The nurse has a patient who is short of breath and calls the health care provider using SBAR

Intrapersonal Communication

Communication that occurs within an individual. In nursing this allows the nurse to assess clients and/or situation and critically think about the clients/situations before verbally communicating

Interpersonal Communication

Communication that occurs between two people. The exchange of information occurs with an individual or a small group

Public Communication

Communication that occurs within large groups of people. This most commonly occurs when the nurse is teaching a large group of people or engaging the community.

Transpersonal Communication

Addresses spiritual needs and provides interventions to meet these needs

Small Group Communication

Communication within a group of people

Referent

The incentive or motivation for communication to occur between one person and another

Sender

The person who initiates the message is referred to as the

Message

The verbal and/or nonverbal information that is expressed by the sender and intended for the receiver

Channel

The method of transmitting and receiving a message. (Sight, Hearing, Touch)

Receiver

The person whom the message is aimed at and received by.

Environment

The emotional and physical climate in which the communication takes place

Feedback

The message that is returned to the sender by the receiver that indicated that the message was received; an essential component of ongiong communication. May be verbal or nonverbal, positive or negative

Interpersonal Variables

Variables that influence communication between the sender and the receiver

Vocab, Meaning (Denotative/Connotative), Clarity/Brevity, Timing/Relevance, Pacing, Intonation

What are the 6 variables of the "Content of a Message"

Denotative

A word that has distinct meanings in many fields is considered to be

Connotative

A word with subjective cultural or emotional meaning is considered to be

Vocabulary

CONTENT OF A MESSAGE:

Theses are the words used to communicate either a written or spoken message. Use of medical jargon may decrease client understanding.

Denotative/Connotative Meaning

CONTENT OF A MESSAGE:

When communicating, participants must share meanings. Word that have multiple meanings may cause miscommunication if interpreted differently.

Clarity/Brevity

CONTENT OF A MESSAGE:

The shortest, simplest communication is usually most effective. Long a complex communications may be difficult to understand

Timing/Relevance

CONTENT OF A MESSAGE:

Knowing when to communicate allows the receiver to be more attentive to the message. Communicating with a client who is in physical discomfort/distracted will make it difficult to convey a message.

Pacing

CONTENT OF A MESSAGE:

The rate of speech can communicate a meaning to the receiver. Speaking rapidly may communicate the impression that you are in a rush and don't have time.

Intonation

CONTENT OF A MESSAGE:

The tone of voice can communicate a variety of feelings. The nurse can communicate feelings such as acceptance, judgement, and dislike through tone of voice.

Nonverbal Communication

Appearance, Posture, Gait, Facial Expression, Eye Contact, Gestures, Sounds, Territoriality, Silence.

These would all be considered forms of?

A (The connotative meaning of the word is different to the client and the nurse.)

A nurse is bathing an older adult client and says to him, "Turn to your side now, honey." The nurse believes she is demonstrating warmth and caring by calling the client "honey." However, the client finds the term offensive. What has caused this miscommunication to occur?

A. The connotative meaning of the word is different to the client and the nurse.

B. The client was unable to hear the nurse's message.

C. The nurse's verbal communication was not congruent with her nonverbal communication.

D. It is not the appropriate time for performing the client's bath.

B (encourages the client to express his thoughts and feelings.)

A nurse recognizes that a helping relationship is established with a client if the communication

A. is equally reciprocal between the nurse and the client.

B. encourages the client to express his thoughts and feelings.

C. has no time limits.

D. occurs spontaneously throughout the nurse-client relationship.

B (sit at eye level with the child.)

When communicating with a child who is seated, the nurse should

A. touch the child.

B. sit at eye level with the child.

C. stand facing the child.

D. stand with a relaxed posture.

A, C, E (Having an open posture and leaning forward, establishing and maintaining eye contact, and responding positively when giving feedback are ways the nurse can demonstrate
active listening. Writing down everything the client says will interfere with the nurse's ability to maintain eye contact and an open posture. Nodding in agreement throughout the conversation may be interpreted as agreement with what the client is saying when it was only intended to indicate attending to what was being said.)

Which of the following are behaviors of active listening? (Select all that apply.)

