• Choose a category
• All
• Classic-Fiction

2 Which behaviours will encourage a patient to talk about their concerns?

Giving reassurance and telling them not to worry.

Asking the patient about their family and friends.

Tell the patient you are interested in what is concerning them and that you are available to listen.

Tell the patient you are interested in what is concerning them and if they tell you, they will feel better.

3 What is the difference between denial and collusion?

Denial is when a healthcare professional refuses to tell a patient their diagnosis for the protection of the patient whereas collusion is when healthcare professionals and the patient agree on the information to be told to relatives and friends.

Denial is when a patient refuses treatment and collusion is when a patient agrees to it.

Denial is a coping mechanism used by an individual with the intention of protecting themselves from painful or distressing information whereas collusion is the withholding of information from the patient with the intention of ‘protecting them’.

Denial is a normal acceptable response by a patient to a life-threatening diagnosis whereas collusion is not.

4 If you were explaining anxiety to a patient, what would be the main points to include?

Signs of anxiety include behaviours such as muscle tension, palpitations, a dry mouth, fast shallow breathing, dizziness and an increased need to urinate or defaecate.

Anxiety has three aspects: physical – bodily sensations related to flight and fight response, behavioural – such as avoiding the situation, and cognitive (thinking) – such as imagining the worst.

Anxiety is all in the mind, if they learn to think differently, it will go away.

Anxiety has three aspects: physical – such as running away, behavioural – such as imagining the worse (catastrophizing), and cognitive (thinking) – such as needing to urinate.

5 What are the principles of communicating with a patient with delirium?

Use short statements and closed questions in a well-lit, quiet, familiar environment.

Use short statements and open questions in a well-lit, quiet, familiar environment.

Write down all questions for the patient to refer back to.

Communicate only through the family using short statements and closed questions.

These multiple choice questions are also available for you to complete online. Visit www.royalmarsdenmanual.com and select the Student Edition tab.

Answers to the multiple choice questions can be found in Appendix 3.

Chapter 6

Elimination

Overview

This chapter will provide an overview of elimination and is divided into three main sections. The first reviews urinary elimination, examining penile sheaths, urinary catheterization and bladder irrigation. The second section reviews faecal elimination, examining diarrhoea, constipation, enemas and suppositories. The final section examines stoma care.

Normal elimination

Assisting the patient with normal elimination

Evidence-based approaches

Principles of care

Elimination is a sensitive issue and providing effective care and management for problems associated with it can be problematic. The difficulties associated with this can be minimized if the nurse seeks to respect the patient’s dignity when carrying out procedures such as assisting them with using a bedpan or a commode.

Preprocedural considerations

It is essential that the procedure is explained clearly to the patient to ensure consent is obtained and patient co-operation is agreed. A manual handling assessment is vital in order to establish if additional equipment such as a hoist is required.

Pharmacological support

Skin breakdown as a result of incontinence is a common problem with either faecal and/or urinary incontinence (Gray et al. 2007). Current nursing practice includes the use of a wide range of skin moisturizers and barrier creams but there is little known about their efficacy or effectiveness (Gray et al. 2007). A recent review suggests that the use of barrier creams with a pH near to that of normal skin can be useful in prevention of