Communication
What Am I?
The patient says, “I'm really scared about my surgery.”
The nurse responds:
“Tell me more about what is frightening you.”
What is therapeutic communication
“Patient states, ‘My pain is an 8/10.’”
Subjective or objective?
Subjective
What is the traditional fifth vital sign?
Pain
What does dyspnea mean?
Difficulty breathing/shortness of breath.
A patient is having difficulty breathing while lying flat.
What should the nurse do first?
Position the patient upright and assess respiratory status
Identify It
The nurse avoids eye contact, speaks quietly, and agrees with everything the patient says.
What is Passive communication
“BP 138/82, pulse 104, respirations 24.”
Subjective or objective?
Objective
Calculate the pulse pressure:
BP = 140/80
60 mmHg
Name four signs of hypoxia
Restlessness, Anxiety, Confusion, Dyspnea, Tachycardia, Tachypnea, Cyanosis
A patient has crackles at the bases of the lungs.
What should the nurse do first?
Assess the patient further—respiratory status, oxygen saturation, work of breathing, and other relevant findings
Identify It
The nurse says:
“I disagree with that approach. Let's discuss another option that may be safer for the patient.”
What is Assertive communication
Define the following documentation types:
PIE
SOAP
DAR
PIE → Problem, Intervention, Evaluation
SOAP → Subjective, Objective, Assessment, Plan
DAR → Data, Action, Response
The apical pulse is 110.
The radial pulse is 94.
What is the pulse deficit?
16 beats/min
Which oxygen device provides a precise concentration of oxygen?
Venturi Mask
A patient has just had an ET tube removed.
Which finding requires immediate attention?
A. Mild sore throat
B. Mild hoarseness
C. Stridor and respiratory distress
D. Mild cough
Stridor and respiratory distress
Name three barriers that can interfere with interprofessional communication
What are Poor communication Lack of respect Hierarchy Assumptions Incomplete information Language barriers Failure to listen Conflicting priorities
What is charting by exception?
Documentation focuses on significant findings or deviations from established normal standards rather than documenting every routine finding.
Define the following pulse types:
Absent
weak/thready
Strong
Bounding
Cannot be felt
Difficult to feel
Easily felt
Very forceful
Which oxygen device has a reservoir bag and is commonly used when a high concentration of oxygen is needed?
Nonrebreather Mask
A patient receiving oxygen becomes restless, confused, and increasingly short of breath.
What is the priority?
Immediately assess airway, breathing, oxygenation, and overall condition and intervene according to the patient's status/protocol.
A hearing-impaired patient is being discharged.
Name four things the nurse should do to improve communication
Face the patient, Provide good lighting, Reduce background noise, Speak clearly, Use written instructions, Use appropriate communication aids/interpreter, Use teach-back to verify understanding
A nurse is curious about a celebrity who is hospitalized. The nurse works at the hospital but is not caring for the celebrity.
Can the nurse open the patient's chart?
NO
Rule: Access patient information only when there is an authorized, job-related need.
You need to quickly assess circulation in an unresponsive adult.
Which peripheral pulse site is appropriate to check?
Carotid Pulse
Why should oxygen therapy in a patient with COPD be carefully titrated?
Oxygen should be given according to the prescribed target and the patient's clinical condition because some patients with chronic CO₂ retention can be sensitive to excessive oxygen.
A patient suddenly becomes severely short of breath.
Put these actions in the best order:
A. Document
B. Assess airway/breathing
C. Position upright
D. Administer oxygen according to order/protocol
E. Reassess
C → B → D → E → A
Why?
The nurse first helps improve ventilation by positioning the patient, rapidly assesses airway/breathing, provides oxygen as appropriate, evaluates the response, and then documents.