Exam 1.docx - Exam 1 NUR 333 1 Therapeutic Relationships...

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Exam 1 NUR 333Therapeutic RelationshipsTherapeutic use of self“distinct gifts” each one of us has that can be used to creatively form positive bonds with othersoInfluenced by personality characteristics of patient and nurseGoals and FunctionsoFacilitates communication of distressing thoughts and feelingsoAssists patients with self care and independenceoHelps patients examine self-defeating behaviors/thoughtsand test alternativesEx. Focusing on what other people should be doing rather than what you should be doingoMaximizes communication skills, helps understand behavior, and enhances patient growthSteps: Identify and explore patient needs, establish clear boundaries, explore alternative problem solving skills, encourage behavioral changeBoundariesoPhysical boundaries, informal boundaries, personal spaceoTransference: Patientunconsciously transfers feelings and behaviors related to significant figures in the patient’s past onto the nurseoCountertransference:Nurseunconsciously (and inappropriately) transfers feelings and behaviors from significant figures in nurse’s past onto the patientoSelf-Check on BoundariesBoredom and indifference“Rescuing” the patientOver-involvementOver-identificationEx. If the patient asks a personal question, tell them we are here to talk about themoPeplau’s ModelHildegard Peplauwas the “mother of psychiatric nursing”—developed and defined the interpersonal relationship between nurses and patientsPhasesPre-orientation phaseOrientation phaseoEstablishing rapport and confidentialityoContract (boundaries)oTerms of terminationWorking phaseTermination phaseTherapeutic techniquesSilence, active listening, clarifying, (paraphrasing, restating, reflecting, exploring), open-ended, projective, and presupposition questionsNon-therapeutic techniquesExcessive questioning, giving approval/disapproval, “why” questions, giving advice, eye contact and touch depending on cultureCulture bound syndromea set of signs and symptoms that are common in a limited number of cultures but virtually non-existent in most other cultural groups1
Exam 1 NUR 333oExamples: ataque de nervios– Latin American: sudden attack of trembling, palpitations, dizziness, dyspnea– thought to be caused by an evil spirit related to intolerable stressghost sickness– Navajo: “being out of one’s mind”,palpitations, dizziness, dyspnea, bad dreams: thought tobe caused by an evil spiritoIf we fail to consider culture in diagnosis, something can bemisdiagnosed because we consider the symptoms abnormal inWestern cultureMental Status ExamoThought content—can refer to delusions (ex. Cameras arewatching you all the time)oThought process—disconnects (ex. I got to the hospital byvan, but not sure how the van got there or how I got to the van)Depressive DisordersClassifications:oDisruptive mood dysregulation disorderchildren between the ages of 6-18 havingfrequent temper tantrums resulting in

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