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NR 222 WEEK 5: EDAPT 2025
The nurse is caring for a client who only speaks and read Spanish. What action should the nurse take when communicating with this client? - ANSWER-Use an authorized interpreter to provide translation for education Verbal and nonverbal communication identification - ANSWER-Nonverbal
- posture and gait
- Gestures
- personal space
- Eye contact
- Appearance Verbal
- Clarity in brevity
- pacing
- intonation
- Meaning Barriers to communication Situations - ANSWER--sad, or suffering from depression
- Withdrawn or have difficulty expressing feelings or needs
- Sensory perception deficits, such as hearing vision, or speech difficulties
- Angry or confrontational
- Uncooperative
- Talkative or lonely
- Demanding
- Frightened, anxious, or have difficulty coping
- Confused or disoriented
- Flirtatious or sexually inappropriate When caring for a client who is hearing impaired, which techniques may improve communication? - ANSWER-Assessing the need for adopted equipment like a hearing aid Keeping conversations, brief and direct Giving the patient time to react CASE STUDY: What are the cues that alert the nurse to be aware of communication needs? - ANSWER-Speaks Polish Understand some English, but speaks very little Deaf since childhood Vision has deteriorated CASE STUDY: As Rachel prepares to provide discharge teaching, which level of communication is most appropriate? - ANSWER-One-on-one CASE STUDY: Rachel enters the room to perform an assessment while waiting for Miss Simpson's daughter to arrive. The client reports that she is in pain and feeling nauseous. The nurse decides to delay/proceed with the teaching session. Rachel is aware that brevity/clarity/timing is important in this situation. - ANSWER-Delay
- Nurse is teaching a client how to choose low sodium foods on a menu Social distance
- Nurse is talking to the clients daughter about the diagnosis Nurse is giving a report to the oncoming shift The nurse is educating a client at the end of each sentence asks "Okay?" The nurses speech is rapid and explanations are lengthy, which aspect of verbal communication is the nurse breaching? - ANSWER-Clarity What is the most important aspect of small group communication? - ANSWER-Organized and concise What are aspects of nonverbal communication? - ANSWER-Eye Contact Posture and gait Personal space Appearance Facial expression Gestures Sounds What are reasons for effective communication and healthcare? - ANSWER-Reduce errors Improve outcomes Increase client satisfaction Meet legal standards Meets clinical standards of care Why communicate? - ANSWER-Develop relationships
Collect relevant data Provide education Interact during intervention Improve patient safety Reduce errors Increase satisfaction interpersonal relationships - ANSWER-- both the nurse and client must be equal participants in the communication partnership
- client responses are not always what is expected
- each client has a specific communication need
- we must pay attention to verbal and nonverbal communication
- at bedside communication always consider privacy Communication throughout the nursing process - ANSWER-Assessment: The nurse asked the client if they have any past surgeries Diagnosis: the nurse analyzes the clients responses and determines that the client is afraid to have surgery Planning: the nurse talks with a client to establish mutual goals Implementation: the nurse teaches a client about the pain management plan after surgery Evaluation: the nurse asked the client if they have any questions Levels of communication: self talk - ANSWER-Refers to your thoughts and inner communication that strongly influence your perception, feelings, behavior, and self-esteem. It is important to be aware of the nature and content of your own thinking.
vocabulary - ANSWER-Communication is ineffective, if senders and receivers cannot translate each others words or phrases Timing and relevance - ANSWER-Both are critical in communication if either is incorrect, communication is ineffective. Intonation - ANSWER-Tone of voice can dramatically alter the meaning and perception of a message Clarity and brevity - ANSWER-effective Communication is simple, brief and direct What are the characteristics of a therapeutic nurse-client relationship? - ANSWER-Goal-oriented Purposeful Positive client change Boundaries Stages of the therapeutic relationship in the correct order - ANSWER--Planning on starting for the purpose for interaction with the client begins
- Meeting, creating rapport, and establishing trust through honesty and empathy
- Mutual problem solving to accomplish therapeutic goals
- separating from the formal therapeutic relationship In which phase of the therapeutic relationship, does the nurse encourage the client through self-exploration and use therapeutic communication to facilitate successful interactions? - ANSWER-Working rapport - ANSWER-Harmony and mutual fondness between people in a relationship
empathy - ANSWER-Ability to understand another's feelings without losing personal identity and perspective. Purpose - ANSWER-Means that the nurse focuses on communication toward a specific client- centered goal. Displaying empathy or not displaying empathy - ANSWER-Empathy
- The nurse is caring for a client who recently experienced the loss of a newborn baby. The nurse sits at the bedside and holds the client's hand while the client quietly cries.
