Test 1 Flashcards
- Know the purposes of patient education.
You will not always be there to control their health and daily activities, you want to educate the patient so they learn how to do things for themselves and take care of themselves effectively so as they can live as healthy and happy as possibly. Include maintenance and promotion of health and illness prevention, restoration of health, and coping with impaired functions.
- Know what best indicates that learning has occurred 329
Having the patient tell you what they have learned, demonstrate procedure back to you, or describe what they are still unclear about
- Differentiate between the learning domains: Cognitive / Affective / Psychomotor 330-331
Cognitive is the thinking domain. Includes all intellectual behaviors, includes knowledge, comprehension, application, analysis, synthesis, and evaluation. Affective is the feeling domain, and deals with expression of feelings and acceptance of attitudes, opinions, or values. Includes receiving, responding, valuing, organizing, and characterizing. Psychomotor is the skill domain, and involves acquiring skills that require integration of mental and muscular activity. Includes perception, set, guided response, mechanism, complex overt response, adaptation, and origination.
- Know the different teaching strategies for different stages of development 334 Toddlers and Preschoolers
Toddlers and Preschoolers: Keep it brief, let them handle the equipment if possible and safe, look and pay attention to body language.
- Know the different teaching strategies for different stages of development 334 School age children
School age children: Encourage them to express emotions, use coloring books, story books, dolls and puppets, all can be useful for children to learn.
- Know the different teaching strategies for different stages of development 334 Adolescents
Adolescents: Prefer to learn without parents around, identify best with peers, teach to a group can be an effective way to facilitate learning, concerned about appearance.
- Know the different teaching strategies for different stages of development 334 Young and Middle aged adults
Young and Middle aged adults: Not interested in learning about other people’s problems, important to explain how lifestyle has long-term affects on health. Encourage participation in teaching plan by setting mutual goals, encourage independent learning.
- Know the different teaching strategies for different stages of development 334 Elderly
Elderly: Motivated to learn new techniques and procedures that promotes independence and ease, may have decreased manual dexterity, decreased sense of touch, vision, and/or hearing, also may have many chronic conditions such as arthritis or neuropathy. Teach when alert and rested, involve in discussion, focus on wellness and strength, keep lessons short.
- Know how to determine a patient’s ability to learn? 332-334
Developmental capability of patient determines ability to learn. Need to know level of knowledge of patient in order to make an efficient lesson plan, learning is better when new information complements prior knowledge. Be considerate of age as well, as different developmental stages require different abilities to learn. Physical capability also factors in, especially depending upon what is being taught. Physical characteristics such as size, strength, coordination, and sensory acuity factor into psychomotor skills. Any condition that impairs energy and physical level also impairs ability to learn. Lastly, the environment plays a role in whether the patient will have a difficult or pleasant time learning.
- Know how to determine when the patient is ready to learn 332| 334
Readiness to learn is the demonstration of behaviors or cues that reflect the learner’s motivation to learn at a specific time. Attention set, motivation, and self-efficacy factor into the patient’s readiness to learn.
- Differentiate between the nursing process and the teaching processes 335 Assessment
Assessment: Nursing process includes collecting data about physical, psychological, social, cultural, developmental, and spiritual needs from the patient, family, medical records, diagnostic tests, literature, and nursing history. The teaching process includes gathering data about patients learning needs, motivation, ability to learn, and teaching resources from patient, family, learning environment, medical record, nursing history, and literature.
- Differentiate between the nursing process and the teaching processes 335 Diagnosis/Analysis
Nursing Diagnosis: In nursing process, this is identifying appropriate nursing diagnosis based on assessment findings. In teaching process, this is identifying patients learning needs on the basis of the three domains of learning.
- Differentiate between the nursing process and the teaching processes 335 Planning
Planning: Nursing process including developing individualized care plan, set diagnosis priorities based on immediate needs, expected outcomes, and patient-centered goals, as well as collaborating with patient on care plan. In the teaching process, this is establishing learning objectives stated in behavioral terms, identifying priorities regarding learning needs, collaborating with patient about teaching plan, and identifying type of teaching method to use.
- Differentiate between the nursing process and the teaching processes 335 Implementation
Implementation: Nursing process includes performing nursing care therapies, include patient as active participant in care, involving family in care when appropriate as well. The teaching process is implementing teaching methods, actively involving patient in learning activities, and including family caregiver as appropriate.
- Differentiate between the nursing process and the teaching processes 335 Evaluation
Evaluation: Nursing process is identifying success in meeting desired outcomes and goals of nursing care, and altering interventions as indicated when goals are not met. Teaching process is determining outcomes of teaching-learning process, measure patient’s achievement of learning objections, and reinforce information as needed.
