Frequently Asked Questions About Cognitive Communication Disorders

Frequently Asked Questions About Cognitive Communication Disorders

5th December 2018OffByRiseNews

Create outcomes and a teaching plan. Frequently Asked Questions About Cognitive Communication Disorders the patient’s current anxiety level.

Assess how the patient uses defense mechanisms. A patient experiencing severe anxiety has a significantly narrowed perceptual field and difficulty attending to events in the environment. A patient experiencing severe anxiety will not learn readily. Determining preferred modes of learning, devising outcomes, and constructing teaching plans are relevant to the task but are not the priority measure. The nurse has already assessed the patient’s anxiety level. Using defense mechanisms does not apply.

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A patient approaches the nurse and impatiently blurts out, “You’ve got to help me! The nurse has closed off patient-centered communication by changing the subject. The introduction of an irrelevant topic makes the nurse feel better. The nurse may be uncomfortable dealing with the patient’s severe anxiety. The nurse has not responded to the patient’s physical needs. There is no evidence of false cognition.

Focusing is a therapeutic communication technique used to concentrate attention on a single issue. A patient experiencing moderate anxiety says, “I feel undone. Why do you suppose you are feeling anxious? What would you like me to do to help you? You must get your feelings under control before we can continue. Increased anxiety results in scattered thoughts and an inability to articulate clearly.

Clarification helps the patient identify his or her thoughts and feelings. Asking the patient why he or she feels anxious is nontherapeutic, and the patient will not likely have an answer. The patient may be unable to determine what he or she would like the nurse to do to help. Telling the patient to get his or her feelings under control is a directive the patient is probably unable to accomplish. A patient with a high level of motor activity runs from chair to chair and cries, “They’re coming! The goal should be to decrease the environmental stimuli. Respecting the patient’s personal space is a lower priority than safety.

The clarification of feelings cannot take place until the level of anxiety is lowered. A patient who is experiencing panic-level anxiety is at high risk for injury, related to an increase in non-goal-directed motor activity, distorted perceptions, and disordered thoughts. Existing data do not support the nursing diagnoses of Self-care deficit or Disturbed energy field. This patient has disturbed thought processes, but the risk for injury has a higher priority. A supervisor assigns a worker a new project.

The worker initially agrees but feels resentful. A passive-aggressive person deals with emotional conflict by indirectly expressing aggression toward others. Compliance on the surface masks covert resistance. Resistance is expressed through procrastination, inefficiency, and stubbornness in response to assigned tasks. Acting out refers to behavioral expression of conflict.

Projection is a form of blaming. Suppression is the conscious denial of a disturbing situation or feeling. A patient is undergoing diagnostic tests. The patient says, “Nothing is wrong with me except a stubborn chest cold.

Denial is an unconscious blocking of threatening or painful information or feelings. Regression involves using behaviors appropriate at an earlier stage of psychosexual development. Displacement shifts feelings to a more neutral person or object. Projection attributes one’s own unacceptable thoughts or feelings to another. A patient with a mass in the left upper lobe of the lung is scheduled for a biopsy. The patient has difficulty understanding the nurse’s comments and asks, “What are they going to do? Moderate anxiety causes the individual to grasp less information and reduces his or her problem-solving ability to a less-than-optimal level.

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Mild anxiety heightens attention and enhances problem-solving abilities. Severe anxiety causes great reduction in the perceptual field. Panic-level anxiety results in disorganized behavior. A patient who is preparing for surgery has moderate anxiety and is unable to understand preoperative information. Reassure the patient that all nurses are skilled in providing postoperative care. Describe the procedure again in a calm manner, using simple language. Tell the patient that the staff is prepared to promote recovery.

Encourage the patient to express feelings to his or her family. Providing information in a calm, simple manner helps the patient grasp the important facts. Introducing extraneous topics as described in the incorrect options will further scatter the patient’s attention. A nurse encourages an anxious patient to talk about feelings and concerns.

What is the rationale for this intervention? Offering hope allays and defuses the patient’s anxiety. Concerns stated aloud become less overwhelming and help problem solving to begin. Anxiety is reduced by focusing on and validating what is occurring in the environment.

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Encouraging patients to explore alternatives increases the sense of control and lessens anxiety. All principles listed are valid, but the only rationale directly related to the intervention of assisting the patient to talk about feelings and concerns is the one that states that concerns spoken aloud become less overwhelming and help problem solving to begin. Have you been a victim of a crime or seen someone badly injured or killed? Do you feel especially uncomfortable in social situations involving people?

Do you repeatedly do certain things over and over again? Do you find it difficult to control your worrying? Patients with GAD frequently engage in excessive worrying. They are less likely to engage in ritualistic behavior, fear social situations, or have been involved in a highly traumatic event.

