The Aging Adult 20
PART A a. Source
MATCHING EXERCISES
Match the elements of the communication process in Part A with the appropriate definition in Part B.
PART A
1. The actual product of the encoder 2. He/she must translate and make a
decision about the product.
3. Verbal and nonverbal evidence that the patient received and understood the product
4. He/she prepares and sends the product.
5. The medium selected to convey the product
6. Factors that distort the quality of the product
Match the examples of patient goals in Part B with the appropriate phase in which they should occur listed in Part A. Answers may be used more than once.
PART A
a. Orientation phase b. Working phase
c. Termination
PART B
7. The patient will demonstrate ability to maneuver on crutches.
8. The patient will acknowledge the goals he has accomplished in physical therapy.
9. The patient will learn the name of the physical therapist and address him by his name.
10. An anorexic patient will establish an agreement with her healthcare professional to return gradually to a normal eating pattern.
11. The patient will express his desire to go home despite the excellent care he received at the agency.
12. The patient will attend a counseling ses-sion dealing with smoking.
13. The patient will verbalize the goals set forth in his transition to a home health-care setting.
14. The patient will establish an agreement with the home healthcare worker about the frequency and length of contacts.
15. The patient will express his concerns about pending surgery to the nurse.
Match the interviewing questions in Part B with the interviewing techniques useful in nurse–patient interactions listed in Part A.
Answers may be used more than once.
PART A
a. Validating question/comment b. Clarifying question/comment c. Reflective question/comment d. Sequencing question/comment e. Directing question/comment PART B
16. “You say you’ve always been healthy and active; is this the first time you’ve been hospitalized?”
17. “You expressed concern about your children at home . . .”
18. “At home you’ve been treating your ulcer with an antacid. Did you take any today?”
19. “You’ve been on your present medication for 3 years. Did you experience any side effects?”
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20. “Your chest pain began after exercising on a lifecycle?”
21. “You’ve been upset about taking medication . . .”
SHORT ANSWER
1. Give an example of the following nonverbal forms of communication and explain how they can provide clues to the patient’s health status.
a. Touch:
b. Eye contact:
c. Facial expressions:
d. Posture:
e. Gait:
f. Gestures:
g. General physical appearance:
h. Mode of dress and grooming:
i. Sounds:
j. Silence:
2. Briefly describe how you would alter your explanation of a surgical procedure to take into account the developmental consid-erations of the following patients:
a. An 8-year-old boy:
b. A 16-year-old girl:
c. A 65-year-old man with a hearing impairment:
3. What clues to a person’s identity can sometimes be determined by knowing that person’s occupation?
4. Briefly explain the role that communication plays in the following steps of the nursing process.
a. Assessing:
b. Diagnosing:
c. Planning:
d. Implementing:
e. Evaluating:
f. Documenting:
5. Explain why the following variables must be considered when establishing rapport between a nurse and patient.
a. Having specific objectives:
b. Providing a comfortable environment:
c. Providing privacy:
d. Maintaining confidentiality:
e. Maintaining patient focus:
f. Using nursing observations:
g. Using optimal pacing:
h. Providing personal space:
i. Developing therapeutic communication skills:
118 UNIT V ROLES BASIC TO NURSING CARE
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing:
The Art and Science of Nursing Care, 7th Edition.
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CHAPTER 21 COMMUNICATOR 119
j. Developing listening skills:
k. Using silence as a tool:
6. Rewrite the following questions/statements to promote more effective communication with the patient.
a. “Did you have a good night?”
b. “Are you ready to try walking on that foot?”
c. “I can’t believe you stopped taking your insulin!”
d. “You aren’t afraid of taking that test, are you?”
e. “No one should be afraid of that procedure; it’s been done a million times!”
f. “Don’t worry; everything will be all right.”
7. Underline the nonverbal communication in the following paragraph:
Mrs. Clarke, age 42, underwent a mastectomy.
She has a husband and two children, ages 10 and 5. When the nurse enters Mrs. Clarke’s room, she finds her patient’s eyes are teary and there is a worried expression on her face.
When asked how she is feeling, Mrs. Clarke replies “fine,” although her face is rigid and her mouth is drawn in a firm line. She is mov-ing her foot back and forth under the covers.
On further investigation, the nurse finds that Mrs. Clarke is worried about her children and her own ability to be a healthy, functioning wife and mother again. After prompting, Mrs.