A. Maintaining an open posture

B. Writing down what the client says so that details are not forgotten

C. Establishing and maintaining eye contact

D. Nodding in agreement with the client throughout the conversation

E. Responding positively when giving feedback

Situation, Background, Assessment, Recommendation

SBAR stands for:

Sit (facing the client), Observe (an open posture), Lean (towards the client), Eye-Contact, Relax

SOLER is the acronym for Active Listening and stands for:

Quality and Safety Education for Nurses

QSEN stands for:

Assessment

Relate these methods of communication to a single element of the nursing process:

• Verbal interviewing and history taking
• Visual and intuitive observation of nonverbal behavior
• Visual, tactile, and auditory data gathering during physical exam
• Written medical records, diagnostic tests and literature review

Diagnosis

Relate these methods of communication to a single element of the nursing process:

• Intrapersonal analysis of assessment findings
• Validation of health care needs and priorities via verbal discussion with patient
• Documentation of nursing diagnostic

Planning

Relate these methods of communication to a single element of the nursing process:

• Interpersonal or small group health care team planning sessions
• Interpersonal collaboration with patient and family to determine implementation methods
• Written documentation of expected outcomes
• Written or verbal referral to health care team members

Implementation

Relate these methods of communication to a single element of the nursing process:

• Delegation and verbal discussion with healthcare team
• Verbal, visual, auditory, and tactile health teaching activities
• Provision of support via therapeutic communication techniques
• Contact with other health sources
• Written documentation of patient's progress in medical record

Evaluation

Relate these methods of communication to a single element of the nursing process:

• Acquisition of verbal and nonverbal feedback
• Comparison of actual and expected outcomes
• Identification of factors affecting outcomes
• Modification and update of healthcare plan
• Verbal and/or written explanation of revisions of care plan to patient

D (Feedback)

(Feedback is the message the receiver returns that indicates understanding. By summarizing what the patient has said, the nurse can determine if the message was received accurately.)

The nurse summarizes the conversation with the patient to determine if the patient has understood him or her. This is what element of the communication process?

A) Referent
B) Channel
C) Environment
D) Feedback

B (Coach her to give herself positive messages about her ability to do this)

(Intrapersonal communication is self-talk. The other options may help her better understand insulin administration or deal with her anxiety, but they do not involve intrapersonal communication.)

Mrs. Jones states that she gets anxious when she thinks about giving herself insulin. How do you use your understanding of intrapersonal communication to help with this?

A) Provide her the opportunity to practice drawing up insulin
B) Coach her to give herself positive messages about her ability to do this
C) Bring her written material that clearly describes the steps of insulin administration
D) Use therapeutic communication to help her express her feeling about giving herself an injection

C (The patient is short of breath)

(Using the acronym SBAR, the nurse should begin with "S," which is Situation. The situation is that the patient is short of breath. The history of lung cancer is Background, the respiratory rate is Assessment, and the request for an order is a Recommendation.)

The nurse has a patient who is short of breath and calls the health care provider using SBAR (Situation-Background-Assessment-Recommendation) to help with the communication. What does the nurse first address?

A) The respiratory rate is 28.
B) The patient has a history of lung cancer.
C) The patient is short of breath.
D) He or she requests an order for a breathing treatment.

D (Talk with him about his favorite hobbies)

(Socializing is used during the orientation phase of a relationship to get acquainted and help establish trust.)

You are caring for Mr. Smith, who is facing amputation of his leg. During the orientation phase of the relationship, what would you do?

A) Summarize what you have talked about in the previous sessions
B) Review his medical record and talk to other nurses about how he is reacting
C) Explore his feelings about losing his leg
D) Talk with him about his favorite hobbies

B (Clarifying)

(The nurse is not sure what the patient means by living up to expectations and is clarifying the patient's concern.)

The nurse states, "When you tell me that you're having a hard time living up to expectations, are you talking about your family's expectations?" The nurse is using which therapeutic communication technique?

A) Providing information
B) Clarifying
C) Focusing
D) Paraphrasing

B ("Why do you always put so much salt on your food?")

(Avoid asking "why" questions. They tend to imply an accusation and can build resentment.)

Which of the following statements would be most likely to block communication?

A) "You look kind of tired today."
B) "Why do you always put so much salt on your food?"
C) "It sounds like this has been a hard time for you."
D) "If you use your oxygen when you walk, you may be able to walk farther."

C (Move to her bedside, get her attention, and repeat the question while facing her)

(You do not want to assume that she is hard of hearing because she is 80, but it is more likely. She may have not responded because you were across the room and water was running. Don't jump to conclusions, but instead try again to communicate with her as you would with someone who is hard of hearing.)

You are caring for an 80-year-old woman, and you ask her a question while you are across the room washing your hands. She does not answer. What is your next action?

A) Leave the room quietly since she evidently does not want to be bothered right now
B) Repeat the question in a loud voice, speaking very slowly
C) Move to her bedside, get her attention, and repeat the question while facing her
D) Bring her a communication board so she can express her needs

B ("When you brush me off like that, it takes me even longer to do my job.")

(Lateral violence can be dealt with by using assertive communication. Simple assertive statements include referencing the person you are addressing, the behavior that is a problem, and its effect. Avoiding the situation, becoming defensive, or making sarcastic remarks does not help to resolve the problem.)

You ask another nurse how to collect a laboratory specimen. The nurse raises her eyebrows and asks, "Why don't you figure it out?" What would be the best response?

