Teach teach teach!
The domains of learning include:
cognitive, affective, psychomotor
"NPO means nothing by mouth. That means you cannot eat or drink." - RN
Name the therapeutic communication technique.
Providing information: Making facts available that the client needs. This helps build trust and assists the client to understand his/her problem and makes him/her feel involved.
"I think Mr. M needs a higher dose of pain medication." - RN
Name the part of SBAR this belongs in.
Recommendation : action requested/recommended. What you want from the other person
Shouting won't make clients with this impairment get what you are saying.
Hearing impaired
Appropriate interventions: hearing aids, limit environmental noises/distractions, speak at normal volume, rephrase when misunderstood, punctuate speech, provide a ASL interpreter, face the client
This should be completed for any occurrence that is not consistent with the standard of practice so systematic errors can be caught and prevented in the future.
Incident report
Using simulation in a teaching plan is most beneficial for this type of learner.
Kinesthetic
- these learners prefer doing, manipulating
- they like videos and simulations
"I am nervous spending the night at the hospital but I do not know why." - client
"I have time. How about we sit together and talk?" - RN
Offering self: Conveys sense of caring; demonstrates a willingness to spend time with the client; can be a general attitude or statement
"Hello. This is nurse Florence calling from LMH NU101. I have Mrs. F, a 36 year old female in room 216. They are newly confused and weak." - RN
What part of the SBAR is this statement?
Situation: concise statement of the problem
Two communication techniques that should be implemented for a client who is cognitively impaired include:
1. Reduce environmental distractions2
2. Prioritize communication
3. Obtain the client's attention before speaking
4. Use simple sentences
5. Stay focused in the communication
6. Ask one question at a time
7. Allow time for the client to respond
8. Include family/friends
If I am no longer able to make decisions about my health this person will be able to consent for treatments for me.
Durable power of attorney
These factors effect the client's ______
1. Client's unwillingness/inability to accept reality of the diagnosis
2. Period of grief
3. Health status
Readiness to learn
i.e. during a period of acute illness focus on the acute disease rather than routine health promotion
Client has been awake every time the night RN goes into the room to check on them.
"I see have been awake each time I come in." - RN
Sharing observation: Observations are made by commenting on the client's appearance and how he/she sounds or acts.
"They have a history of typer 2 diabetes. They were admitted 2 nights ago with an elevated blood glucose of 300 which has been treated with sub q insulin." - RN
What part of SBAR is this?
Background: Pertinent and brief info r/t the situation
"Your apple is at 6 o'clock." - RN
The RN would be appropriate in stating this to a client with which special need?
Visual impairment
An interaction which occurs between two people or within a small group. Includes nonverbal and verbal.
Interpersonal communication
An internal state which helps arouse, direct, and sustain human behaviors.
Motivation to learn
( this results in more client involvement)
"What is on your mind this morning?" - RN
Broad opening: allows client to steer the conversation and a range of responses from the client.
"I think they are dehydrated. Their urine output has been 20mL/hr and dark amber." -RN
What part of SBAR is this?
Assessment: What you think/found is going on
A client who primarily speaks Cantonese must have access to this service...
Professional interpreter services
When caring for a client who has poor health literacy two things I can implement in my practice include:
1. Prioritize what you say
2. Breakdown complex information
3. Multiple teaching sessions
4. Use simple language
5. Use teach-back method
6. Use an active voice (not passive)
To improve client compliance following a teaching plan the nurse should utilize which technique?
Teach-back
- have the client teach back the informaiton
- allows for confirmation of understanding
- improves client compliance
- use open ended questions to assess what was learned
"I toss and turn at night." - client
"You have trouble falling asleep at night?" - RN
Name the therapeutic communication technique.
Clarification technique of Paraphrasing: Restates the client's feelings/thoguhts to confirm what they have communicated was heard.
The major purpose of communicating VIA SBAR is:
provide SAFE and effective continuity of care
Although this client will not respond it is important that the RN...
[An unresponsive client] Any of the following is correct:
1. Use their name and introduce yourself
2. Communicate verbally and by touch
3. Speak to the client as if they can hear everything
4. Explain all procedures and sensation
5. Orient them to person, place, and time
*remember hearing is the last sense to go!
"I now understand COPD is a chronic illness that will play a role in my life going forward." -client states following a teaching session
This statement indicates the client obtained knowledge in which domain of learning?
Affective domain
- = attitudes
- includes feelings, attitudes, opinions, and values