1. Define important words in this chapter

1. 1. Define important words in this chapter • active listening • a way of communicating that involves giving a person your full attention while he is speaking and encouraging him to give information and clarify ideas; includes nonverbal communication. • barrier • a block or an obstacle. • body language • all of the conscious or unconscious messages your body sends as you communicate, such as facial expressions, shrugging your shoulders, and wringing your hands. • care conference • a meeting to share and gather information about residents in order to develop a care plan.

2. 1. Define important words in this chapter • care plan • a written plan for each resident created by the nurse; outlines the steps taken by the staff to help the resident reach his or her goals. • charting • the act of noting care and observations; documenting. • code • in health care, an emergent medical situation in which specially-trained responders provide resuscitative measures to a person.

3. 1. Define important words in this chapter • code status • formally written status of the type and scope of care that should be provided in the event of a cardiac arrest, other catastrophic failure, or terminal illness; terms and acronyms are used to identify the care desired by the person, such as “DNR” (do not resuscitate) and “no code.” • critical thinking • the process of reasoning and analyzing in order to solve problems; for the nursing assistant, critical thinking means making good observations and promptly reporting all potential problems. • culture • a set of learned beliefs, values, traditions, and behaviors shared by a social, ethnic, or age group.

4. 1. Define important words in this chapter • edema • swelling in body tissues caused by excess fluid. • incident • an accident, problem, or unexpected event during the course of care. • incident report • a report documenting an incident and the response to the incident; also known as an occurrence report or event report. • medical chart • written legal record of all medical care a patient, resident, or client receives.

5. 1. Define important words in this chapter • Minimum Data Set (MDS) • a detailed form with guidelines for assessing residents in long-term care facilities; also details what to do if resident problems are identified. • nonverbal communication • communication without using words, such as making gestures and facial expressions. • nursing process • an organized method used by nurses to determine residents’ needs, plan the appropriate care to meet those needs, and evaluate how well the plan of care is working; five steps are assessment, diagnosis, planning, implementation, and evaluation.

6. 1. Define important words in this chapter • objective information • factual information collected using the senses of sight, hearing, smell, and touch; also called signs. • orientation • a person’s awareness of person, place, and time. • prefix • a word part added to the beginning of a root to create a new meaning. • prioritize • to place things in order of importance.

7. 1. Define important words in this chapter • root • the main part of a word that gives it meaning. • rounds • physical movement of staff from room to room to discuss each resident and his or her care plan. • sentinel event • an unexpected occurrence involving death or serious physical or psychological injury. • subjective information • information collected from residents, their family members and friends; information may or may not be true but is what the person reported; also called symptoms.

8. 1. Define important words in this chapter • suffix • a word part added to the end of a root or a prefix to create a new meaning. • verbal communication • communication involving the use of spoken or written words or sounds. • vital signs • measurements—temperature, pulse, respirations, blood pressure, pain level—that monitor the functioning of the vital organs of the body.

9. 2. Explain types of communication • Define the following terms: • verbal communication • communication involving the use of spoken or written words or sounds. • nonverbal communication • communication without using words, such as making gestures and facial expressions.

10. 2. Explain types of communication • Define the following terms: • body language • all of the conscious or unconscious messages your body sends as you communicate, such as facial expressions, shrugging your shoulders, and wringing your hands. • active listening • a way of communicating that involves giving a person your full attention while he is speaking and encouraging him to give information and clarify ideas; includes nonverbal communication.

11. 2. Explain types of communication • Communication is the exchange of information with others which involves sending and receiving messages. • People have different roles during communication. For example, a person can be the “sender” or the “receiver.” The person who communicates first is the “sender.” The person who receives the message is the “receiver.”

12. Transparency 3-1: Communication Process

13. 2. Explain types of communication • The process shown in Transparency 3-1 occurs over and over, with the sender and receiver switching roles during a conversation. • Communicating verbally means using words. Verbal communication includes the way words are spoken or written. • How the voice sounds when someone speaks is as important as the words he uses.