- The nurse is caring for an injured client who is far from home with no support system. The nurse arranges for transportation home and grocery delivery to relieve the client's anxiety. Not Empathy
- The nurse is caring for a client who is hospitalized on Thanksgiving day. The client is tearful and missing their family on the holiday. The nurse responds, "why are you crying? It's Thanksgiving day!"
- At the end of the shift, the nurse is caring for a client who has experienced stool incontinence. The nurse frowns when they realize this will delay leaving on time. preinteraction phase - ANSWER-Begins when the nurse starts preparation for the client and occurs before initial contact with the client. Orientation phase aka introductory phase - ANSWER-when the nurse and the patient meet and get to know each other working phase - ANSWER-Begins as a nurse, collaborators partners in promoting the clients health.
CASE STUDY: Prisha speaks to the healthcare provider and learns that Mr. Lang was recently diagnosed with a heart condition that requires daily medication. The provider explains that Mr. Lang was hesitant to take the drug and did not want to return to the clinic for monthly laboratory testing. Which phase of the therapeutic relationship does this represent? - ANSWER- Preinteraction CASE STUDY: How do the phases of the nurse-client relationship compare to the nursing process? - ANSWER-The nurse is performing assessment during the orientation phase. CASE STUDY: Upon entering the exam room, Prisha states, "Hello, Mr. Lang. I saw that today is your birthday. Do you have any plans to celebrate?" This statement begins the orientation phase of the therapeutic relationship. This phase should include formal/informal communication that is friendly/professional. - ANSWER-Informal Friendly CASE STUDY: Prisha remembers her late grandfather who refused to take his medication and how her grandmother struggled to watch his health decline. She notices that Mr. Lang's partner is very concerned, so Prisha provides reassurance by touching Mr. Lang's partner's hand. Which characteristic of the therapeutic relationship is Prisha displaying? - ANSWER-Empathy CASE STUDY: After providing education about medication compliance, Prisha thanks Mr. Lang and makes an appointment for him to return to the clinic in one month. What has Prisha accomplished? - ANSWER-The therapeutic relationship has terminated and a plan for the future was established. Which family may benefit from motivational interviewing?
- The family of a child who suffered a head injury following a motor vehicle accident and the family has replaced the damaged child restraint device.
- The family of a child recently diagnosed with diabetes mellitus and the family is concerned about changing their eating habits.
- The family of a child diagnosed with rotavirus and the family is prepared for discharge and verbalizes understanding of all instructions for home care.
- The family of a child diagnosed with dehydration following a soccer game and the family has purchased a large water bottle and sports drinks for the next match. - ANSWER--The family of a child recently diagnosed with diabetes mellitus and the family is concerned about changing their eating habits. Clara reviews the client's medical record. Clara specifically wants to review the client's ethnicity and family form to determine any cultural needs to be addressed as part of dietary teaching. Additionally, Clara consults with the facility dietician for strategies to encourage family diet change. Which phase of the therapeutic relationship do Clara's actions demonstrate? - ANSWER- Preinteraction Which Statement best describes therapeutic communication?
- It only involves nonverbal communication techniques, such as touch and eye contact.
- It is a communication style used by the healthcare provider, not the nurse.
- It is a skill used to meet a client's expressed or unexpressed needs in a timely and respectful manner.
SURETY: E - ANSWER-Establish or remain intermittent EYE CONTACT with the client to convey your willingness to listen. Absence of eye contact may indicate that you not interested. SURETY: T - ANSWER-Use respectful and appropriate TOUCH to convey empathy and compassion. SURETY: Y - ANSWER-Trust YOUR intuition! As you grow more confident in you communication abilities, learn to individualize, adapt, and apply communication techniques. Other communication strategies - ANSWER-Clarifying, focusing, paraphrasing, validation, asking relevant questions, summarizing, confrontation. CASE STUDY: In which phase of the therapeutic relationship does building rapport occur? - ANSWER-Orientation CASE STUDY: Review the following interaction, then answer the question. Client: Yes, I've actually had to turn away customers. My schedule is so overbooked. Nurse: Thank you for making time to see us today. Tell me how it makes you feel to turn away customers. What therapeutic communication technique is Iryna using with this client? - ANSWER-Asking relevant questions CASE STUDY: Review the following interaction, then answer the question.
