NURS 250 Exam 2: Communication Notes

• Summarized notes for NURS 250 Exam 2

Communication Techniques

• Active listening involves full engagement, including eye contact and summarizing what is being said.
• Non-verbal communication uses body language and gestures to express feelings.
• Open-ended questions encourage patients to provide detailed responses.
• Therapeutic communication employs specific techniques to build patient trust and understanding.
• Non-therapeutic communication includes methods that block patient expression and hinder the development of rapport.
• Motivational interviewing is a patient-centered approach designed to encourage behavior change.
• The five steps of motivational interviewing are engaging, focusing, evoking, planning, and reflecting.
• The five stages of change in motivational interviewing are pre-contemplation, contemplation, preparation, action, and maintenance.
• The SBAR protocol is a structured communication method for effective information transfer.
• SBAR stands for Situation, Background, Assessment, and Recommendation.
• The CUS protocol is a framework used to express safety concerns in healthcare settings.
• CUS stands for Concerned, Uncomfortable, and Safety issue.

Documentation

• Patient care documentation provides a record that ensures continuity of care and offers legal protection.
• Relevant assessments, interventions, and patient responses must be documented.
• Personal opinions and unverified information must not be included in documentation.
• To correct documentation errors, mark the error, date and initial it, and do not erase.
• Patient education modalities should be tailored to the individual's learning style and needs.

Pharmacology

• Absorption refers to the movement of a drug from its administration site into the bloodstream.
• Distribution involves the transport of drugs via the bloodstream to tissues and organs.
• Metabolism is the conversion of drugs, mainly by the liver, into forms that can be eliminated.
• Excretion is the elimination of drugs from the body, primarily through the kidneys.
• Therapeutic effects are the desired beneficial outcomes of a medication.
• Adverse effects are harmful and unintended reactions to a medication.
• Side effects are minor and expected reactions associated with medication use.
• Toxic effects are harmful effects that result from excessive drug dosing.
• Idiosyncratic effects are unpredictable and unique reactions specific to individual patients.

Medication Routes

• Parenteral routes of administration bypass the gastrointestinal (GI) tract.
• Parenteral routes include IV (intravenous), IM (intramuscular), SQ (subcutaneous), inhaled, and topical.
• Enteral routes involve drug delivery through the gastrointestinal tract.
• Enteral routes include PO (oral), sublingual, rectally, and via feeding tubes.

Medication Administration Techniques

• When administering oral medications, ensure the patient can swallow and avoid crushing pills unless permitted.
• Topical medications should be applied thinly to the skin, taking care to prevent cross-contamination.
• For nasal medication administration, instruct the patient to breathe in while sitting upright.
• Eye drops should be placed carefully in the lower conjunctival sac.
• When administering ear drops, warm the drops and pull the ear back to ensure proper delivery.
• For vaginal medication administration, wear gloves and position the patient supine with knees bent.
• When administering rectal medications, position the patient in the left Sims' position for suppository insertion.
• Inhaled rescue medications are fast-acting bronchodilators used for immediate symptom relief.
• Inhaled maintenance medications are long-acting drugs used to prevent symptoms on a regular basis.
• Insulin is measured in units to ensure accurate dosing.
• Calibrated syringes should be used for precise medication dosing.
• When using glass vials, use a filter needle to avoid drawing up glass particles.
• When administering insulin, rotate sites to prevent tissue damage, check blood glucose levels, and confirm the type and dose of insulin.
• Subcutaneous injections are administered at a 45-90 degree angle.
• Subcutaneous injection sites include the abdomen, upper back-side of the arm, upper thigh, and upper back.
• Intramuscular injections are administered at a 90-degree angle.
• Intramuscular injection sites include the deltoid, ventrogluteal, and vastus lateralis muscles.
• Aseptic techniques should be followed to prevent contamination during medication administration.
• Safe parenteral practices include using aseptic techniques, labeling syringes for multiple doses, and avoiding needlestick injuries.
• Always use a leading zero before a decimal to prevent errors.
• Never use a trailing zero after whole numbers to avoid confusion.
• When preventing medication errors in children, calculations must consider the child's weight for accuracy, and pediatric-specific formulations should be used.
• The Six Rights of Medication Administration are right patient, right medication, right dose, right route, right time, and right documentation.
• Aging can result in slower drug metabolism, thus increasing drug sensitivity in the elderly needing lower doses.

Nutrition

• Protein contains 4 calories per gram.
• Carbohydrates contain 4 calories per gram
• Fat contains 9 calories per gram.
• Normal BMI falls between 18.5-24.9

Summarized notes for Nursing 250 Exam 2 focus on communication techniques. Key areas include active listening, non-verbal cues, open-ended questions, and therapeutic versus non-therapeutic methods. Motivational interviewing steps and change stages, along with the SBAR protocol, are also covered.