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10 Cards in this Set

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Opening the relationship:
Gather supplies, prepare material, knock when entering room, introduce myself, ask the patient if now is a good time to speak to him about IS for roughly 5-10 minutes.
Ensure patients needs are met prior to lesson: toileted, medicated, repositioned, hydrated, fed, vital sings, BGM
Position yourself in the patient’s personal (1.5-4ft) space. Face the patient squarely. Cross neither your legs or arms to maintain an open posture. Lean toward the person. Maintain eye contact throughout interaction.
Employ therapeutic communication techniques throughout interaction like the following
- provide general leads
- be specific and attentive
- use touch
- restate or paraphrase
- give information
- acknowledge
- clarify time or sequence
- focus
- summarize and plan
Avoid elder-speak ( speech style similar to babytalk that gives the mssage of dependence and incompetence to older adults (Kozier & Erb, pg 467)
Clarify the problem:
Explain that you will be teaching him how to use an inscentive spirometer to keep his lungs healthy during the hospital stay
Working phase:
Explain that when humans lay in bed their lungs don’t expand as much as they should. When the lungs don’t expand like they should, fluid accumulates. Bacteria can grow in fluid which might accumulate in your lungs resulting in pneumonia. Hospitalized patients are at risk for pneumonia related to their inactivity.
Ask the patient to relate IS use to a decrease in pneumonia.
Practice sound attentive listening skills (use of all senses to listen; verbal and non-verbal) Take note to whether or not the verbal messages match non verbal messages. (Kozier & Erb, pg 468)
Explain that the incentive spirometer can be used to keep the lungs active and prevent fluid from building up do to inactivity.
Hand the patient the IS device and explain the parts. The blue tube is what you place in your mouth. The chamber with tick marks on the side contains a disk that will move up when you breath and is used to measures the amount of air you breath in. The ball in the other chamber measures how fast you take the breath.
Explain that to use the IS a person relaxes and breaths out, places lips around mouthpiece, and while holding the device upright inhales slowly and deeply.
Explain that you breath the breath in long enough to keep the ball or disk raised for at least 3 seconds
Explain that if you are inhaling too rapidly the IS might make a whistle and you should inhale more slowly.
Ask the patient if he has any questions.
Ask the patient to demonstrate proper use of the IS. Make corrections as needed and give encouragement often
Explain that the exercise should be repeated every hour while you are awake (of if your physician instructs you otherwise).
Ask the patient to tell you his plan as to how he will know when to do the IS (eg: whenever a tv show ends, the clock gets to 15 minute mark, etc)
Termination phase:
Summerize the skills learned by the patient. Thank him for his time. Exit the room.