Nurse: What exactly do you do for work? Client: I cut and style hair, mostly for brides and bridesmaids. Nurse: That sounds fun! Client: It is fun. I love my job, but yesterday I worked from 6 a.m. until 6 p.m. Nurse: That must have been an exhausting day. What therapeutic communication technique is Iryna using with this client? - ANSWER-Sharing empathy CASE STUDY: Review the following interaction, then answer the question. (Nurse makes eye contact with the client.) Nurse: Your hair looks very pretty today. Client: Thank you! I just got it cut last week. (A few minutes of silence passes while the client looks at herself in the mirror.) Client: I would love to do your hair for you one day. Nurse: If my hair gets any grayer, I may take you up on that offer.
Asking relevant questions Active listening matching - ANSWER-Letter Active Listening Skill S - Pull a chair close to the bedside and sit at an angle facing the client. U - Avoid a defensive position by uncrossing your arms and legs. R - Make your voice and posture communicate to the client that you are relaxed and comfortable. E - Maintain intermittent eye contact with the client to convey your willingness to listen. T - Use respectful and appropriate touch to convey empathy and compassion. Y - As you grow more confident in your communication abilities, trust your intuition and learn to individualize and apply communication techniques. Xavier Jones is talking with a family whose grandfather has just passed away. While answering questions and providing information, Xavier shares a story about his experience of losing his grandmother last year. What communication technique is Xavier using? - ANSWER-Self- disclosure Non-therapeutic communication techniques encourages/discourage conversation and expression of feelings and causes positive/negative responses or behaviors in others. - ANSWER- Discourage Negative Which communication techniques are considered non-therapeutic? - ANSWER-False reassurance Disapproving Which communication technique involves repeating the client's exact statements word for word? - ANSWER-Parroting
Asking personal questions - ANSWER-Asking person questions that are not relevant to the situation, is not professional or appropriate. Don't ask questions just to satisfy your curiosity. Non-therapeutic: "Why aren't you married?" Therapeutic: "How would you describe your relationship with your partner?" Asking for explanations - ANSWER-Nurses are often tempted to ask clients why they believe, feel, or act a certain way. However, this is non-therapeutic. Clients often interpret a "why" question as an accusation or test of competence. Asking "why" questions causes resentment, insecurity, and mistrust. Non-therapeutic: "Why are you afraid to have surgery?" Therapeutic: "You seem scared. Tell me more about how you are feeling." Giving personal opinions - ANSWER-When nurses offer personal opinions, it impedes the client's decision-making ability. Now, personal opinions differ from professional advice. Often, clients need professional suggestions to help them make healthy choices. Suggestions are options for the client to accept or reject. Personal opinions can sway a client in one direction or another. Non-therapeutic: "If I were you, I would put my son in daycare so I could return to work." Therapeutic: "Let's talk about which options are available to help you care for your son and continue to work." John is talking to Tim and states, "Tim, you should quit your job if you are so unhappy." - ANSWER-An example of a personal opinion
Client: I need it fixed now. I can't watch the news. Nurse: I'm sure it is just the batteries in the remote. Don't worry about it. What non-therapeutic communication technique is Jeffery using with this client? - ANSWER- False reassurance Review the following interaction, then answer the question. Client: Seriously! I need the TV fixed. Nurse: What did you do to it? Client: I did not do anything to it. Nurse: You did not do anything to it. Client: Why do you not believe me? Nurse: Of course, I believe you. Why wouldn't I believe you? What non-therapeutic communication techniques is Jeffery using with this client? Select all that apply. - ANSWER-Asking for an explanation Parroting Defensive
Review the following interaction, then answer the question. Client: Can you call someone to fix my TV? Nurse: Let's go and see what the cafeteria is serving for lunch. What non-therapeutic communication technique(s) is/are Jeffrey using with this client? Select all that apply. - ANSWER-Changing the subject Review the following interaction, then answer the question. Nurse: It must be frustrating for your TV to not be working when you want to watch the news. Let me see if I can help you. Jeffery is displaying EMPATHY/SYMPATHY toward the client, which is a THERAPEUTIC/NON- THERAPEUTIC response. - ANSWER-Empathy Therapeutic What is the non-therapeutic technique "If I were you, I would take a leave of absence from work." - ANSWER-Giving advice What is the non-therapeutic technique "It's time for your medications. We can talk about your concerns about discharge later." - ANSWER-Changing the subject What is the non-therapeutic technique "I'm sure your test results will be normal." - ANSWER-False reassurance