A patient in the emergency department has no physical injuries but exhibits disorganized behavior and incoherence after minor traffic accident. Individuals who are experiencing severe to panic-level anxiety require a safe environment that is quiet, nonstimulating, structured, and simple. A room with a desk and two chairs provides simplicity, few objects with which the patient could cause self-harm, and a small floor space around which the patient can move. A small, empty storage room without windows or furniture would be like a jail cell. A person has minor physical injuries after an automobile accident.

Frequently Asked Questions About Cognitive Communication Disorders

The person is unable to focus and says, “I feel like something awful is going to happen. The person whose anxiety is severe is unable to solve problems and may have a poor grasp of what is happening in the environment. Somatic symptoms such as those described are usually present. The individual with mild anxiety is only mildly uncomfortable and may even find his or her performance enhanced. The individual with moderate anxiety grasps less information about a situation and has some difficulty with problem solving. Two staff nurses applied for a charge nurse position.

After the promotion was announced, the nurse who was not promoted said, “The nurse manager had a headache the day I was interviewed. Projection is the hallmark of blaming, scapegoating, thinking prejudicially, and stigmatizing others. Conversion involves the unconscious transformation of anxiety into a physical symptom. Introjection involves intense, unconscious identification with another person. Splitting is the inability to integrate the positive and negative qualities of oneself or others into a cohesive image. A patient tells a nurse, “My new friend is the most perfect person one could imagine—kind, considerate, and good looking. I can’t find a single flaw.

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Idealization is an unconscious process that occurs when an individual attributes exaggerated positive qualities to another. Denial is an unconscious process that calls for the nurse to ignore the existence of the situation. Projection operates unconsciously and results in blaming behavior. Compensation results in the nurse unconsciously attempting to make up for a perceived weakness by emphasizing a strong point. A patient experiences an episode of severe anxiety.

Frequently Asked Questions About Cognitive Communication Disorders

Buspirone is long acting and not useful as an as-needed drug. Amitriptyline and desipramine are tricyclic antidepressants and considered second- or third-line agents. Two staff nurses applied for promotion to nurse manager. Altruism is the mechanism by which an individual deals with emotional conflict by meeting the needs of others and vicariously receiving gratification from the responses of others.

The nurse’s reaction is conscious, not unconscious. No evidence of aggression is exhibited, and no evidence of conscious denial of the situation exists. Passive aggression occurs when an individual deals with emotional conflict by indirectly and unassertively expressing aggression toward others. A person who feels unattractive repeatedly says, “Although I’m not beautiful, I am smart.

Compensation is an unconscious process that allows an individual to make up for deficits in one area by excelling in another area to raise self-esteem. Repression unconsciously puts an idea, event, or feeling out of awareness. Identification is an unconscious mechanism calling for an imitation of the mannerisms or behaviors of another. Devaluation occurs when the individual attributes negative qualities to self or to others. A person who is speaking about a contender for a significant other’s affection says in a gushy, syrupy voice, “What a lovely person. Reaction formation is an unconscious mechanism that keeps unacceptable feelings out of awareness by using the opposite behavior.

Instead of expressing hatred for the other person, the individual gives praise. Denial operates unconsciously to allow an anxiety-producing idea, feeling, or situation to be ignored. Projection involves unconsciously disowning an unacceptable idea, feeling, or behavior by attributing it to another. An individual experiences sexual dysfunction and blames it on a partner by calling the person unattractive and unromantic. Rationalization involves unconsciously making excuses for one’s behavior, inadequacies, or feelings.

Regression involves the unconscious use of a behavior from an earlier stage of emotional development. Compensation involves making up for deficits in one area by excelling in another area. Introjection is an unconscious, intense identification with another person. A student says, “Before taking a test, I feel a heightened sense of awareness and restlessness. Mild anxiety is rarely obstructive to the task at hand.

Frequently Asked Questions About Cognitive Communication Disorders

It may be helpful to the patient because it promotes study and increases awareness of the nuances of questions. The incorrect responses have different symptoms. Teaching about the symptoms of anxiety, their relation to precipitating stressors, and, in this case, the positive effects of anxiety serves to reassure the patient. Advising the patient to discuss the experience with a health care provider implies that the patient has a serious problem. Listening without comment will do no harm but deprives the patient of health teaching. Antioxidant vitamin supplements are not useful in this scenario.

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If a cruel and abusive person rationalizes this behavior, which comment is most characteristic of this person? I don’t know why it happens. I have always had poor impulse control. That person should not have provoked me.

Inside I am a coward who is afraid of being hurt. Rationalization consists of justifying one’s unacceptable behavior by developing explanations that satisfy the teller and attempt to satisfy the listener. A patient experiencing severe anxiety suddenly begins running and shouting, “I’m going to explode! I’m not sure what you mean.