14. 2. Explain types of communication • Think about these questions: • How do you feel when a teacher or supervisor sounds irritated when answering a question you have asked? • Try to imagine how residents feel when nursing assistants seem annoyed in the tone of their voice.

15. 2. Explain types of communication • Body language has to do with all of the conscious or unconscious messages your body sends as you communicate. It includes posture, body movements, facial expressions, and gestures. It can be positive or negative.

16. Transparency 3-2: Body Language

17. 2. Explain types of communication • Think about this question: • What signals are the two people on Transparency 3-2 sending to each other through their body language?

18. 2. Explain types of communication • Body language can be positive or negative. • Examples of positive nonverbal communication: • Smiling in a friendly manner • Leaning forward to listen • With permission, putting your hand over a resident’s hand

19. 2. Explain types of communication • Examples of negative nonverbal communication: • Rolling your eyes • Crossing your arms in front of you • Tapping your foot • Pointing at someone while speaking

20. 2. Explain types of communication • Think about this question: • Can you think of other examples of either positive or negative nonverbal communication?

21. 2. Explain types of communication • Remember these guidelines for good communication: • Use appropriate words. • Be aware of your body language. • Use an acceptable tone of voice. • Wait for responses and let pauses happen. • Practice active listening. • Use mostly facts when communicating.

22. 3. Explain barriers to communication • Define the following term: • barrier • a block or an obstacle.

23. 3. Explain barriers to communication • As a nursing assistant (NA), you will encounter various barriers to communication with your residents. • It is important to be aware of these barriers and ways to avoid them.

24. Transparency 3-3: Barriers to Communication

25. 3. Explain barriers to communication • Barriers to communication: • Resident does not hear, does not hear correctly, or does not understand you. • Resident is difficult to understand. • NA, resident, or others use words that are not understood. • NA uses slang or profanity. • NA uses clichés.

26. 3. Explain barriers to communication • Barriers to communication (cont'd.): • NA responds with “why.” • NA gives advice. • NA asks questions that only require yes/no answers. • Resident speaks a different language. • NA or resident uses nonverbal communication.

27. 4. List ways that cultures impact communication • Define the following term: • culture • a set of learned beliefs, values, traditions, and behaviors shared by a social, ethnic, or age group.

28. 4. List ways that cultures impact communication • The following aspects of communication are influenced by culture and are important to understand when caring for residents: • Eye contact • Touch • Language • Touch is an important way to communicate, and there are differences among cultures and among individual personalities, in terms of how comfortable they are with touch.

29. 4. List ways that cultures impact communication • Examples of acceptable touch include the following: • Giving residents respectful personal care, such as bathing, dressing, feeding, and shaving • Hugging, if the resident permits or asks for it • Holding a resident’s hand when she asks you to

30. 4. List ways that cultures impact communication • Examples of unacceptable touch include the following: • Sitting on a resident’s lap or asking a resident to sit on your lap • Kissing a resident • Hugging a resident who pulls away from you • Inappropriately touching or rubbing against a resident or staff member

31. 4. List ways that cultures impact communication • Think about this question: • Can you think of other examples of acceptable and unacceptable touch?

32. 4. List ways that cultures impact communication • Discussion: • Describe how your culture influences your own communication and use of touch. • Are there are any other cultural considerations when working with residents from different cultures than your own which you can think of that would be useful in your job?

33. 5. Identify the people you will communicate with in a facility • There are many different people you will communicate with on the job. This is another reason why understanding communication and communicating clearly are so important. • Remember that you will communicate with the following while on the job: • Doctors, nurses, supervisors, and other staff members • Other departments • Residents • Families and visitors • The community

34. 6. Understand basic medical terminology and abbreviations • Define the following terms: • edema • swelling in body tissues caused by excess fluid. • root • the main part of a word that gives it meaning. • prefix • a word part added to the beginning of a root to create a new meaning. • suffix • a word part added to the end of a root or a prefix to create a new meaning.

