Mental Health - Test 1 - Ch. 9. 10

Front 1

empathy and sympathy
-which is objective?

Back 1

empathy is more objcetive. "what is this persons experience like for them" the nurses feelings are no involved and the focus is on the patient

Front 2

what is the "therapeutic use of self?"

Back 2

ability to use ones personality consciously and in full awareness to establish relationships and to structure nursing interventions

Front 3

in a therapeutic relationship, what does the nures maximize?

Back 3

his/her communication skills, understanding of bheaviors, personal strength to enhance the pts growrth.
-focus is on the pts ideas, experiences, and feelings.

(social relationship: mutual needs are met)

Front 4

3 types of boundaries:

Back 4

1. phyiscal (general envt, office space)
2. contract (set time, confidentiality)
3. personal space

Front 5

what occurs when the patient transfer their stuff onto the nurse (mught be about past experience, past relationships, you may remind them of someone)

Back 5

transference ---blurs boundaries

Front 6

what occurs when the patient transfers their issues onto the nurse and assigns them roles

Back 6

transference- blurs boundaries

Front 7

what occurs when the nrues displaces their stuff onto the patient

Back 7

countertransference

Front 8

what occurs when the nurse displaces onto the patients feelings and behaviors related to significant figures in the nurses past

Back 8

countertransference

Front 9

signs that you are engaging in countertransference include:

Back 9

boredom
rescue
overinvolvement
overidentification
misuse of honesty
anger
helplessness or hopelessness

Front 10

countertransference reactions of the nurse:

boredom
-solution:

Back 10

redirect the pt if they provide more info than you need

clarify info with pt

Front 11

countertransference reactions of the nurse:

rescue (reaching for unattainable goals, resisting peer feedback, and giving advice)
-solution

Back 11

-avoid secret alliances
-develop realistic goals
-don't alter meeting schedule
-letthe patient guide interaction
-facilitate pt problem solving

Front 12

countertransference reactions of the nurse:

anger
-solution:

Back 12

-maintain therapeutic relationship
-explore and focus on the patients experience rather than on your own

Front 13

what are abstract standards that represent an ideal either positive or negative

Back 13

values
-it's important to understand our own values and attitudes so we become more aware of the beliefs or attitudes we hold

Front 14

self-awareness requires that we understand what?

Back 14

what we value and those beliefs that guide our behavior

Front 15

Peplau's model of the nurse-patient relationship:
-a professional nurse-pt relationship consists of a nurse who:

Back 15

has the skills and expertise and a pt who wants to alleviate suffering, find solutions to problems, and explore different ways to increase quality of life

Front 16

Peplau's model of the nurse-patient relationship:
-facilitates ______ movement for the nurse and the patient

Back 16

forward

Front 17

Peplau's model of the nurse-patient relationship:

preorientation phase consists of:

Back 17

getting data on the patient

Front 18

Peplau's model of the nurse-patient relationship:

orientation phase:

Back 18

developing contract with the pt
-how long you will be there
-termination is address
-confidentitality
-nurses role and responsibilities of the pt (set parameters)

Front 19

Peplau's model of the nurse-patient relationship:

discharge planning begins when?

Back 19

in the orientation phase

Front 20

Peplau's model of the nurse-patient relationship:

working phase:

Back 20

establishing goals
facilitating behavior charge

Front 21

what should the nurse do if the patient threatens suicide?

Back 21

assess if there is a plan
-tell the pt that this is serious and that u dont want to harm the pt but you need to tell the staff

Front 22

what does the nurse do if that patient asks the nurse to keep a secret?

Back 22

the nurse CANNOT make a promise b/c the info may be important to the health/safety of other

Front 23

if that patient asks the nurse a personal question

Back 23

can answer in a word or two and then refocuses back on the patient

Front 24

if the patient makes sexual advances to the nurse, what should she do?


what if the patient doesn't stop?

Back 24

set clear limits on expected behavior "i'm not comfortable having you touch me. this tiem is for you to focus on your problems and concerns"

restate the nurses role throughout the relationship


if the patient doesn't stop, the nures might say "if you can't stop this behavior, i'll have to leave. i'll be back at (time) to spend time with you then.
(leaving gives the pt time to gain control and the nurse returns at the stated time)

Front 25

what should the nurse do if the patient cries?

