Therapeutic Environment

by Anne Vanderputten

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    About the Lecture

    The lecture Therapeutic Environment by Anne Vanderputten is from the course Psychosocial Integrity. It contains the following chapters:

    • Therapeutic Environment and Safety
    • Stressors
    • Safety
    • Social support and control
    • Definition of Security
    • Definition of Security
    • Principles of Security
    • Nursing Summary

    Included Quiz Questions

    1. Provide reorientation to the patient, lower TV volume, dim lighting to promote less stimulation of the environment
    2. Contact the physician for an order for medication
    3. Determine if the patient is hard of hearing
    4. Sit with the patient for one hour and allow the patient time to verbalize anxiety
    1. Assess the immediate environment for safety risk, keep the patient in close proximity for observation, follow institutional policy and procedure
    2. Restrain the patient
    3. Contact a security officer to watch the patient
    4. Allow family members to stay with the patient
    1. Discuss with the physician and suggest moving the patient to a room with a window view
    2. Ensure a family member is with the patient 24 hours a day
    3. Reorient the patient and provide pain medication
    4. Turn on all the lights and television to keep the patient in touch with reality
    1. Assess the patient’s need for extra warmth, educate the patient and family about fall risks, and ask the family not to bring items from home which are not needed by the patient
    2. Requesting the family to leave and return during regular visiting hours
    3. Contact security to remove items
    4. Inform the patient’s spouse the rules of the hospital
    1. Safety is the highest concern in providing nursing care
    2. Safety is an important need but self-actualization is higher
    3. Safety is a basic human need provided outside the healthcare environment
    4. Security is responsible for all safety in the hospital
    1. Discuss fall risk education with the patient and suggest area rugs be removed
    2. Tell the family it is better to have smooth clean floors
    3. Look for other environmental hazards
    4. Request an occupational therapist consult to provide the patient with a walker
    1. “It is stressful to have so many interruptions to your sleep. If you would like, we can discuss with your doctor about ordering tests and labs during the daytime hours.”
    2. “If you do not want care, it is your patient right to refuse.”
    3. “You could have died from your heart attack and we have to monitor your heart condition.”
    4. “I understand but we are here to do our job.”
    1. Reorient the patient to date and be sure to have a calendar posted in patient's view
    2. Suggest the physician discharge the patient
    3. Ask the patient if he/she is frequently confused
    4. Adjust plan of care to include frequent reorientation for the patient
    1. Reassure the patient, that staff will answer the call light and the nurse will check on the patient every hour or sooner if needed
    2. Tell the patient the unit is short staffed and it is difficult to answer the call light so frequently
    3. Consult respiratory therapy
    4. Dim the lights in the room
    1. Able bodied patients will evacuate first
    2. Nurses should secure windows
    3. Community providers will evacuate patients
    4. Nursing staff should check in at home to ensure their family is safe

    Author of lecture Therapeutic Environment

     Anne Vanderputten

    Anne Vanderputten

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