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44 Cards in this Set
- Front
- Back
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Communication Definition
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DEFINITION: Interchange of information between 2 or more people.
Used for the purpose of exchanging Ideas, Thoughts, and Feelings |
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7 modes of Communication
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Verbal (oral) = may be words or symbols
Example: talking, singing, writing Paraverbal Cues (paralinguistic cues) = things that are like the sounds of our communication Example: pitch and tone - This may effect the reception of message Nonverbal Gestures = Gestures or movements in conversation, the vibes we send out Example: gestures, posture, eye movements Body Language = Includes a lot of nonverbal, but how we position our selves Example: how we stand, how we sit, how we hold our arms or hands -80-90% of communication is picked up on through body language communication Signing (for hearing impaired) = another form of language through signing Abstract = Artistic messages Example: Artistic photographs, pictures, how we dress Metacommunication = this is the thinking about the message, inner dialogue, focusing on the communication itself, analyzing; thinking about your intention and see if you got it right FORMS OF COMMUNICATION Encode = sending the message out Decode = receiving and understanding message Processing = inner dialogue and understanding (then without thinking) Receiver encodes feedback Sender decodes feedback Processes Problems with this process of communication could be languages; how a person decodes message (and so they don’t get it); |
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(9) Influencing factors of Communication
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Ability = person's ability to give or receive message
Example: age, vision, hearing, and cognitive ability - Talking to an infant is different. They may not understand words. But they might catch the tone. Friendly vs. Yelling - Older individuals with difficulty in hearing. How they hear will be crucial Perceptions = how a person interprets Example: What a person brings to the interaction Personal space (proxemics) = how close the relationship is Example: as nurses we ask a lot of personal things, but usually the person is uncomfortable because of physical space issues (sometimes people either back off physically or mentally) - Intimate Space <1.5’ - Personal Space = 1.5-4’ - Social Space = 4-12’ - Public Space > 12’ Territoriality = this is all about humans natural instinct to try to control their environment Example: when we move around their things in the rooms, we are invading their territory almost every moment though.... This is a constant area of awareness. Roles & Relationships = communication changes per relationship Example: Students to Teachers, Nurses to Nurses, Nurses to Clients, Friend to Friend, Father to Son - Often expectations are different and may have to be fixed. Time = The amount of time to respond may differ per patient Example: when interviewing older adult, it may take longer for THEM to answer because of how long it takes for access of information - We must monitor time and allow what is necessary. We must tweak reality a bit, making sure we do not rush clients (even if we have too much to do) Environment/Privacy = We need to set the stage for communication Example: Temperature, lighting, noises (too noisy we can't concentrate or hear properly), Privacy (some questions are very personal or may seem very private to the client) Attitudes = Are easily detectable, and MUST be manipulated personally Example Positive: (+) caring, warmth, respect (must always have respect as human being) Example Negative: (-) condescending, lack of interest (tapping foot, or checking watch), coldness Emotions & Self-Esteem = may affect how client receives message Example: scare or emotional, confidence, attitudes, perceptions vary |
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Types & Levels of Communication
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Interaction = a communication between two or more people
Interpersonal Relationship = within two individuals communication, RELATIONSHIP Example: professional or social, tends to be more professional (in regard to nursing) Helping Relationship = focus is on nurse/client relationship, purpose is for the nurse to assist in behavior changes Example: purpose is the nurse to provide assistance Therapeutic Relationship = purpose is for the nurse to effectively interacting with the client not just with assisting, but maybe with teaching, providing emotional support, interventions Effective = client understands it, and the feedback shows that it was understood Ineffective = somewhere along the conversation, communication was interrupted and now message is not understood Non-therapeutic = The nurse CAN be non-therapeutic Social = Friends, acquaintances, no real goals for communication Structured = more like interviewing, or taking history, there are specific reasons or goals for communication Interdisciplinary = Nurses with Physicians, Nurses with Techs, This also includes client (client is always the center of the interdisciplinary team) Therapeutic = Nurse and client, focus on client Levels of Communication: Intrapersonal (Transpersonal) = within your self, within your head Interpersonal = with one or two people Small Group = considered small, fewer numbers as compared to public (Prof. Ahrens does not expect us to know numbers) Example: class room setting currently in 54/64 Organizational (Public) = Public communications |
