CH. 1
Which organization defined the scope of nursing practice?
The American Nurses Association (ANA)
What type of care do hospitals provide? (Pg. 288)
Hospitals provide acute, secondary, and tertiary care
Kinesthetic, Visual, and Auditory Channels of Communication (Pg. 176, Box 8.1)
Visual – Communication through sight (charts, pictures, written words, gestures).
Auditory – Communication through hearing (spoken words, tone of voice, spoken instructions).
Kinesthetic – Communication through touch and movement (holding a hand, giving a back rub, demonstrating a procedure).
What is the main goal of educating and counseling? (Pg. 210, 212)
The goal is to help clients achieve optimal health and independence by promoting self-care, informed decision-making, and behavior change.
Education → teaches skills and knowledge.
Counseling → supports emotional, behavioral, and problem-solving needs.
What is the goal of therapeutic communication? (Pg. 96–97)
The goal of therapeutic communication is to establish a trusting nurse–client relationship that promotes:
Understanding of the client’s experience.
Expression of thoughts, feelings, and concerns.
Personal growth and positive change.
Improved functioning and coping.
Founder of modern nursing; improved sanitation and infection control during the Crimean War; emphasized evidence-based, holistic care.
Florence Nightingale
Difference between ambulatory, inpatient, and outpatient care (Pg. 268, 288)
Ambulatory care: Care provided to patients who do not stay overnight in the facility (e.g., clinic visits, same-day surgery).
Inpatient care: Care for patients who are admitted and stay overnight or longer in the hospital.
Outpatient care: Care provided without an overnight stay (similar to ambulatory), such as diagnostic procedures, lab tests, or therapy sessions.
Non-verbal ways to communicate caring (Pg. 195)
Making eye contact.
Using open body language (not crossing arms).
Touch (when appropriate).
Smiling, nodding, and attentive posture.
Active listening (leaning forward, minimal interruptions).
Silence (allowing the patient space to speak or feel supported).
Evaluating the effectiveness of client education (Pg. 231)
Ask the patient to teach-back in their own words.
Observe a return demonstration (skills like insulin injections, wound care).
Assess whether patient goals/outcomes are met (improved self-care, adherence).
Therapeutic Communication Techniques (Pg. 103, Table 6.1)
Active Listening: Paying close attention, nodding, maintaining eye contact, showing presence.
Broad Openings: Encouraging the client to talk.
“Tell me more about how you’ve been feeling.”
Restating: Repeating back what the client said.
Client: “I can’t sleep.” Nurse: “You’re having trouble sleeping?”
Clarification: Asking for explanation to ensure understanding.
“Can you explain what you mean when you say you ‘can’t go on’?”
Reflection: Directing the client’s feelings back to them.
“You seem upset about that decision.”
Focusing: Keeping the conversation on the important topic.
Exploring: Asking the client to expand on a thought or feeling.
Silence: Allowing time for the client to think and process.
Offering General Leads: Encouraging continuation.
“Go on…” or “And then?”
Giving Information: Providing facts to promote understanding.
Summarizing: Reviewing the main points of the conversation.
Founded the American Red Cross; brought supplies and care to soldiers during the Civil War.
Clara Barton
What do nurses who work in physicians’ offices typically do? (Pg. 296)
Perform patient education and health teaching.
Take vital signs, health histories, assist with exams.
Give immunizations, medications, dressings.
Act as a liaison between the provider and patient, coordinating referrals
SBAR Communication – What is included in each letter (Pg. 185)
SBAR = Situation, Background, Assessment, Recommendation
S – Situation: What is happening right now? (Identify self, patient, and immediate concern.)
Example: “This is Nurse Smith on 4E. I’m calling about Mr. Jones, who is short of breath and his O₂ sat is 85% on room air.”
B – Background: Relevant information about the patient’s history.
Example: “He was admitted yesterday with pneumonia, has a history of COPD, and is on antibiotics.”
A – Assessment: What you think is going on; your clinical impression.
Example: “His lung sounds are diminished on the right; he appears increasingly restless.”
R – Recommendation: What you need or suggest.
Example: “I recommend we increase his oxygen and request a chest X-ray. Would you like me to start oxygen at 2 L?”
Elements of the teaching–learning relationship for the best outcome (Pg. 226)
Nurse and client share a trusting relationship.
Active participation from the client.
Clear goals that are realistic and patient-centered.
Nurse provides feedback, reinforcement, and encouragement.
Respect for client’s preferences, culture, and learning style.
Advocate for mental health reform; improved care for people with mental illness; also served as Superintendent of Army Nurses during the Civil War
Dorothea Dix
Define respite, palliative, and bereavement care (Pg. 292)
Respite care – Short-term relief for family caregivers by temporarily providing care for the patient.
Palliative care – Focuses on relief of symptoms, pain, and stress of serious illness; can be provided along with curative treatment.
Bereavement care – Support services offered to the family after a patient’s death.
Nurse-client relationships: How do they develop? Phases (Pg. 187–188)
The therapeutic nurse–client relationship has 4 phases:
Pre-interaction phase – Nurse prepares by reviewing patient’s information before the first meeting.
Orientation phase – Nurse and patient meet, establish trust, clarify roles, and identify problems/goals.
Working phase – Active problem-solving, teaching, supporting, and interventions occur.
Termination phase – Relationship ends; goals are evaluated, progress is summarized, and closure is provided.
Teaching and learning for clients who require an interpreter (Pg. 217)
Use a professional, trained medical interpreter (not family).
Speak directly to the patient, not the interpreter.
Use short, simple sentences.
Allow extra time for translation and understanding.
Provide written materials in the patient’s preferred language if available.
What is the nursing process?
a systematic, patient-centered method nurses use to provide care.
It has five steps:
Assessment – Collect data (patient history, physical exam, labs).
Diagnosis – Identify the patient’s actual or potential health problems.
Planning – Set measurable, realistic goals and outcomes; create a care plan.
Implementation – Carry out the interventions (teaching, medication, treatments).
Evaluation – Check if the goals were met; adjust the plan as needed.
Type of care in acute care, rehabilitation, and hospice (Pg. 292)
Acute care – Short-term, immediate treatment for serious injury, illness, or surgery.
Rehabilitation – Restores patients to the highest level of function and independence, often after illness or injury (e.g., stroke rehab, physical therapy).
Hospice care – End-of-life care focusing on comfort, dignity, and support for patients with a terminal illness and their families
Responding to non-verbal communication from clients (Pg. 177)
Observe body language, facial expressions, gestures, and tone.
Clarify meaning by gently asking: “I notice you seem worried, would you like to talk about it?”
Validate what you think the patient is expressing.
Adjust your communication style (e.g., sit down if the patient seems withdrawn).
Motivational interviewing techniques (Pg. 236)
Open-ended questions: “What concerns you most about your health?”
Affirmations: Acknowledge strengths (“You’ve already made progress by cutting down.”).
Reflective listening: Repeat or rephrase to show understanding.
Summarizing: Pull together patient’s statements to highlight progress.
Eliciting change talk: Encourage the patient to express reasons for change.