GROUP 3 NOTES:
Communication:
-Therapeutic Communication: (verbal)
-Open Ended Questions
-Never ask why
-“tell me more” “tell me how you feel about that”
-“don’t worry” avoid false reassurance
-Interpreter has to facility approved, no family members or non medical staff
-Should make eye contact
-avoid “elder speak” (honey, sweetheart) call the patient by their name
-Non Verbal:
-Eye level with patient (sitting)
-Body language, don’t cross arms
-Open body language
-Listen inventively
-nonjudgmental, unbiased
-Levels of Communication
-Intrapersonal: Self talk
-Interpersonal: Between two or more people
-Group, Public Speaking
-Factors Affecting Verbal Communication
-Explain from simple to complex
-No medical jargon
-Factors Affecting Nonverbal communication:
-Facial Expression
-posture and gait
-personal appearance
-Gestures
-Touch
-Factors the affect communication in general:
-environment
-developmental variations
-gender
-personal space
-territoriality
-sociocultural factors
-roles and relationships
-Communicating within the healthcare team
-SBAR: situation, background, assessment, recommendation, questions
Teaching/Learning:
-Learning Domains:
-Cognitive: math, using your brain STORAGE AND RECALL
-psychomotor: skill, in practice HANDS ON SKILL, THINKING AND DOING
-affective: emotions, role model CHANGING FEELINGS, BELIEFS,
ATTITUDES, “role modeling”
-patient education:
-ANA Standard (slide 6)
-five rights of teaching:
-right time, context, goal, content, method
-Factors that affect client learning:
-Motivation, readiness, timing, active involvement, feedback given, repetition,
learning environment, developmental stage ETC (slides 13&14)
-Barriers (slide 15)
Pain:
-Subjective
-5th vital sign
-the only way to accurately assess pain is to ask your patient and believe them
-Scales:
Wong baker (faces), cognitive impairment, developmental stage
Number scale 1-10
-Classification on pain:
-origin:
-referred: Heart attack, pain on arm
-radiating: sore throat
-somatic: deep in bones or joints (cancer)
-visceral: organs, typically abdomen
-phantom: originates from an area that has been surgically removed,
amputation, nerve pain, treat the opposite leg
-cutaneous/superficial: skin/subcutaneous tissue
-psychogenic: arises from the mind, perceives the pain despite the fact that
no physical cause can be identified
-Cause:
-Nociceptive: pain receptors respond to potential damaging stimuli
(mechanical, thermal, chemical) (acute)
-Neuropathic pain: nerve pain (chronic)
Activity:
-
Principles of body mechanics:
o Body alignment, balance, coordination, joint mobility (slides 10&11)
Romberg: balance
Rapid hand eye: coordination
ROM
Effects of immobility:
-
o Constipation
o Joint contractures
o Muscle weakness
o Balance problems
o DVT, stroke, emboli
o Pooling of secretions in the lower lobe
o Orthostatic hypotension
o Depression
Assessment: Symmetrical, +2, bilateral
Nursing diagnoses that specifically describe activity and exercise problems
include:
Activity Intolerance is a state in which a patient has insufficient physical or
psychological energy to carry out daily activities.
Impaired Physical Mobility is limitation of independent purposeful
movement of the body.
Risk for Disuse Syndrome exists when a patient’s prescribed or unavoidable
inactivity creates the risk for deterioration of other body systems.
Sedentary Lifestyle is a habit of life that is characterized by a low physical
activity level.
Incentive Spirometer, every 2 hours for patient who is immobile
Promoting Exercise
Safety:
-Falls:
-assess for fall risk
-Keep environment free of clutter
-assist to the bathroom
-call light within reach
-lock wheelchair when transferring
-items close by
-nonskid socks
-bed/chair alarm
-Keeping beds locked
-Restraints:
-NO PRN, review order every 24 hours
-do not tie to bed rails
-padded
-can fit two fingers in-between
-ROM and skin every two hours
-reevaluate
Infection Control:
-WASH YOUR HANDS
-donning and doffing PPE
-Precautions: Droplet, Airborne, Contact
-Biohazard, proper disposal
-don’t shake out sheets, hold away from body
-chain of infection: infectious agent, reservoir, portal of exit, mode of
transmission, portal of entry, susceptible host
Sensory:
-Overload:
-being in the ICU- ICU psychosis, sensory overload
-environmental factors: sharing a room, light, sound, touch, vision, hearing,
taste, smell
-Deficit:
- Isolation put pt at risk for deficit
- salt “double edged sword”