35. 6. Understand basic medical terminology and abbreviations • In order to communicate well with other members of the care team, you need to learn medical language. You will use medical terms for specific conditions. • Medical terms are made up of these word parts: • roots • prefixes • suffixes

36. 6. Understand basic medical terminology and abbreviations • A root is the main part of the word that gives it meaning. • A prefix comes at the front of the word. It works with a word root to make a new term. • For example, the root “scope” means an instrument to look inside. The prefix “oto” means ear. An otoscope is an instrument used to examine the ear.

37. Handout 3-1: Prefixes • a, an:without, not, lack ofanalgesic = without pain • ante: before, in front ofantepartum = before delivery • bi: two, twice, doublebifocal = two lenses • brady: slowbradycardia = slow pulse, heartbeat • contra: againstcontraceptive = prevents pregnancy • dis: apart, free fromdisinfected = free from microorganisms • dys: bad, painfuldysuria = painful urination • endo: inner endoscope = instrument for examining the inside of an organ • epi: on, upon, overepidermis = outer layer of skin • erythro: red erythrocyte = red blood cell

38. Handout 3-1: Prefixes (cont’d.) • ex: out, away from exhale = to breathe out • hemi: half hemisphere = one of two parts of the brain • hyper: too much, high hypertension = high blood pressure • hypo: below, underhypotension = low blood pressure • inter: between, within interdisciplinary = between disciplines • leuk: white leukocyte = white blood cell • mal: bad, illness, disorder malformed = badly made • micro: small microscopic = too small for the eye to see • olig: small, scant oliguria = small amount of urine • patho: disease, suffering pathology = study of disease

39. Handout 3-1: Prefixes (cont’d.) • per: by, through perforate = to make a hole through • peri: around pericardium = sac around the heart • poly: many, much polyuria = much urine • post: after, behind postmortem = period after death • pre: before, in front of prenatal = period before birth • sub: under, beneathsubcutaneous = beneath the skin • supra: above, oversuprapelvic = located above the pelvis • tachy: swift, fast, rapidtachycardia = rapid heartbeat

40. Handout 3-2: Roots • abdomin(o): abdomenabdominal = pertaining to the abdomen • aden (o): gland adenitis = inflammation of a gland • angi (o): vessel angioplasty = surgical repair of a vessel using a balloon • arterio: artery arteriosclerosis = hardening of artery walls • arthr (o): jointarthrotomy = cut into a joint • brachi (o): arm brachial = pertaining to the arm • bronchi, bronch (o): bronchusbronchopneumonia = inflammation of lungs • card, cardi (o): heart cardiology = study of the heart • cerebr (o): cerebrum cerebrospinal = pertaining to the brain and spinal cord • cephal (o): head cephalalgia = headache

41. Handout 3-2: Roots (cont’d.) • chole, chol (o): bile cholecystitis = inflammation of the gall bladder • colo: colon colonoscopy = examination of the large intestine or colon with a scope • cost (o): rib costochondral = pertaining to a rib • crani (o): skull craniotomy = cutting into the skull • cyan (o): blue cyanosis = blue, gray, or purple tinge to the skin due to lack of oxygen in the blood • cyst (o): bladder, cyst cystitis = inflammation of the bladder • derm, derma: skin dermatitis = inflammation of the skin • duoden (o): duodenum duodenal = pertaining to the duodenum, the first part of the small intestine • encephal (o): brain encephalitis = inflammation of the brain • gaster (o), gastro: stomach gastritis = inflammation of the stomach

42. Handout 3-2: Roots (cont’d.) • geron: aged gerontology = study of the aged • gluco: sweet glucometer = device used to measure blood glucose • glyco, glyc: sweet glycosuria = glucose (sugar) in the urine • gyneco, gyno: woman gynecology = study of diseases of the female reproductive organs • hema, hemato, hemo: blood hematuria = blood in the urine • hepato: liver hepatomegaly = enlargement of the liver • hyster (o): uterus hysterectomy = surgical removal of the uterus • ile (o), ili(o): ileum ileorrhaphy = surgical repair of the ileum • laryng (o): larynx laryngectomy = excision of the larynx • lymph (o): lymph lymphocyte = type of white blood cell

