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Exam 1: Therapeutic Communications and The Nursing Process in Drug Therapy and Patient Safety

Terms in this set (21)

What is the definition of therapeutic communication?
- interpersonal interaction b/t the nurse and patient during which the nurse focuses on the needs of the client to promote an effective exchange of info b/t the nurse and patient
what are the primary goals of therapeutic communication?
-establishing rapport
-actively listening
-gaining the patients perspectives
-exploring the patients thoughts and feelings
-guiding the patient in problem solving
Name a few therapeutic verbal communication skills:
-accepting
-broad openings
-encouraging comparison
-formulating a plan of action
-giving information
-restating
-silence
-summarizing
Name some nontherapeutic Communicaiton Techniques
-advising
-agreeing
-defending
-introducing an unrelated topic
-probing
-reassuring
-requesting
what are the most common nonverbal communication skills that we use in an everyday basis?
-Facial expressions (Expressive, Impassive, Confusing)
-Body language (gestures, postures, movements, body position)
-Vocal Cues (Voice volume, tone, pitch, intensity, emphasizes, speed, and pauses)
-Eye Contact (^ during listening, decreases during speaking)
how would you clarify context to understand it better ?
-You would gather information from both verbal and nonverbal sources and also validate feelings with the patient
-Also, you would focus the assessment on WHO was there, WHAT happened, WHEN it occurred, HOW the even progressed, and WHY the client believes it happened as it did.
what is the study of distance zones b/t people during communication?
Proxemics
What are the 4 distance zones ?
intimate (0-18 inches)
personal (18-36 inches)
social (4-12 ft)
public (12-25 ft)
What are concrete messages ?
The words are explicit and need no interpretation; speaker uses nouns instead of pronouns

Example: "What health symptoms caused you to come to the hospital today?" OR "When was the last time you took your antidepressant medications?"
Describe and give an example of a Abstract message ?
Unclear patterns of words that often contain figures of speech that are difficult to interpret; REQUIRES the listener to interpret what the speaker is saying

Example: a nurse who wants to know why a patient is admitted to the unit asks "How'd you get here?" (The terms how and here are vague)
Name some responsibilities of the nurses in drug therapy:
-Nurturing
-Caring
-Assessing
-Diagnosing
-Intervening with patients to: treat, prevent, educate
in the first stage of the nursing process, assessing, how does that relate to drug therapy?
it must include info on the Hx of past illnesses and the current complaint as well as a complete drug history and a physical exam; this provides a database of baseline data to ensure safe administration of a drug and to evaluate effectiveness and adverse reactions
how is diagnosing involved in the drug therapy ?
developed from info gathered during assessment phase of the nursing process--it states the actual or potential response of a patient to a clinical situation
how is planning involved in the drug therapy ?
it uses the info gathered and the resultant nursing Dx to determine the desired patient outcomes, setting goals for safe and effective drug administration.
How is the implementation phase related to the drug therapy ?
it puts the nursing interventions into action.
the interventions r/t drug therapy are: safely administrating the drug, providing comfort measures to help pt cope w/ therapeutic or adverse effects, providing pt and family education to ensure safe and effective drug therapy
how is the evaluation phase r/t the drug therapy ?
it is the continuing process of patient care that leads to changes in assessment, diagnosis, and interventions; the patient is continually being evaluated for: therapeutic response, the occurrence of adverse drug effects, and the occurrence of drug-drug, drug-food, drug-alternative therapy, or drug-laboratory test interactions
what are the two major aspects associated with the assessment ?
-Patients History (past illnesses and the current problem
-Examination of his or her physical status (weight, age, physical parameters r/t the disease state or known drug effects)
describe the essential elements of a medication order:
-client's full name
-date/time of order
-name of med
-ordered dosage
-form of medication
-route of administration
-time/frequency of medication
-signature of ordering physicians or licensed independent practitioners signature
Describe the 8 rights nurses should go through to prevent medication errors:
-right patient
-right drug
-right storage
-right route
-right dose
-right preparation
-right time
-right documentation
A nurse is assigned to care for a client with a respiratory problem in a health care facility. What should a nurse consider with regard to the expected outcome for a client undergoing drug therapy?
A. Amount of time the client will take to recover fully
B. Amount of drugs the client will require during the treatment
C. Possible adverse reactions that could occur during the therapy
D. Maximum level of wellness that is reasonably attainable for the client
D. Maximum level of wellness that is reasonably attainable for the client

Rationale: The nurse should know that the expected outcome is a direct statement of how patient goals are to be achieved. The expected outcome describes the maximum level of health promotion that is reasonably attainable for the patient.. The expected outcome for a client does not include the amount of time the client will take to recover fully, the amount of drugs the client will require during the treatment, or the possible adverse reactions that could occur during the therapy.
Considering drug therapy, what would be an appropriately stated expected outcome for a client?
A. "The client will verbalize three medication side effects prior to discharge."
B. "The client will take the medication."
C. "The client will demonstrate pain relief."
D. "The client's blood pressure will be improved."
A. "The client will verbalize three medication side effects prior to discharge."

Rationale:
An effective outcome statement is clear, attainable, measurable, and has an established time frame. None of the other statements is measurable or has an established time frame.
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