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Elements of Therapeutic Communication
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Empathy = NOT SYMPATHY (feeling the same way), being able to realize how that person may feel
Example: Understanding the feelings of client, but not feeling bad for them Positive Regard = having and then demonstrating to another person that you value them as a human being, respect for them being a person Comfortable Sense of Self = confidence to practice what we know, not necessarily that we know more or are better |
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Enhancers of Effective Communication
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- Attentive listening & Physical attending - “posture of involvement” (leaning forward while listening)
- Clarify - Open-ended questions - Focusing - Exploring - Be specific, tentative, informative - Use Touch - Silence - Summarize - Patience - Dependability - Honesty - Objectivity - Acceptance - Genuineness |
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Barriers to Effective Communication
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- Failure to Listen
- Unwarranted/False Reassurance - Judgmental Responses (accidentally inputting opinions) - Defensive Behaviors - Probing, Testing, Challenging - Gestures - Posture - Position - Eye Contact - “Busy Work” > texting, on phone, ‘checking’ |
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Nurse/Client Contract
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May be Verbal or Written Nurse/Client Contract
Based on TRUST 1. Preinteraction 2. Orientation - Who you are - What you want to do - When you will be there 3. Working 4. Termination Seidel's 4 C's for Nurse/Client Positive Relationship Courtesy Comfort Connection Confirmation Advocacy - not maternalistic Credibility Circle of Confidentiality |
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Change Definition
People as Change Systems |
To alter; to make different
Passing from one state or form to another Giving up for something else Adaptation: Roy pg 33, people and their environment are in a constant interaction. People are Changing Systems: Integrated Open system That respond to both internal and external stimulus Trajectory - Integrated - Compensating - Compromised Planned change: - A controlled process of making something different (Sullivan & Decker) - Purposeful effort to bring about improvements in a system with the assistance of a change agent (Spradley) - Goal Orientation |
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Definition of Teaching
Definition of Learning |
Teaching > Providing information to facilitate learning
Learning > Produces change in behavior, over time & not totally due to growing |
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Thorndike - Behaviorism Teaching Theory
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Learning works best when you connect it with something you already know
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Lewin - Cognitivism Teaching Theory
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People learn based on activity
There are four basic factors 1) change in cognitive structure, 2) change and increase in motivation, 3) sense of belonging to or in a group, 4) increase voluntary muscle control involved |
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Humanism Teaching Theory
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natural tendency for people to learn
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Gagne Teaching Theory
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people learn in an orderly fashion
simple to complex & concrete to abstract |
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Bandura Teaching Theory
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behavior is regulated by internal mechanisms that is regulated by a person’s self-efficacy
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Pedagogy
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- how children learn
- teacher gives information and children suck it up like a sponge |
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Androgogy (Knowles)
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- have maximum learning when you connect what they are learning to something they are experiences
- adults have to be ready to learn and motivated - knowledge has to be relevant and make sense\ - assimilates new information if they can put that information to immediate use |
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Gerogogy (Hogstel)
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developed by Hogstel
- older adults learn slightly differently; older adults continue to learn - focus on wellness - need to find connection with life; make short term goals - it may take longer to respond - go slower |
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Principles of Learning - Facilitators
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- Motivation
- Readiness - Simple > Complex - Repetition (Takes up to 7 times of repetition in hearing to learn something and retain it) - Active Involvement - Positive Environment (Temperature, able to focus) - Reward (Positive Feedback vs. Negative Feedback) - Use info immediately |
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Principles of Learning - Inhibitors
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Cultural barriers
- Language - Values Distractions - (may cause) Anxiety - Discomfort with Room Environment - Physiologic Factors (Pain) |
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Factors & Potential Impact on Learning - Principles of Learning
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- Learning Styles (some learn better through listening, manipulation, movement, speaking, interactions, etc. Many learn best with a combination)