A) Say nothing and walk away. Find a different nurse to help you.
B) "When you brush me off like that, it takes me even longer to do my job."
C) "Why do you always put me down like that?"
D) "I guess I just enjoy having you make fun of me."

C (18 inches to 4 feet from the patient.)

(The personal zone is 18 inches to 4 feet. This distance allows for easy communication without invading the person's personal space.)

When the nurse takes the patient's nursing history, he or she sits:

A) Next to the patient.
B) 4 to 12 feet from the patient.
C) 18 inches to 4 feet from the patient.
D) 12 inches to 3 feet from the patient.

C (Shifting quickly from subject to subject.)

(Shifting quickly from subject to subject may be difficult for an older person to follow, especially if the person is hard of hearing. Focusing on the patient's feelings and encouraging reminiscence help the person process changes or loss.)

When working with an older adult, the nurse remembers to avoid:

A) Touching the patient.
B) Allowing the patient to reminisce.
C) Shifting quickly from subject to subject.
D) Asking the patient how he or she feels.

D (The professional nurse works with colleagues and the patient's family to provide combined expertise in planning care.)

(Collaboration involves everyone working together to best meet the needs of the patient. A care plan that incorporates the expertise of professionals from varied disciplines best addresses patient needs.)

The statement that best explains the role of collaboration with others for the patient's plan of care is which of the following?

A) The professional nurse consults the health care provider for direction in establishing goals for patients.
B) The professional nurse depends on the latest literature to complete an excellent plan of care for patients.
C) The professional nurse works independently to plan and deliver care and does not depend on other staff for assistance.
D) The professional nurse works with colleagues and the patient's family to provide combined expertise in planning care.

ADE

(Consistency, courtesy, competency, and honesty build trust. Rushing and avoiding spending time with the patient may decrease or slow the development of trust.)

Identify behaviors that foster the development of trust. (Select all that apply.)

A) Answer the call light promptly.
B) Call the patient by first name unless requested otherwise.
C) Do all the care as quickly as possible and leave the room so the patient can rest.
D) Answer questions honestly.
E) Demonstrate competence when doing treatments.

C (Obtains an interpreter to facilitate communication of medication information)

(It is essential that patients understand discharge instructions to safely care for themselves at home. If a patient has limited ability to speak or understand English, he or she has a legal right to an interpreter to ensure understanding of essential information.)

A patient with limited English proficiency is going to be discharged on new medication. How does the nurse complete the discharge teaching?

A) Uses a dictionary to give directions for medication administration
B) Explains the directions to the patient's 14-year-old daughter
C) Obtains an interpreter to facilitate communication of medication information
D) Uses a picture board and visual aids to communicate medication administration information

BCE

(Privacy and lack of distraction create an environment conducive to therapeutic communication. Nursing presence and touch convey caring and compassion and allow the patient to collect her thoughts. Providing information tells people what they need or want to know. "Why" questions may seem intrusive and block communication.)

Your patient has just been told that she has cancer, and she is crying. Which actions facilitate therapeutic communication? (Select all that apply.)

A) Turning on the television to her favorite show
B) Pulling the curtain to provide privacy
C) Offering to discuss information about her condition
D) Asking her why she is crying
E) Sitting quietly by her bed and hold her hand

C (Deflect your eyes downward to show respect)

(Many cultures, especially the eastern cultures, view direct eye contact as rude. Deflecting your eyes downward indicates respect.)

Mr. Sakda emigrated from Thailand. When taking care of him, you note that he looks relaxed and smiles but seldom looks at you directly. How do you respond?

A) Use therapeutic communication to assess for increased anxiety
B) Sit down and position yourself closer so you are at eye level
C) Deflect your eyes downward to show respect
D) Continue to maintain eye contact

Which strategy would the nurse use when communicating with a patient who has difficulty speaking because of injuries caused by facial trauma?

Face the patient, be sure that your face/mouth is visible to him or her, and do not chew gum or talk while chewing. Speak clearly but do not exaggerate lip movement or shout. Speak a little more slowly but not excessively slow. Check whether patient uses hearing aids, glasses, or other adaptive equipment.

Which action would the nurse take when communicating with a patient with aphasia quizlet?

The nurse is caring for a patient with aphasia. Which precautions should the nurse take when communicating with this patient? Ask simple questions. Avoid using visual clues.

Which communication technique would the nurse use when communicating with a patient who has a hearing impairment?

When communicating with the patient who has hearing impairment, the nurse should communicate at normal volume rather than shouting. The nurse should rephrase rather than simply repeat statements if the patient misunderstands.

Which action would the nurse perform during the working phase of a helping relationship?

The working phase of a helping relationship involves nurses working together with clients to set their goals, and encourage them to solve their problems and express their feelings. This phase also involves helping the clients take actions to meet their goals.