offer warm beverages.

  • Nursing Interventions (Specific):

    • Infants/Children/Unconscious: Administer warm liquids intravenously.

    • Clinical Settings: Use a hypothermia blanket or a transfusion of warmer blood.

    • External Warming: Apply warm clothes to heat points such as the armpits and groin.

Hyperthermia (Elevated Body Temperature)

  • Risk Factors: Hot environments lacking ventilation, high humidity, salt depletion, low water intake, obesity, and usage of certain medications (antihistamines or antipsychotics).

  • Elderly-Specific Risk Factors: Advanced age (65+65+) leads to poor adaptation to sudden temperature changes. Risks include poor ventilation and chronic conditions (heart, lung, kidney disease, high blood pressure, diabetes).

  • Signs/Symptoms: Rapid heart rate, headache, dizziness, thirst, fatigue, dry/hot skin, muscle aches, and loss of appetite.

    • Infants/Children: May experience seizures and wincing.

    • Older Adults: May experience confusion or delirium.

Nursing Interventions for Hyperthermia

  • For Patients > 19 years old: Administer antipyretic drugs such as aspirin, ibuprofen, or acetaminophen to reduce fever.

  • Environmental Modification: Increase heat transfer using cool packs, cool sponge baths, and cooling blankets.

  • Hydration/Nutrition: Provide oral fluids to maintain cellular/intravascular status and prevent dehydration. Provide simple carbohydrates to prevent tissue breakdown from a hypermetabolic state.

  • Age-Specific Interventions:

    • Infants: Environment modification, oral fluids, simple carbs.

    • Children: Environment modification, oral fluids, simple carbs.

    • Adults: Antipyretics, environment modification, oral fluids, simple carbs.

    • Elderly: Antipyretics, environment modification, oral fluids, simple carbs. Expected Vital Signs Across the Lifespan

Temperature ranges for adults are typically between 97°F to 100.4°F (36.1°C to 38°C), while for the elderly, the expected range may slightly decrease, often falling between 96.8°F to 98.3°F (36°C to 36.8°C), reflecting changes in thermoregulation with age.

  • Note: Older adults lose some thermoregulatory control; their average may be lower.

    • Infant: 96–99.7∘F96\text{--}99.7^{\circ}\text{F} (35.6–37.6∘C35.6\text{--}37.6^{\circ}\text{C})

    • Children: 96–99∘F96\text{--}99^{\circ}\text{F} (35.6–37.2∘C35.6\text{--}37.2^{\circ}\text{C})

    • Adult: 96.4–99.5∘F96.4\text{--}99.5^{\circ}\text{F} (35.8–37.5∘C35.8\text{--}37.5^{\circ}\text{C})

    • Elderly: 96.4–99.5∘F96.4\text{--}99.5^{\circ}\text{F} (35.8–37.5∘C35.8\text{--}37.5^{\circ}\text{C})

Pulse (Presented by Zariah)

  • Newborn: 95–170 bpm95\text{--}170\,\text{bpm}

  • Infant: 85–170 bpm85\text{--}170\,\text{bpm}

  • Toddler: 70–150 bpm70\text{--}150\,\text{bpm}

  • Child: 65–130 bpm65\text{--}130\,\text{bpm}

  • Adolescent: 60–115 bpm60\text{--}115\,\text{bpm}

  • Adult: 60–100 bpm60\text{--}100\,\text{bpm}

Respiration (Presented by Cydnie)

  • Newborn: 30–60 breaths/min30\text{--}60\,\text{breaths/min}

  • Infant: 30–50 breaths/min30\text{--}50\,\text{breaths/min}

  • Toddler: 20–40 breaths/min20\text{--}40\,\text{breaths/min}

  • Child: 15–25 breaths/min15\text{--}25\,\text{breaths/min}

  • Adolescent: 12–20 breaths/min12\text{--}20\,\text{breaths/min}

  • Adult: 12–20 breaths/min12\text{--}20\,\text{breaths/min}

Blood Pressure (Presented by Sara Wince)

  • Infant: 85/37 mmHg85/37\,\text{mmHg}

  • Children: 95/57 mmHg95/57\,\text{mmHg}

  • Adult: 120/80 mmHg120/80\,\text{mmHg}

  • Elderly (Women): 139/68 mmHg139/68\,\text{mmHg}

  • Elderly (Men): 133/69 mmHg133/69\,\text{mmHg}