- Age - Previous Experiences [intuitive learning] - Socioeconomic -- Education [impact person's learning ability, such as vocabulary] -- Health Beliefs & Practices |
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Learning Styles
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Visual – must see it; seeing is believing
Auditory – must listen; listen up! Social – Verbal and Visual Exchange; Can we chat about it? Independent – someone who chooses not to be involved in study group; Mother, I’d rather do it myself! Kinesthetic – movement and manipulation; let me get a grip on this! Conceptual – thinking about it; I need to think about this! Factual – Key points; Just the facts |
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Learning Domains - Bloom's Taxonomy
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Cognitive - Intellectual skills
(thinking, knowing, understanding) Affective - Feelings, Emotions (interests, attitudes, appreciation) Psychomotor - Motor skills |
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Nursing is Teaching - General Teaching Principles
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- Help learner meet learning objectives
- Rapport important - Use learner’s previous experiences to link or connect new info - Communicate clearly & concisely - Teaching activity focus on learning objectives - Health Maintenance, Promotion, Illness Prevention - Restoration of Health - Coping with Impaired Functions |
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Lewin's Force Field Model
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Target system- who / what needs to adapt/change
Driving forces - facilitate the change Restraining forces - impede the change |
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Change in target occurs when there is an increase in # or intensity of Drivers and restrainers are constant
OR an increase in # or intensity of restrainers when drivers are constant |
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Skinner & Pavlov Learning Approach
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Motivation for Learning
(reward for manipulating environment) |
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Bandura Learning Approach
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Self-Efficacy:
Persons pervious expierence supports your belief in yourself, Incorporation of past experiences - I can do this! |
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Ajzen Learning Approach
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Theory of Reasoned Action:
Began Planned Behavior = - Awareness, motivation, Action - Identified the role of intention |
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Prochaska Learning Approach - Transtheoretical Model
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5 Stages of behavioral change:
- Pre contemplation - Contemplation - Preparation - Action - Maintenance |
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Functions of the Neurological System
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Receive sensory stimuli
- from the environment Integrate adaptive bodily functions - identify and integrate the adaptive processes needed to maintain current body functions Orchestrate bodily functions - changes required for adaptation and survival Integrate CNS & endocrine - Integrate the rapid responsiveness of the CNS with the more gradual responsiveness of the endocrine system Control cognitive & voluntary - behavioral processes - Memory, thought, speech, movement Control subconscious and involuntary |
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Functions of the Brain and Anatomy
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Brain receives its blood supply from the two internal carotid arteries and two vertebral arteries. Blood drains through venous plexus, dural sinus, and into internal jugular veins
Cerebrum Gray outer layer houses higher mental functions and is responsible for general movement, visceral functions, perception, behavior, and the integration of these functions LOBES - Frontal lobe contains the motor cortex associated with voluntary skeletal movement and fine repetitive motor movements as well as the control of eye movements. - Parietal lobe is primarily responsible for processing sensory data as it is received. It assists with interpretation of tactile sensations (temperature, pressure, pain, size, shape, texture) as well as visual, gustatory, olfactory, and auditory sensations. Recognition of body parts and awareness of body position (proprioception) are dependent on the parietal lobe. - Occipital lobe contains the primary vision center and provides interpretation of visual data. - Temporal lobe is responsible for the perception and interpretation of sounds and determination of their source. It is also involved in the integration of taste, smell, and balance. The reception of speech and interpretation of speech is located in the Wernicke area. - Basal Ganglia System functions as the extrapyramidal pathway and processing station between the cerebral motor cortex and the upper brainstem. Through its interconnections with the thalamus, motor cortex, reticular formation, and spinal cord, the basal ganglia refine motor movements. Cerebellum Aids the motor cortex of the cerebrum in the integration of voluntary movement. It processes sensory information from the eyes, ears, touch receptors, and musculoskeleton. Integrated with the vestibular system, the cerebellum uses the sensory data for reflexive control of muscle tone, balance, and posture to produce steady and precise movements. - Develops Cephalocaudal (head to tail) & Proximal/Distal (Medial to Periphery) - Research Shows that excessive alcohol intake damages the Crebellum Brainstem the pathway between the cerebral cortex and the spinal cord, and it controls many involuntary functions. |