43. Handout 3-2: Roots (cont’d.) • mamm (o): breast mammogram = x-ray of the breast • mast (o): breast mastectomy = excision of the breast • melan (o): black melanoma = mole or tumor, may be cancerous • mening (o): meninges; membranes covering the spinal cord and brainmeningitis = inflammation of the membranes of the spinal cord or brain • necro: death necrotic = dead tissue • nephr (o): kidney nephrectomy = removal of a kidney • neur (o): nerve neuritis = inflammation of a nerve • onc (o): tumor oncology = study of tumors • ophthalm (o): eye ophthalmologist = eye doctor • oste (o): bone osteoarthritis = disease of the joints

44. Handout 3-2: Roots (cont’d.) • ot (o): ear otology = science of the ear • pharyng (o): pharynx pharyngitis = inflammation of the throat, sore throat • phleb (o): vein phlebitis = inflammation of a vein • pneo (a): breathing tachypnea = rapid breathing • pneum: air, gas, respiration pneumonia = inflammation of the lung • pod (o): foot podiatrist = foot doctor • proct (o): anus, rectum proctology = study of the rectum • pulm (o): lung pulmonary = relating to the lungs • splen (o): spleen splenomegaly = enlarged spleen • stomat (o): mouth stomatitis = inflammation of mouth

45. Handout 3-2: Roots (cont’d.) • therm (o): hot, heat thermoplegia = heatstroke • thorac (o): chest thoracotomy = incision into chest wall • thromb (o): blood clot thrombus = blood clot blocking a vessel • toxic (o), tox (o): poison toxicology = study of poisons • trache (o): trachea, windpipe tracheostomy = incision to make an artificial airway • urethr (o): urethra urethritis = inflammation of urethra

46. 6. Understand basic medical terminology and abbreviations • A suffix is found at the end of a word. A suffix by itself does not form a full word. When you add a prefix or a root, the suffix turns it into a working medical term. • For example, the suffix “meter” means measuring instrument. The prefix “thermo” means heat. A thermometer is an instrument that measures body temperature.

47. Handout 3-3: Suffixes • -cyte: cell leukocyte = white blood cell • -ectomy: excision, removal of splenectomy = removal of spleen • -emesis: vomiting hyperemesis = excessive vomiting • -emia: blood condition anemia = lack of red blood cells • -ism: a condition hyperthyroidism = condition caused by an excessive production of thyroid hormones • -itis: inflammation stomatitis = inflammation of the mouth • -logy: study of hematology = study of the blood • -megaly: enlargement splenomegaly = enlarged spleen • -oma: tumor melanoma = mole or tumor, may be cancerous • -osis: condition halitosis = bad breath

48. Handout 3-3: Suffixes (cont’d.) • -ostomy: creation of an opening ileostomy = creation of an opening into the ileum • -otomy: cut into laparotomy = cutting into the abdomen • -pathy: disease myopathy = disease of the muscle • -penia: lack leukopenia = a lack of white blood cells • -phagia: to eat dysphagia = difficulty swallowing • -phasia: speaking aphasia = absence of speaking • -phobia: exaggerated fear acrophobia = fear of high places • -plasty: surgical repair angioplasty = surgical repair of a vessel using a balloon • -plegia: paralysis paraplegia = paralysis of lower portion of the body • -rrhage: excessive flow hemorrhage = excessive flow of blood

49. Handout 3-3: Suffixes (cont’d.) • -scopy: examination using a scopecolonoscopy = examination of the large intestine or colon with a scope • -stomy: creation of an opening colostomy = opening into the colon • -tomy: incision, cutting into thoracotomy = incision into chest wall • -uria: condition of the urine dysuria = painful urination

50. 6. Understand basic medical terminology and abbreviations • Abbreviations help healthcare workers communicate more efficiently, and many abbreviations are used in healthcare. Two examples of a common medical abbreviations are “BP” for blood pressure and “temp” for temperature.