Back 25

-stay with the pt and reinforce that it is all right to cry.

-nurse offers tissues when appropriate

Front 26

what should the nurse do if the patient does not want to talk?

Back 26

at first the nurse might say something like "it's all right. i would like to spend time with you. we dont have to talk"

the nurse might spend short periods (5 min) with the pt throughout the day.

Front 27

Peplau's model of the nurse-pt relationship

termination phase:

Back 27

summarize what was achieved.

focus on strengths and progress

discuss ways for pt to incorporate them into daily life

Front 28

what is this an example of:
-ddefends clients inappropriate behavior to psychaiatrist

Back 28

countertransference

(also uneasy when interacting with the client)

Front 29

3 personal characteristics of the nurse that can help promote change and growth in patients and a therapeutic relationship are:

Back 29

1. genuineness
2. empathy
3. positive regard

Front 30

what is self awareness of ones feelings as they arise within the relationship and the ability to communicate them when appropriate, is key for building trust

Back 30

Genuineness

Front 31

when one is _____, one gets the sense that what is displaced on the outside of the person is congruent with the internal processes

Back 31

genuine

Front 32

-_______is conveyed by listening to and communicating with patients w/o distorting their messages and being clear and concrete in communication.

Back 32

genuineness

Front 33

positive regard-, implies _____

Back 33

respect

Front 34

________ is the ability to view another person as being worthy of caring about and as someone who has strengths and achievement potential.

Back 34

positive regard

Front 35

______ is communicated indirectly by attitudes and actions rather than direct words

Back 35

positive regard

-an attitude would be willingness to work with the patient, taking it seriously
-actions, suspending suspending value judgments, helping pt develop their own resources

Front 36

Identify two common circumstances in which boundaries are blurred in the nurse-patient relationship.

Back 36

1)when the relationship is allowed to slip into a social context.
2)when the nurses needs (for attention, affection, emotional support) are met at the expense of the patient’s needs.

Front 37

What does defining the parameters of the relationship in the of the nurse-patient relationship include?

Back 37

the pt needs to know the nurses role and the responsibilties of both the pt and the nurse

Front 38

Describe what the nurse should establish during the first contact with the patient.

Back 38

that the nurse is safe, confidential, reliable, consistent, and that the relationship will be conducted within appropriate and clear boundaries.

Front 39

In the working phase of the nurse-patient relationship, the patient’s “dysfunctional behaviors and basic assumptions about the world are often __________ and the patient usually is unable to change the dysfunctional _______.”

Back 39

defensive


at will

Front 40

What is a common response of beginning students about terminating the relationship with the patient?

Back 40

feeling guilty about terminating the relationship

Front 41

What were the two major factors that hampered the development of positive relationships?

Back 41

inconsistency and unavailability (lack of contact, infrequent meetings, meetings in the hallway)

Front 42

how does active listening help the patient?

Back 42

it strengthens the patient's ability to solve problems (and enhance self-estem)

Front 43

clarifying techniques
-what is the use:

Back 43

helps both participants identify major differences in their frame of reference, giving them the opportunity to correct misconceptions before they cause any serious misunderstandings

Front 44

clarifying techniques
-mimizing feelings

give a description

Back 44

indicates that the nurse is unable to understand or empathize with the pt

Front 45

nontheapeutic techniques

"everyone gets down in the dumps"

Back 45

minimizing feelings

(indicates that the nurse is unable to understand or empathize with the pt. the pts feelings are belittled)

Front 46

nontheapeutic techniques

"i know what you mean"

Back 46

minimizing feelings

(indicates that the nurse is unable to understand or empathize with the pt. the pts feelings are belittled)

Front 47

nontheapeutic techniques

"things get worse before they get better"

Back 47

minimizing feelings

(indicates that the nurse is unable to understand or empathize with the pt. the pts feelings are belittled)

Front 48

nontheapeutic techniques

"i wouldn't worry about that"

