Need Help With Teaching Care Plan

[manchester]

Hello,

I am currently working on my first teaching care plan. I hope that I am on the right track. This is what I have so far.

Please help and tell me If I am doing this correctly. Thank You

Knowledge Deficit:

Code Status: Full Code

Allergies: No Known Allergies

Roy Rogers 63 male who presented to the ER complaining left knee pain. He is unable to bear weight and has severe pain when moving left leg. The patient states "I was riding my motor scooter when the bike suddenly ceased and I fell off the bike landing on left side." He denies any loss of consciousness, nausea, vomiting and denies any other injuries or pain. Patient states in good general health. Patient is able to understand and read English.

Code Status: Full Code

Allergies: No Known Allergies

Alcohol/tobacco/other drugs: Non-smoker drinks occasionally. No use of illegal drugs.

Past medical history: Reports unspecified arthritis in knees and ankles.

Past Surgical history: No past surgeries.

Family History:

Social History: Single and lives with family; non-smoker; drinks occasionally

Physical: BP 124/70; P 71; R 19; Temp: 36.8

Neuro: Alert and oriented to person, place, appropriate behavior for age. No c/o of dizziness, headache, memory loss, loss of consciousness. No paralysis noted. Pupils are reactive to light and equal. No vision or hearing loss, Speech clear.

Cardiac: Regular heart rate and Rhythm. Peripheral pulses palpable in both upper and lower extremities. No edema noted.

Respiratory: Lungs clear. No shortness of breath noted. Oxygen saturation 99% on room air. Capillary refill less than 3 seconds.

GI: Abdomen non-distended, non-tender, active bowel sounds in all 4 quadrants. No nausea or vomiting. No complaints of constipation or diarrhea, frequency normal.

GU: No urinary incontinence, urgency or changes in urine output.

MU: Pain to left knee with rest and movement. Swelling noted to left knee. Normal range of motion to R/L upper extremities and right lower extremity.

Nursing Diagnosis:

Risk for injury related to lack of knowledge of postoperative exercises related to no previous exposure.

Signs and Symptoms: Before discharge patient states to the nurse " I don't remember all the exercise and do I have to continue them at home?"

Plan:

1.After teaching patient will correctly demonstrate post operative exercises

2. After teaching Patient will list three benefits of continuing post operative exercises at home.

3. Patient will relate his opinions on why the exercises are important to keep doing after discharge. Level on performing the post op exercises

Implementations:

1. After teaching patient will correctly demonstrate postoperative exercises

Exercises demonstrated are:

Ankle pumps: by pumping your foot forward and back

Gluteus squeeze: by squeezing and holding your gluteus for 3 seconds then releasing.

Quad muscles: by tightening the thigh muscle and pushing back on knee against bed holding this position for 3 seconds then releasing

Short Arc Quads: by taking a towel and rolling it under thigh and lifting foot straight up off bed at the same time don't lift thigh off roll and hold this position for 3 seconds.

Heel Slides" by taking the bottom of heel and sliding it toward your gluteus and bending knee at the same time.

Straight Leg Raise: by taking the affected leg and slowly raise leg 8-12 inches off the floor.

Discussion was presented in an audiovisual demonstration, handout was also provided.

2. After teaching Patient will list three benefits of continuing post operative exercises at home.

Pt will verbally state three measures:

1. By exercising the affected leg this will increase the blood flow to the muscle and bone to aid in recovery

2. The exercise will keep my joints mobile

3. Exercising will also keep muscle tone to the affected knee

3. Patient will relate his opinions on why the exercises are important to keep doing after discharge. Level on performing the post op exercises

Evaluation:

Learning Needs:

Learning style

Learning Need

Describe setting

[Daytonite, BSN, RN]

a written teaching plan goes something like this:

1. overview: a synopsis about what is going to be taught in the course
   
2. goal(s): the aim(s) or outcome(s) that you want your learner to achieve as a result of the lesson you plan
   
3. objectives: the more specific information that the learner will come away from the course knowing that will achieve the goal(s) you have determined.
   
4. content: a play-by-play of the specific content that is going to be taught and in the sequence it will happen. your content should address and cover all the objectives. this part of the written lesson plan is presented in an outline format.
   
5. procedures and materials: how all the above will be achieved, i.e. lecture, demonstration, discussion, etc. materials that can be used and resources that can be needed for the lesson to be successful and essential to teaching your lesson plan are listed and may include demonstrations, audio-visuals, handouts, experiments, stories, game playing and any number of other creative items.
   