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Brainstem Anatomy and its functions
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Diencephalon (CN I-II)
- Pituitary Gland - Thalamus = the major integrating center for perception of various sensations such as pain and temperature (along with the cortical processing for interpretation). The thalamus also relays sensory aspects of motor information between the basal ganglia and cerebellum. - Hypothalamus = controls global actions of heart rate, temperature, fluid and electrolyte balance, & appetite Midbrain (III-IV) = controls different reflexes (eye and head movement, hearing or auditory reflex path), corticospinal path Pons (V-VIII) = Eyes (lots of control of pupil, eye movement), and some control of respiration Medulla Oblongata (IX-XII) = respiratory, circulatory, and vasamotor control (constriction and dilation), huge relay center for ascending and descending spinal tracts, many nerves pass through and cross over. |
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List Cranial Nerves, Know Pneumonics
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Cranial nerves - Stem from Brain Stem
I. Olfactory S - Smell II. Optic S - Sight III. Oculomotor M (P) - eye muscle IV. Trochlear M - eye muscle (sup. oblique) V. Trigeminal B - face/teeth sensory, mastication muscle VI. Abducens M - eye muscle (ext. rectus) VII. Facial B (P) - face muscle/sensory VIII. Acoustic S - ear IX. Glossopharyngeal B (P) - tonsil, tongue, pharynx X - Vagus nerve B (P) - heart, lungs, GI XI - Accessory nerve M - Sternocleidomastoid and Trapezius XII - Hypoglossal nerve M - tongue Oh, Oh, Oh, To Touch And Feel A Girl's Very Soft Hands Some Say Marry Money But My Brother Says Big Brains Matter Most |
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Spinal Nerves
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31 pair
Afferent = ascending pathways = sensory fibers Efferent = descending pathways = motor fibers Reflex Response = Reflex Arch = Travels just to Spinal cord and then back out Spinal Innervation of dermatomes (a region of skin supplied by a single sensory nerve) Cervical - 8 (breakfast) Thoracic - 12 (lunch) Lumbar - 5 (dinner) Sacral - 5 (dessert) Coccygeal - 1 (snack after midnight) The higher up the spine an injury may occur the more damage the injury may cause. |
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Level of Injury and Paralysis of Spine
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Level of Injury and Paralysis of Spine
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Peripheral Nervous System Sensory Pathways
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Spinothalamic tracts
- Anterior: crude touch - Lateral: pain & temperature Posterior Columns - Position, vibration & fine touch Touch has two paths - one is fine touch (goes up posterior columns and crosses at medulla) - crude crosses at the level of the spinal cord and goes up - Position and vibration crosses at the medulla - Pain and Temperature cross at the level of the spinal cord |
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Peripheral Motor Pathways (higher muscle pathways)
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Corticospinal (pyramidal) tract
- crosses at brainstem and goes down - voluntary movement, skilled movements, fine movements Extrapyramidal tract - involuntary motor control (modify and help to integrate) - controlling movements, arm muscle tone - exit spinal cord to the anterior horn and out to the periphery Cerebellar System - muscle activity |
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Autonomic NS
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Sympathetic NS;
Vital signs ↑ - up (heart rate rises to bring oxygen to brain) Muscle tension ↑ - up (grab steering wheel tighter) Diaphoresis = profuse sweating Dilated pupils = (take in as much information as possible) Pallor = (blood taken from skin to supply to inner organs) Bronchodilation = (provide better oxygen intake for organs) Peristalsis ↓ - down (no longer need to use bathroom, all that water is recirculating and blood taken to organs) Parasympathetic NS: Vital signs ↓ - down (heart rate smooths out and relaxed) Peristalsis ↑ - up (production of feces and filtrate) Nausea Bronchoconstriction Weak Faint Pallor |
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Reflexes
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Order of Reflex Arch:
- Impulse - Afferent fiber to spinal cord - Synapse with spinal motor neuron - Reflex arc along efferent fiber - Response Superficial / cutaneous - Ex: Abdominal Reflex Deep tendon (DTR's) - Biceps - Triceps - Brachioradialis - Patellar (knee jerk) - Achilles |
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Effects of Aging on the Nervous System
Elderly & Children |
Elderly have Decreases in.....
- Neurons in brain and spinal column - Slowing of neural processes - Efficiency of A.N.S. - Brain weight - Nerve velocity conduction(reflexes) - Response to multiple stimuli Children Develop Directional: - Cephalocaudal - Proximal/distal Variance in acquisition of skills & physical development |
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Babinski Reflex
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Crawl Reflex
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Dance Reflex
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Tonic Neck Reflex
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Moro Reflex
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