Back 48

falsely reassuring

(may cause the pt to stop sharing feeligns if the pt thinks they will be ridicueld or not taken seriously)

Front 49

nontheapeutic techniques

"everything will be all right"

Back 49

falsely reassuring

(may cause the pt to stop sharing feeligns if the pt thinks they will be ridicueld or not taken seriously)

Front 50

nontheapeutic techniques

"you will do just fine, you'll see"

Back 50

falsely reassuring

(may cause the pt to stop sharing feeligns if the pt thinks they will be ridicueld or not taken seriously)

Front 51

nontheapeutic techniques

"how come you still smoke when your wife has lung cancer"

Back 51

making value judgements

(prevents problem solving...can make the pt efel guilty, angry, musunderstood, or anxious)

Front 52

nontheapeutic techniques

"why did you stop taking your medication"

Back 52

asking why questions

(implies criticism. makes the pt feel defensive)

Front 53

nontheapeutic techniques

"how's your appetite, are you losing weight, are you eating enough"

Back 53

asking excessive questions

(results in the pt not knowing which ? to answer and being confused about what's being asked)

Front 54

nontheapeutic techniques

"i'm proud of you for applying for that job"

Back 54

giving approval, agreeing

(implies that the pt is doing the right thing and that not doing it is wrong. may lead the pt to focus on pleasing the nurse)

Front 55

nontheapeutic techniques

"i agree with your decision"

Back 55

giving approval, agreeing

(implies that the pt is doing the right thing and that not doing it is wrong. may lead the pt to focus on pleasing the nurse)

Front 56

nontheapeutic techniques

"you should really have shown up for the medication group"

Back 56

disapproving, disagreeing

can make a person defensive

Front 57

nontheapeutic techniques

"i disagree with that"

Back 57

disapproving, disagreeing

can make a person defensive

Front 58

nontheapeutic techniques

patient- "i'd like to die"
nurse- "did you go to alocholics anonymouse like we discussed"

Back 58

changing the subject

(may leave the pt feeling alienated and isolated and increase feelings of hopelessness)

Front 59

communication techniques

is comparing good or bad

Back 59

it is good

-helps patient clarify similarities and differences

Front 60

communication techniques

is focusing good or bad

Back 60

good

-conecntrates attention on a single point

Front 61

the nurse should not probe or question patients about sensitive areas that they do not wish to discuss
-what should they do instead?

-what should they strive to do?

Back 61

pay attention to nonverbal communication.
-strive to keep the pts anxiety to a minimum

Front 62

what are the 7 helpful guidelines for conducting the initial interview:

Back 62

1. speak briefly
2. when you do not know what to say, say nothing
3. when in doubt, focus on feelings
4. avoid advice
5. adoid relying on questions
6. pay attention to nonverbal cues
7. keep the focus on the patient

Front 63

Identify and briefly define Peplau’s two main principles that can guide the communication process during the nurse-patient interview.

Back 63

1)clarity, which ensures that the meaning of the message is accurately understood by both parties “as the result of joint and sustained effort of all parties concerned”

2)continuity, which promotes connections among ideas “and the feelings, events, or themes conveyed in those ideas”

Front 64

Using silence as a therapeutic communication technique is worthwhile as long as it is:

Back 64

is worthwhile and serving some function and not frightening the patient

Front 65

Why do some nurses often feel the need to fill every silent period with words when they are with their patient?

Back 65

because of their own anxiety, self-consciousness and embarrassment. when this occurs, the nurse’s need for comfort has taken priority over the needs of the patient.

Front 66

When are closed-ended questions useful for the nurse to use:

-specific examples (2)

Back 66

they are used to give you specific and needed information.

-closed ended questions are most useful during an initial assessment or intake interview or to ascertain results, as in “are the medications helping you” “when did you start hearing voices” “did you seek therapy after your first suicide attempt”

Front 67

After the initial introductions, how does the nurse hand the interview over to the patient?

Back 67

by using one of a number of open-ended questions or statements

“where should we start?”
“tell me a little about what has been going on with you”
“tell me a little about what has been happening in the past couple of weeks”