6. evaluation: determining if you met the goals of the teaching plan. this can be done through a return demonstration, short post test, short question and return answer session with the client to verify they understand the information correctly or a task the participant needs to perform.
   

as you can see, it very much follows the steps of a care plan. however, the teaching plan itself becomes a nursing intervention of a nursing diagnosis. the nursing diagnosis you are choosing is:

risk for injury related to lack of knowledge of postoperative exercises related to no previous exposure.

• wasn't the patient already injured in the motor scooter accident and had to have surgery?
  
  
• lack of knowledge of postoperative exercises related to no previous exposure
  does not sound like a risk factor for a
  physical
  injury; this diagnosis has to do with
  potential physical
  injury to the body. it does not make sense that not knowing how to do postoperative exercises is going to be a cause of physical injury to someone. how can you explain that?
  
  
• since you are focusing on teaching, a better diagnosis would be
  deficient knowledge, postoperative exercises related to lack of information aeb patient stating to the nurse before discharge "i don't remember all the exercises, and do i have to continue them at home?"
  or your teaching plan can be included along with other nursing interventions for assessment, care and management of
  impaired physical mobility related to musculoskeletal impairment secondary to arthritis, physical trauma and surgery aeb
  [signs and symptoms of the limited knee movement]. there are 4 types of nursing interventions and your teaching plan would come under educating the patient:
  
  
  • assess/monitor/evaluate/observe (to evaluate the patient's condition
    
    
  • care/perform/provide/assist (performing actual patient care)
    
    
  • teach/educate/instruct/supervise (educating patient or caregiver)
    
    
  • manage/refer/contact/notify (managing the care on behalf of the patient or caregiver)
    
    

read the teaching plan detail above. not all of your teaching plan information is detailed enough or organized. look at the syllabus and teaching plans your instructors have given you. you are going to do something similar although not as long. you will need to do a search of the internet for specific post-op exercises that you can print out and attach to your care plan since you mention you are giving him a handout. that handout should be attached to the care plan. i am guessing that you will probably find this information on a hospital outpatient library site such as the university of pittsburgh medical center health library - http://www.upmc.com/healthatoz/pages/home.aspx - see links at left (diseases and conditions. procedures, patient education materials, etc.) i have found beautiful printable pages there for crutch walking and other orthopedic procedures before. other hospitals that you can explore for information are on this thread: https://allnurses.com/nursing-student-assistance/medical-disease-information-258109.html - medical disease information/treatment/procedures/test reference websites

1.after teaching patient will correctly demonstrate post operative exercises

2. after teaching patient will list three benefits of continuing post operative exercises at home.

3. patient will relate his opinions on why the exercises are important to keep doing after discharge. level on performing the post op exercises

this is how you are going to evaluate if your teaching goals were met.

implementations:

1. after teaching patient will correctly demonstrate postoperative exercises

exercises demonstrated are:

ankle pumps: by pumping your foot forward and back

gluteus squeeze: by squeezing and holding your gluteus for 3 seconds then releasing.

quad muscles: by tightening the thigh muscle and pushing back on knee against bed holding this position for 3 seconds then releasing

short arc quads: by taking a towel and rolling it under thigh and lifting foot straight up off bed at the same time don't lift thigh off roll and hold this position for 3 seconds.

heel slides" by taking the bottom of heel and sliding it toward your gluteus and bending knee at the same time.

straight leg raise: by taking the affected leg and slowly raise leg 8-12 inches off the floor.

this is all teaching content and should be part of your nursing interventions.

discussion was presented in an audiovisual demonstration, handout was also provided.

discussion, audiovisual demonstrations and handouts are part of your teaching interventions.

2. after teaching patient will list three benefits of continuing post operative exercises at home.

pt will verbally state three measures:

1. by exercising the affected leg this will increase the blood flow to the muscle and bone to aid in recovery

2. the exercise will keep my joints mobile

3. exercising will also keep muscle tone to the affected knee

these are the goals, or outcomes, you want your learner to achieve.

3. patient will relate his opinions on why the exercises are important to keep doing after discharge. level on performing the post op exercises

- this is part of your evaluation process

learning needs:

part of your initial assessment (step #1 of the nursing process) in initially determining that there is a learning need in the first place. what cues (evidence) do you have that the patient needs any kind of teaching? (ex:

before discharge patient states to the nurse " i don't remember all the exercise and do i have to continue them at home?".

)i think it's also important to note that he is 63 years old and also has arthritis. what was a 63 year old man with arthritis of the knee doing on a scooter?

learning style:

this is another assessment item. ask how he learns best: see

procedures and materials

above.