FoN Ch 25

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Maintenance and promotion of health and illness prevention:
The nurse is a visible, competent resource for patients who want to improve their physical and psychological well-being. IN the school, home, clinic, or workplace, nurses provide information and skills that allow patients to assume healthier behaviors.
Restoration of health:
As the nurse, you learn to identify patients’ willingness to learn and motivate interest in learning. Injured or ill patients need information and skills to help them regain or maintain their levels of health.
Coping with impaired functions:
New knowledge and skill are often necessary for patients to continue ADLs and learn to cope with permanent health alterations.
Interactive process that promotes learning
Acquisition of new knowledge, behaviors, and skills
Learning objective
Describes what the learner will be able to do after successful instruction
Cognitive learning
knowledge, comprehension, application analysis, synthesis and evaluation
Affective learning
Receiving, responding, valuing, organizing, and characterizing
Psychomotor learning
Integration of mental and muscular activity, ranging from perception to origination
Attentional set
The mental state that allows the learner to focus on and comprehend a learning activity
Force that acts on or within a person, causing the person to behave in a particular way
A person’s perceived ability to successfully complete a task
List the five stages of adaptation to illness and grief:
1. Denial or disbelief
2. Anger
3. Bargaining
4. Resolution
5. Acceptance
TJC’s SPEAK UP Initiative’s helps patients understand their rights when receiving medical care.
S-Speak up if you have questions or concerns
P- Pay attention to the care you get
E- Educated yourself about your illness
A- Ask a trusted family member or friend to be your advocate
K- Know which medicines you take and why you take them
U- Use a hospital, clinic, surgery center, or other type of health care organization that has been carefully evaluated
P- Participate in all decisions about your treatments
Learning in children:
depends on the child’s maturation; intellectual growth moves from the concrete to the abstract as the child matures. Information presented to children needs to be understandable and based on the child’s developmental stage.
Adult learning:
tend to be self-directed learners; they often become dependent in new learning situations. The amount of information provided and the amount of time varies depending on the patient’s personal situation and readiness to learn/
Physical capability:
To learn psychomotor skills, the following physical characteristics are necessary: size, strength, coordination, and sensory acuity.
The nursing process requires:
assessment of all sources to date to determine a patient’s total health care needs
The teaching process focuses on:
the patient’s learning needs and willingness and capability to learn
Learning needs:
– information or skill needed by the patient to perform self-care and to understand the implications of a health problem
– patient’s experiences that influence the need to learn
– information that the family members require
Motivation to learn:
– behavior
– health beliefs and sociocultural background
– perception of severity and susceptibility of a health problem and the benefits and barriers to treatment
– perceived ability to perform behaviors
– desire to learn
– attitudes about providers
– learning style preference
Ability to learn:
– physical strength, movement, dexterity and coordination
– sensory deficits
– reading level
– developmental level
– cognitive function
– physical symptoms that interfere
Teaching environment:
– distractions or persistent noise
– comfort of the room
– room facilities and available equipment
Resources for learning:
– willingness to have family members and others involved in the teaching plan
– family members’ perceptions and understanding of the illness and its implications
– financial or material resources
– teaching tools
Functional illiteracy
is the inability to read above a fifth-grade level
Describe how the nurse would define the problem. (Nursing Diagnosis)
The nurse assess information related to the patient’s ability and need to learn and interprets data and cluster defining characteristics to form diagnoses that reflect the patient’s specific learning needs. This ensures that teaching will be foal directed and individualized.
Setting priorities:
should be based on the patient’s immediate needs (perception of what is most important, anxiety level, and amount of time available) nursing diagnoses, and the goals and outcomes established for the patient
Time the teaching for when a patient is most attentive, receptive and alert and organize the activities to provide time for rest and teaching learning interactions
Organizing teaching material:
into a logical sequence progressing from simple to complex ideas
the nurse outlines the task the patient will perform and gives explicit instructions
the nurse and the patient set objectives and become involved in the learning process together
provides the patient with the opportunity to manage self-care
using a stimulus that increases the probability for a response
One-on-one instruction
most common method of instruction
Group instruction
economical way to teach a number of patients at one time
Return demonstration
the chance to practice the skill
supplement verbal instruction with familiar images
Role play
people play themselves or someone else
the nurse poses a pertinent problem or situation for patients to solve, which provides an opportunity to identify mistakes
Identify the nurse’s responsibility in evaluating outcomes of the teaching process:
The nurse is legally responsible for providing accurate, timely patient information that promotes continuity of care. Documentation of patient teaching supports quality improvement efforts and promotes third-party reimbursement.
An internal impulse that causes a person to take action is:
Demonstration of the principles of body mechanics used when transferring patients from bed to chair would be classified under which domain of learning?
Which of the following patients is most ready to begin a patient-teaching session?
Mr. Jones, a patient who had a heart attack 4 days ago and now seems somewhat anxious about how this will affect his future
The nurse works with pediatric patients who have diabetes. WHich is they youngest age group to which the nurse can effectively teach psychomotor skills such as insulin administration?
School age
Which of the following is an appropriately stated learning objective for Mr. Ryan, who is newly diagnosed with diabetes?
Mr. Ryan will perform blood glucose monitoring with the EZ-check monitor by the time of discharge.
A patient needs to learn to use a walker. Which domain is required for learning this skill?
Psychomotor domain
The nurse is planning to teach a patient about the importance of exercise. When is the best time for teaching to occur?
– When the patient’s pain medications are working
– Just before lunch, when the patients is most awake and alert
A patient newly diagnosed with cervical cancer is going home. The patient is avoiding discussion of her illness and postoperative orders. What is the nurse’s best plain in teaching this patient?
– Provide only the information that the patient needs to go home
The school nurse is about to teach a freshman-level high school health class about nutrition. What is the best instructional approach to ensure that the students meet the learning outcomes?
Develop topics for discussion that require problem solving
A nurse is going to teach a patient how to perform breast self-examination. Which behavioral objective does the nurse set to best measure the patient’s ability to perform the examination?
The patient will perform breast self-examination correctly on herself before the end of the teaching session
A patient with chest pain is having an emergency cardiac cauterization. Which teaching approach does the nurse use in this situation?
Telling approach
The nurse is teaching a parenting class to a group of pregnant adolescents. The nurse pretends to be the baby’s father, and the adolescent mother is asked to show how she would response to the father if he gave her a can of beer. Which teaching approach is this?
Role play
An older adult is being started on a new antihypertensive medication. In teaching the patient about the medication the nurse:
Allows the patient time to express himself or herself and ask questions
A patient needs to learn how to administer a subcutaneous injection. Which of the following reflects that the patient is ready to learn?
Expressing the importance of learning the skill correctly
A patient who is hospitalized has just been diagnosed with diabetes. He is going to need to learn who’s to give himself injections. Which teaching method does the nurse use?
When a nurse is teaching a patient about how to administer an epinephrine injection in case of a severe allergic reaction, he or she tells the patient to hold the injection like a dart. Which of the following instructional methods did the nurse use?
A nurse needs to teach a young woman newly diagnosed with asthma how to manage her disease. Which of the following topics does the nurse teach first?
How to use an inhaler during an asthma attack
A nurse is teaching a group of young college-age women the importance of using sunscreen when going out in the sun. What type of content is the nurse providing?
Health promotion and illness prevention
A nurse is planning a teaching session about healthy nutrition with a group of children who are in first grade. The nurse determines that after the teaching session the children will be able to name three examples of foods that are fruits. This is an example of:
A learning objective
A nurse is teaching a 27-year-old gentleman how to adjust his insulin dosages based on his blood sugar results. What type of learning is this?

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