- Know the four steps of the teaching process 335
- Assess learning readiness a. Would you like to know more? I would like to share this with you… 2. Assess what the client knows as a baseline a. Ask what they know about the topic 3. Teach simple to complex 4. Evaluate knowledge learned a. Repeat information b. Return demonstration
- Know what is needed in defining learning objective/outcome 338
In setting goals and outcomes, setting priorities is based on the immediate needs of the patient, as well as what the patient perceives as most important to learn, and his/her readiness to learn. Setting priorities includes timing of teaching and organizing teaching material. Outcomes are the expected knowledge gain the patient will experience, and be able to use and apply to their health care.
- Know how to assessing the ability to learn 332| 336
Determine the patient’s physical and cognitive ability to learn. Health care providers often underestimate patients’ cognitive deficits. Many factors impair the ability to learn, including fatigue, body temperature, electrolyte levels, oxygenation status, and blood glucose level. In any health care setting several of these factors often influence a patient at the same time. Assess the following factors related to the ability to learn:
- Physical strength, endurance, movement, dexterity, and coordination—Determine the extent to which the patient can perform skills. For example, have the patient manipulate equipment that will be used in self-care at home.
- Sensory deficits (see Chapter 49) that affect the patient’s ability to understand or follow instruction
- Patient’s reading level—This is often difficult to assess because patients who are functionally illiterate are often able to conceal it by using excuses such as not having the time or not being able to see. One way to assess a patient’s reading level and level of understanding is to ask the patient to read instructions from an educational handout and then explain their meaning (see the discussion of health literacy, p. 337).
- Patient’s developmental level—This influences the selection of teaching approaches (see Box 25-3).
- Patient’s cognitive function, including memory, knowledge, association, and judgment
- Pain, fatigue, anxiety, or other physical symptoms that interfere with the ability to maintain attention and participate—In acute care settings a patient’s physical condition can easily prevent a patient from learning. (Potter 336)
- Know safety concerns when administering sub Q injections daily 571-572
Risk of introducing infection, medications can be expensive, pain experienced from repeated needle sticks, not best method for patients with bleeding issues, risk of tissue damage, can cause anxiety. Sterile abscesses can form when medication sits under skin.
- Know what a “Z-track” is and why it may be used 629
Holding the skin back when injecting so that the release of the skin upon completion of injection and removal of needle forms a seal that keeps the medication in the desired area, instead of accidently coming back out of the injection site. Used also to minimize local skin irritation.
- Know how to calculate infuse rates 573-577
Simple mathematical calculations to determine how much medication is given to the patient based on the order and the medication disbursement amount. Metric system is used, calculations done for all forms of medication routes. If liquid, make sure to incorporate liquid amount (mL) into calculation, so you know how much medication the patient is receiving per amount of liquid given in order to administer correct amount.
- Know the about aspiration on IM injections 601-609
Aspiration during IM medications indicate whether you are injecting the medicine correctly into the muscle. If blood appears, dispose of needle and medication, redraw up a new dosage.
- Know the procedure for intra dermal injections 604-605
Used for skin testing, injected into dermis. Sites should be lightly pigmented, free of lesions, and relatively hairless. Inner forearm and upper back are ideal locations. Use tuberculin or small hypodermic syringe, at an angle of 5-15 degrees with the bevel of the needle pointing up. As you inject, a small bleb will appear on surface of skin. If bleb does not appear or is site bleeds after needle is removed, there is a good chance you entered sub Q tissue, if this is the case results will not be valid.
- Differentiate between the rates of absorption of different administration methods 567-570
Medications on the skin absorb slow due to physical makeup, medications placed on mucous membranes and respiratory airways are absorbed quickly because these tissues contain many blood vessels. IM is a fairly quick method of absorption. Oral administration absorption rates are slow because it passes through the GI tract. IV injection is the most rapid because it immediately enters the systemic circulation.
- Know what to do when you question about a medication order 584-588
Go through the 6 rights, ask a colleague to check your work/calculations, always use critical thinking and be knowledgeable about the medication you are administering. Polly Molly Dolly rode the trolly. Patient, Meds, Dosage, Route, Time, Documentation, Why taking meds Do this check 3 times: before getting meds, at meds cabinet, at patient’s bedside
Ex: Physician’s order for X oral suspension with concentration of 1 mg / 5 mL, need 80 mcg per kg of patient’s weight, patient is 155 lbs. Systolic blood pressure must be over 90 to give. How much mL of X to give.
