Mrs. Maria Ramirez, an American of Puerto Rican descent, is faced with the difficult decision of whether to continue chemotherapy in the face of a rapidly spreading malignancy. What communication techniques could the nurse use to help her at this point, and what traps must the nurse avoid in such situations?
Jan, a nurse colleague, is having difficulty standing up to a physician who has an abrupt, intimidating communication style. She often ends up with a lot of unspoken anger, developing tension headaches, and easily becoming tearful. What could the nurse do to help.
Mr. Hess, a client with Parkinson’s disease living at an extended care facility, has a stiff, expressionless face. He sits slumped in a recliner chair all day and seems lost in his own world, rarely looking at or interacting with anyone. When he does talk, he mumbles in a soft voice, and his words are difficult to understand. What kinds of things could the nurse do to establish a helping/healing relationship with Mr. Hess?
Jennifer Hughes, a new graduate, is very discouraged. In school, she had felt a great deal of anxiety about her own performance, and even now she finds it difficult to be positive about herself or her job. What knowledge about communication could she use to help improve her situation?
Mrs. Esther Larson, a client who has been recently admitted to a hospice program, confides in the nurse that she feels overwhelmed with the number of things she must attend to now that she’s facing the possibility of death. She says, “My thoughts are all over the place. I don’t know where to start.” What communication techniques, based on the critical thinking model, could the nurse use to help her at this point?
Mrs. S has a 10-year-history of HTN and a 5-year-history of DM. Recently her HTN has become uncontrolled, and she has been diagnosed with depression. Her medications, which have recently been changed, include captopril (Capoten), 25 mg 3 times a day; diltiazem (Cardizem), 240 mg. every morning; metformin (Glucophage XR), 1500 mg before the evening meal; and sertraline (Zoloft), 100 mg. at bedtime. The nurse identifies the priority nursing diagnosis as “Deficient knowledge R/T change in medications”. The nurse wants to develop a plan of care that uses the three domains of learning. What are the client’s teaching priorities? Which learning needs would require a cognitive method? Which need would be more appropriate to satisfy through affective or psychomotor methods?