We will help you regain control. The safety needs of the patient and other patients are a priority. The patient is less likely to cause self-harm or hurt others when several staff members take responsibility for providing limits. The explanation given to the patient should be simple and neutral. Simply being told that others can help provide the control that has been lost may be sufficient to help the patient regain control. Running after the patient will increase the patient’s anxiety. A person who has been unable to leave home for more than a week because of severe anxiety says, “I know it does not make sense, but I just can’t bring myself to leave my apartment alone.

Teach the person to use positive self-talk. Assist the person to apply for disability benefits. Ask the person to explain why the fear is so disabling. Advise the person to accept the situation and use a companion. This intervention, a form of cognitive restructuring, replaces negative thoughts such as “I can’t leave my apartment” with positive thoughts such as “I can control my anxiety.

This technique helps the patient gain mastery over the symptoms. The other options reinforce the sick role. Which comment by a person experiencing severe anxiety indicates the possibility of obsessive-compulsive disorder? I check where my car keys are eight times. My legs often feel weak and spastic. I’m embarrassed to go out in public.

I keep reliving the car accident. The repetitive behavior is designed to decrease anxiety but fails and must be repeated. The statement, “My legs feel weak most of the time,” is more in keeping with a somatoform disorder. Being embarrassed to go out in public is associated with an avoidant personality disorder. Reliving a traumatic event is associated with post-traumatic stress disorder.

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Drinking alcohol or taking other anxiolytic medications along with the prescribed benzodiazepine should be avoided because depressant effects of both drugs will be potentiated. Drowsiness is an expected effect and needs to be reported only if it is excessive. Patients should be taught not to deviate from the prescribed dose and schedule for administration. Which statement is mostly likely to be made by a patient diagnosed with agoraphobia?

Frequently Asked Questions About Cognitive Communication Disorders

Being afraid to go out seems ridiculous, but I can’t go out the door. I’m sure I’ll get over not wanting to leave home soon. When I have a good incentive to go out, I can do it. My family says they like it now that I stay home. Individuals who are agoraphobic generally acknowledge that the behavior is not constructive and that they do not really like it. Patients state they are unable to change the behavior.

Patients with agoraphobia are not optimistic about change. Most families are dissatisfied when family members refuse to leave the house. A patient has the nursing diagnosis Anxiety, related to __________, as evidenced by an inability to control compulsive cleaning. Many compulsive rituals accompany obsessive thoughts. The patient uses these rituals to relief anxiety. Unfortunately, the anxiety relief is short lived, and the patient must frequently repeat the ritual.

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The other options are unrelated to the dynamics of compulsive behavior. A patient performs ritualistic hand washing. What should the nurse do to help the patient develop more effective coping strategies? Allow the patient to set a hand-washing schedule. Encourage the patient to participate in social activities. Encourage the patient to discuss hand-washing routines.

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Focus on the patient’s symptoms rather than on the patient. Because patients diagnosed with obsessive-compulsive disorder become overly involved in rituals, promoting involvement with other people and activities is necessary to improve the patient’s coping strategies. Daily activities prevent the constant focus on anxiety and its symptoms. The other interventions focus on the compulsive symptom. For a patient experiencing panic, which nursing intervention should be implemented first? Gather a show of force in preparation for gaining physical control.

Calm, brief, directive verbal interaction can help the patient gain control of the overwhelming feelings and impulses related to anxiety. Administering an anxiolytic medication should be considered if providing calm, brief, directive communication is ineffective. Which finding indicates that a patient with moderate-to-severe anxiety has successfully lowered the anxiety level to mild? I don’t want anything to eat. The ability to concentrate and attend to reality is increased slightly in mild anxiety and decreased in moderate-, severe-, and panic-level anxiety.

Patients with high levels of anxiety often ask, “What’s the matter with me? Staying in a room alone and pacing suggest moderate anxiety. Expressing a lack of hunger is not necessarily a criterion for evaluating anxiety. A patient tells the nurse, “I don’t go to restaurants because people might laugh at the way I eat, or I could spill food and be laughed at. Acrophobia is the fear of heights. Agoraphobia is the fear of a place in the environment. Post-traumatic stress disorder is associated with a major traumatic event.

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A patient checks and rechecks electrical cords related to an obsessive thought that the house may burn down. The nurse and patient explore the likelihood of an actual fire. Cognitive restructuring involves the patient in testing automatic thoughts and drawing new conclusions. Desensitization involves a graduated exposure to a feared object.

Relaxation training teaches the patient to produce the opposite of the stress response. Flooding exposes the patient to a large amount of undesirable stimuli in an effort to extinguish the anxiety response. A patient has a fear of public speaking. Beta-blockers, such as propranolol, are often effective in preventing symptoms of anxiety associated with social phobias. Neuroleptic medications are major tranquilizers and not useful in treating social phobias.