Clarke says, “I don’t know if my husband will still love me like this.” She sighs and falls silent, reflecting upon her recovery. The nurse tries to make Mrs. Clarke comfortable and puts her hand over Mrs. Clarke’s hand. She establishes eye contact with Mrs. Clarke and
reassures her that things have a way of work-ing out and suggests that she give her
situation some time.
8. Mr. Uhl is a 72-year-old man with early signs of Alzheimer’s disease. He is living with his daughter and son-in-law in a large city, where he is functioning well under supervision. His doctor suggests a daycare center to fill in the gaps when the daughter is away at her part-time job. Nurse Parish, employed by the day-care center, enters into a helping relationship with Mr. Uhl, even though she knows she will be starting a new job at the end of the month that will force them to terminate their relationship. Write two patient goals the nurse may prepare for Mr. Uhl in the follow-ing phases of their short helpfollow-ing relationship.
a. Orientation phase:
(1) (2)
b. Working phase:
(1) (2)
c. Termination phase:
(1) (2)
9. Give an example of the following
interpersonal skills necessary for the promo-tion of a healthy nurse–patient relapromo-tionship.
Rate your own skills in these areas on a scale of 1 to 10.
a. Warmth and friendliness:
b. Openness:
c. Empathy:
d. Competence:
e. Consideration of patient variables:
10.Mr. Johnson, age 69, has been diagnosed with prostate cancer. He is despondent and refuses to participate in his own care. Give an exam-ple of a nurse’s dialog with Mr. Johnson that shows each component of the assertive response:
a. Empathic component:
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b. Description:
c. Expectation:
d. Consequence:
11.List five common blocks to communication and describe nursing’s role in overcoming these obstacles.
a.
b.
c.
d.
e.
APPLYING YOUR KNOWLEDGE
CRITICAL THINKING QUESTIONS
1. Write a general script for communicating with patients beginning with, “Hello, my name is . . .” to the end of the conversation. Make your script specific to the needs of the follow-ing patients:
a. A 4-year-old boy is admitted to the hospital with multiple fractures following a car accident.
b. A teenage girl is admitted to the burn unit with third-degree burns following a fire in her home.
c. A 29-year-old rape victim is brought to the emergency room for treatment and testing.
d. A 60-year-old man with a history of strokes is brought to the emergency room with left-sided paralysis.
How competent and comfortable are you in each situation? What skills do you need to develop?
2. Pick a partner and try to communicate the following messages using only nonverbal communication:
a. I’m thirsty.
b. I have a pain in my stomach.
c. It’s too hot in here.
d. I’d like you to read me a story.
e. I’d like to go home now.
f. Where is the bathroom?
g. Can I have another pain reliever?
h. I’d like to go to sleep now.
i. It’s too noisy in here.
j. I can’t fall asleep.
Reflect on the importance of nonverbal communication.
3. Observe and interpret a patient’s nonverbal communication, and then ask the patient if your interpretation was correct; for example,
“You seem to be in a lot of pain; is that correct?”
4. Ask a friend who has been a close confidant of yours to rate you on the following attributes that stimulate a healthy nurse–patient relationship: warmth and friendliness, openness, empathy, competence, and consid-eration of patient variables. See if this evalua-tion is consistent with your own feelings when practicing patient care. Work on the areas on which you had a lower score the next time you are with patients.
REFLECTIVE PRACTICE USING CRITICAL THINKING SKILLS
Use the following expanded scenario from Chapter 21 in your textbook to answer the questions below.
Scenario: Mrs. Irwina Russellinski is a 75-year-old woman transferred from the emergency department, diagnosed with pneumonia.
Her chart reveals that she is hard of hearing,
“slightly confused” at times, and speaks “bro-ken English.” Mrs. Russellinski has a daughter living nearby who is listed as a contact person.
Mrs. Russellinski tells the nurse not to call her daughter because “she is too busy with her own family and shouldn’t have to bother with a sick mother.” A nursing assessment is needed.
120 UNIT V ROLES BASIC TO NURSING CARE
Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing:
The Art and Science of Nursing Care, 7th Edition.
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1. What communication skills might the nurse use to complete an assessment of Mrs. Russellinski?
2. What would be a successful outcome for this patient?
3. What intellectual, technical, interpersonal, and/or ethical/legal competencies are most likely to bring about the desired outcome?
4. What resources might be helpful for Mrs. Russellinski?
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