Metaparadigm of Nursing/Communication/Assessing – Flashcards
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domain
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the perspective of a profession
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metaparadigm of nursing
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directs the activity of the nursing profession
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4 links within the paradigm
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person, health, setting, nursing
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Ceclia, an adolescent, is in the ER for RUQ pain. Cecilia is which link in the paradigm?
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Person
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This link in the paradigm is dynamic, different for each person, and can be affected by multiple things.
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Health
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Bob is in a car accident and is taken to the hospital where he is treated for fractured ribs. The hospital is which link in the paradigm?
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Setting
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define health
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the state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity
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define nursing
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the diagnosis and treatment of human responses to actual or potential health problems
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Maslow's Hierarchy of Needs
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an interdisciplinary theory that aids in designating priorities in nursing care
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5 levels of Maslow's hierarchy
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Basic needs, safety/security, love and belonging, self-esteem, and self-actualization.
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5 things that can affect a person's health
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age, sex, socio-economic issues, frame of mind, and religious beliefs
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food, water, shelter, sex are
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basic needs
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Once a pt's basic needs are met, the nurse can focus on which course of action next?
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Safety and security
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A patient is now pain free, safely tucked in bed, and requesting that his family come in. According to Maslow would this follow the next step in the hierarchy?
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Yes, love and belonging
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What is self-esteem?
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the feeling that one is worthwhile, competent, and independent.
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What is the 5th tier is Maslow's Hierarchy of needs?
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Self-actulization
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The need for beauty and aesthetics, harmonious relationships, and spiritual fulfillment are indicative of what?
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Self-actualization
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Can unmet needs in Maslow's hierarchy lead to death?
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Yes
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True or False: Needs are universal
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True
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True or False: Needs are never interelated, each one must be met completely before moving up the tier of needs?
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False
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When assessing a patient, the ABCs stand for?
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Airway, breathing, circulation
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G.A.S. stands for
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General Adaptation Syndrome
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General Adaptation Syndrome is what?
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3 stage reaction to dealing with stress
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What are the 3 stages of GAS
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alarm, resistance, exhaustion
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The alarm stage is like
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"flight or flight"
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T/F: your heart rate increases, bp increases, and epi is released into your system during stage 1?
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True
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The arousal of the GAS reaction is which body's system being activated?
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Sympathetic nervous system
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If the stressor continues or the individual is faced with a life or death situation what happens next in GAS?
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Resistance stage
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What happens in the body once the resistance stage has been activated?
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Body systems return to normal, body attempts to adapt
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If the body cannot adapt to the stress and return to normal homeostasis which stage is next in GAS?
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Exhaustion
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What physiological response does the body go through during the exhaustion stage?
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depleted energy, adaptation resources are limited
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If the body continues to stress and not stabilize, what is the ultimate result?
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Death
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This is the evaluation to an event and what it means to them.
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primary appraisal
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After the primary appraisal, the individual realizes there is harm or danger involved, this creates what?
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Stress
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d/t the realization of stress, the secondary appraisal is activated and the body now begins to do what?
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cope
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Neuman's Model
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the model that is based on the concept of stress and how to deal with it
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what are the 3 prevention levels in Neuman's Model
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Primary, secondary, and tertiary
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This level of prevention is focused on promoting wellness by reducing stress and risk factors.
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primary
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The second level of Neuman's model starts after the symptoms...
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appear
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This level of Neuman's model is about support and rehabilitation back towards wellness.
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Tertiary
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PTSD
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Post traumatic stress disorder
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eustress
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good stress
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three types of crisis, that can cause PTSD
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developmental, situational, aventitious
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competent stress care includes
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critical thinking and use of the critical thinking model
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types of factors that can cause stress
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situational, maturational, and socio-cultural
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Chronic illness, job issues, and finances are listed under what type of stress factor
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situational
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different life stages that an individual goes through can cause stress these are referred to as
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maturational
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environment and social stressors are
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socio-cultural factors
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This is a dynamic process that allows people to build effective and working relationships through sharing.
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Communication
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Communication can be expressed
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verbally, non-verbally, and symbolically
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What are the 5 different levels that people can communicate on.
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Intrapersonal, interpersonal, group, public speaking, transpersonal.
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What are the two parts of communication
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Content and process
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The actual message, subject matter, words or gestures
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content
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The process of sending, receiving, and interpreting a message has 5 parts, these are
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Sender, message, receiver, feedback, and channel.
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this level of communication occurs between two or more people
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interpersonal
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this level of communication occurs within ones' self
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intrapersonal
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group communication involves
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interaction among several people
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T/F Social and therapeutic relationships both require active listening?
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True
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T/F Social relationships include making goals, limiting self-disclosure, and center around only one individual.
