Therapeutic Communication
Provide an example of an open-ended question.
Provide an example of a closed-ended question.
Will be determined by the class...
What are Maslow's hierarchy of needs from bottom to top?
What is physiologic, safety, love/belonging, esteem, and self-actualization.
* Please remember that we must address physiologic needs before we can address other needs.
Which eating disorder is the patient usually underweight?
What is anorexia.
Those with bulimia can be overweight, underweight or the appropriate weight.
What is a spiral fracture and what type of injury would cause a spiral fracture?
A spiral fracture is when a bone is twisted with force. This can happen with certain movements. If the story doesn't match up with the injury...suspect abuse.
What should be avoided while using Antabuse or disulfiram?
What is any type of alcohol.
Why?
What is growth?
What is physical change and increase in size. Most humans follow a similar pattern of growth. It can be monitored by height, weight, bone size and dentition.
A patient with anorexia feels the need to exercise multiple times a day. What should the nurse do?
Limit the amount of exercise (perhaps set a time frame and allow the patient to exercise just once per day). The nurse must actively intervene to interrupt undesirable behaviors. The goal of therapy is behavior modification.
Which of the following would you suspect is child abuse?
A. A child cries when the nurse walks into the room.
B. A child has retinal hemorrhages
C. A child has a single fracture on x-ray
D. A child is brought to the ER moments after the injury.
What is B. The child has retinal hemorrhages which is a symptom of shaken baby.
A. Opiates
B. Amphetamines
C. Benzos
D. Barbiturates
What is A. Opiates.
Which of these responses is therapeutic?
A. Things will get better with time.
B. I'm sorry you feel that way.
C. Let's not focus on the negative things.
D. I can see this is a difficult problem for you.
D
What is the stage you would describe me (Kelsey) to be in for Erikson's stages of development?
What is generativity vs. stagnation
A nurse is caring for a patient with anorexia. Which intervention by the nurse is inappropriate?
A. Encouraging 2-3 lbs of weight gain weekly.
B. Offering the patient liquid supplements
C. Giving the patient a specific duration for mealtimes.
D. Allow the patient to eat in private to promote trust.
D. Allow the patient to eat in private--> the patient should be observed during mealtimes and for an hour after meals to assure the food is not thrown away or purged.
What is the priority for a patient admitted for alcohol detoxification?
What is safety. Monitoring for signs of withdrawal and avoiding DTs. Monitoring VS and initiating seizure precautions.
What is the antidote for opiate-induced respiratory depression?
What is Narcan.
**It has a shorter half life than the opiate so more than one dose of narcan is usually needed.
What is transference?
In psychoanalytic theory, transference occurs when a client projects feelings about someone else, particularly someone encountered in childhood, onto her therapist..
Example: A boy's mother took care of him but did not "love" him or comfort him. He is in therapy and does not look to this therapist for comfort. He figures no one truly cares.. He is transferring the mother's characteristics to his therapist.
Which theorist is known as a moral theorist?
Kohlberg
A nurse is caring for a patient with anorexia and purging behavior. Which of the following nursing interventions is appropriate?
A. Allow the pt to select their own meal times
B. Establish consequences for purging behavior
C. Provide the pt with a very high-fat diet
D. Implement one-to-one observation during meal times.
What is D.
A young woman that is 30 weeks pregnant and involved in an abusive relationship states to the nurse that she thinks the abuse will get better after the baby is born, everyone is just stressed right now and her boyfriend is always so sorry afterwards. What should the nurse do?
1. Support her positive attitude and that the abuse will probably stop after the baby is born.
2. Assure her that abusive patterns usually remain the same and will likely not get worse.
3. Assist her in developing an emergency plan since the pattern of violence is likely to continue.
What is 3.
Abuse usually gets worse over time. The cycle of abuse usually continues.
*We do not tell victims to leave their partners but we give them resources and empower them to make their OWN choices.
Barbiturates, Benzos and alcohol all enhance the effects of GABA so they have similar withdrawal symptoms when stopped. What symptoms of withdrawal would be concerning and would require the nurse to call the physician?
A. labile BP, insomnia
B. N/V, tremors
C. Dilated pupils, flushed skin
D. Seizures, delirium
What is D. Seizures and delirium or confusion
A nurse is communicating with a new patient. Which of the following is a barrier to therapeutic communication?
A. Offering advice
B. Reflecting meaning
C. Listening attentively
D. Giving information
What is A.
A nurse is caring for a patient who has a prescription for disulfiram (Antabuse) for the treatment of this alcohol use disorder. The nurse informs the patient that this medication can cause nausea and vomiting if he drinks alcohol. This form of treatment is an example of which of the following?
A. Aversion therapy
B. Flooding
C. Biofeedback
What is A.
It's weigh in day at the hospital for a patient with anorexia. What should the nurse anticipate?
A. The pt will not want to see the weight.
B. The pt will be eager to get on the scale.
C. The pt will wear baggy clothes to the weigh in.
What is C.
For most anorexia patients seeing their weight increase causes a lot of stress. They will not want to see their weight. They will likely wear baggy clothes to make it appear as though they have gained more weight than they actually have.
Please name three nursing interventions to help a victim disclose an experience of domestic violence.
What is Speaking to the victim alone.
Provide a safe, non-intimidating environment
Specifically ask the victim if she is safe at home...
What medication is administered to patients that are going through alcohol withdrawal to avoid seizures and delirium?
Benzodiazepines (librium, ativan)
Propranolol may be used to help decrease the pulse and BP.