Patient education assignement..... struggling/need help

Nursing Students Student Assist

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We just got thrown this patient teaching assignment that's due monday, with very little instruction and I'm having a hard time coming up with good answers. Please let me know what you can make of it/point me in the right direction. As you can tell it takes a bit of creativity.

Thanks a lot.. :wink2:

Client Profile:

42 yrs old

Divorced

12 yr old daughter in gr. 6. School 2 blocks from home

Chartered accountant - several small business clients, works out of home

Admitted to a medical unit w/ complaints of intermittent bouts of abdominal pain, diarrhea , and rectal bleeding.

Has had severe diarrhea and weight loss (8 kg over 2 months)

Very pale, tires easily, dehydrated

Dr believes she has Ulcerative Colitis affecting her sigmoid and descending colon.

Dr believes it can be controlled w/ medication. Surgery is not required at this time.

Pt booked for a colonoscopy tomorrow to confirm diagnosis

1-2 days after colonoscopy is to be discharged w/ following meds:

Sulfasalazine, mesalamine, and prednisone

Right now she:

Has an IV of D5NS w KCL meq

Is NPO

To complete the Peg Prep routine for the colonoscopy

Describe what you know/would like to know about the pt that would facilitate your planning

Describe how you would assess the pt's learning needs (what they already know, need to know - demonstrate that you have researched the pt's diagnosis, tests and treatment)

What are the pt's learning needs? Identify ALL of them

Identify 3 priority learning needs and write a nursing diagnosis for each one (3)

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Specializes in med/surg, telemetry, IV therapy, mgmt.

no creativity at all here. you must care plan this. a care plan is a determination of the patient's nursing problems and then coming up with strategies (nursing interventions) to do something about the nursing problems. a teaching plan is one of the strategies (nursing interventions). a written teaching plan goes like this and you can see that it follows the similar steps of the nursing process even though it is an intervention:

  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.

describe what you know/would like to know about the pt that would facilitate your planning

assessment (step #1 of the nursing process) consists of the following:

  • a health history (review of systems) - this information was given to you: 42 yrs old, admitted with complaints of intermittent bouts of abdominal pain, diarrhea, and rectal bleeding. has severe diarrhea and weight loss (8 kg over 2 months). her doctor believes she has ulcerative colitis affecting her sigmoid and descending colon and the plan will be to discharge her on medication to control it. she is dehydrated. she is having a colonoscopy tomorrow to confirm this medical diagnosis.

  • performing a physical exam - you were given the following information and symptoms: abdominal pain, diarrhea, weight loss, pale and tires easily [in case you don't recognize this, it is anemia]

  • assessing their adls (at minimum: bathing, dressing, mobility, eating, toileting, and grooming) - no information provided

  • reviewing the pathophysiology, signs and symptoms and complications of their medical condition - you need to look up information about ulcerative colitis and dehydration, possibly anemia:

you also will need to give nursing interventions for the treatment of the diarrhea and rectal bleeding.

  • reviewing the signs, symptoms and side effects of the medications/treatments that have been ordered and that the patient is taking - the iv, being npo and the prep for the colonoscopy are treatments ordered by the doctor. i am not familiar with this peg prep. i had a colonoscopy in february and a new prep call moviprep was ordered to clean out my bowel. the bowel clean out was started 2 days before the test (day 1 was clear liquids; day 2 was the moviprep) and there was something i had to do every 15 minutes. look up each of the drugs she will be getting. prednisone has some serious side effects she needs to be educated about:

describe how you would assess the pt's learning needs (what they already know, need to know - demonstrate that you have researched the pt's diagnosis, tests and treatment)

you want to assess for and make sure the patient knows the following:

  • i'd be questioning the patient and going through her chart and looking at her medical history to find this information

  • knowledge of their disease, how it is diagnosed and treated

  • any treatments and tests they need to be doing after discharge

  • their diet

  • allowed physical activity

  • medications they need to take

  • referrals to any outside agencies or support groups

  • follow up appointments with the doctor that will be necessary after discharge

  • teaching materials and/or contact with outpatient professionals for continued care and teaching that need to be provided to the patient

what are the pt's learning needs? identify all of them

this is from page 829 of
nurse's 5-minute clinical consult: diseases
:

  • the disorder, diagnosis, and treatment

  • prescribed dietary changes

  • importance of avoiding gi stimulants such as caffeine, alcohol and smoking (refer to a smoking cessation program if indicated)

  • medication administration, dosage and possible adverse affects

  • importance of regular physical examinations

identify 3 priority learning needs and write a nursing diagnosis for each one (3)

deficient knowledge (specify subject)
is used when there is no other nursing problem to attach a teaching subject to. this patient has signs and symptoms of anemia and you were told she is dehydrated, had diarrhea and is being treated medically with iv fluids. the nursing diagnosis for that is
deficient fluid volume
. weight loss is a symptom of
imbalanced nutrition: less than body requirements.
abdominal pain is a symptom of
acute pain
. there are going to be long term side effects from the prednisone that she needs to be told about. be clear in your mind about how the pathophysiology of the chronic inflammation is going to affect the signs and symptoms of this disease (
https://allnurses.com/general-nursing-student/histamine-effect-244836.html
).

these websites tell you about colonoscopies, the preparation for them and what patients need to be taught about them:

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