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False
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Person space is
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invisible, something we all have, varies d/t culture, nature of relationship, and situation
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T/F In a therapeutic relationship we must be mindful of personal space, person's mental health, an individual's culture and situation.
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True
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What are the 4 ZONES of personal space?
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Intimate, personal, social, and public
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While caring for your patient you have to physically assess their feet, which personal zone of space does this fall under?
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Intimate
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This zone of space is regarded as the most appropriate for pt teaching.
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Personal
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While making rounds with the doctor you are mainly engaging in which zone of personal space?
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Social
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What are the 4 zone of TOUCH
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Social, consent, vulnerable and intimate
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While assisting a pt from their wheelchair you offer them your hand to stand. Which zone of touch are you engaging in?
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Social
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You notice that your newly diagnosed stroke patient is drooling, you offer to wipe their mouth for them. This would be entering into which zone of touch?
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Consent
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hands, arms, shoulders and back
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social zone
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mouth, wrist, feet
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consent zone
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When entering the ________________ zone, including the neck, face, or front of the body you must take special care.
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Vulnerable
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When assisting a patient with a bed bath, you must take great sensitivity to this zone of touch?
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Intimate
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denotation, connotation, intonation, clarity, brevity, timing and relevance are all important because
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they can cause your communication to be effective or ineffective
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the exchange of a message without words
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non-verbal communication
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T/F you can communicate through your posture, gait, facial expressions, personal appearance and smile
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True
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This type of communication is patient centered, establishes a therapeutic relationship, and conveys acceptance and respect.
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Therapeutic communication
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5 characteristics of therapeutic communication are
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Empathy, respect, genuineness, concreteness, and confrontation
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When you place yourself mentally and emotionally in your patient's place, you are exerting which therapeutic characteristic?
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Empathy
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By valuing the needs and feelings of your patient, adjusting your expectations, and showing you care you are exhibiting what therapeutic characteristic?
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Respect
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Explain genuineness
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honesty, handling situations appropriately, offering encouragement, and positive feedback
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When you offer a patient advice in terms they can understand, you are using what form of therapeutic communication?
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Concreteness
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By asking a patient to clarify information, you are using what form of therapeutic communication?
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Confrontation
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What are the 4 phases of the therapeutic relationship?
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Pre-interaction, orientation, working, and termination
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when you research your patient prior to meeting them, you are engaging in what phase of the therapeuitc relationship?
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pre-interaction
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T/F The orientation phase is when you assess, diagnose, and do interventions on your patient?
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False
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When you first define your relationship with your patient, you are entering the __________ phase.
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Orientation
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Now that you know that Ms. Smith is having left arm pain, you can begin to assess her and make a care plan. This phase of your therapeutic relationship is?
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Working phase
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It is time for you to go home, but before you do, you must first conclude your therapeutic relationship. What phase is this?
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Termination
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When you are engaged in active listening, it is suggested that you S-O-L-E-R.
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Sit facing patient, open posture, lean forward, eye contact, and relax
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T/F You can enhance activel listening by establishing trust, being assertive, exploring issues, clarifying info, and sharing your observations.
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True
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When a nurse asks too many questions, argues with their patient, expresses disapproval, offers advice or provides false reassurance a patient may feel.....
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barriers in their communication have been built
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Having coffee with a friend, what kind of relationship is this
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Social
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a "helping" relationship is AKA
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therapeutic
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If a nurse is overhelping, controlling, and narcissistic they can create _______ blurring.
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role
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7% of communication is
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words
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38% of communication is
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tone
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55% of communication is
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body language
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this type of communication can hold a deeper meaning, can be implicit or explicit
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metacommunication
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SBAR+R stands for
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Situation, background, assessment, reccomendations, and response with repeat
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This is the nmemonic that is used to communicate with other health care professionals.
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SBAR+R
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this assessment is comprehensive, including a physical, mental, and spiritual assessment
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Global, health, or comprehensive
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What are the two main components of a health assessment?
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nursing history and physical assessment
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T/F The purpose of a global assessment is to establish a database, establish rapport, convey info to the patient, and determine healthcare needs?
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True
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PQRST - this mnemonic is useful in getting what from a patient?
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The reason they are seeking care`
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PQRST stands for
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provocative/palliative, quantity/quality, region/radiation, severity, and timing
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This type of assessment focuses on a problematic area.
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Focused
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This type of assessment is done on a pt that needs emergent care.
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Emergency
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This type of assessment is aka "shift" assessment, and includes a head to toe and body system exam.
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on-going
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2 steps in the nursing assessment
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collection and verification of pt data and analysis of data and diagnosis
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Subjective and objective
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two types of data that is collected from a patient during an assessment
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This info is observable and measurable
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objective
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this info is verbal data that your patient shares with you about their health problems
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subjective
