Patient education and BSE/TSE
how often should women ages 20-39 have a clinical breast exam
1-3 years
how long should teaching session length be so patient can digest info and precent them from becoming too tired
15- 30 minutes
how often should you receive a mammogram
45-54 yearly 55 and over every 3 years
what is an example of nursing process involving learning
A: pt concerned treatment isn't working, once per week, demonstrate incorrect use of inhaler ND: knowledge deficit R/T incorrect use of inhalerAEB pt using inhaler incorrectly, coming to office because treatment isn't working P: goal- pt will be able to do a return demonstration of inhaler correctly prior to discharge I: demonstrate correct use of inhaler R- providing multiple layer in which knowledge is taught keeps pt engaged E: goal met- pt able to return demonstrate correctly use of inhaler at discharge. pt feels better about treatment plan
who came up with learning styles
Fleming
why can gynecomastia happen in older men
Pituitary tumors testicular tumors meds with estrogen
what are various learning styles (vark)
Visual Auditory/ aural Reading Kinesthetic
may need to provide more details about treatments- mutual goals and know why they need to know or do something
adults
includes changes in attitudes values and feelings
affective domain
what is an example of documentation of teaching
after 2 demonstrations, the pt is able to correctly and safely perform administration of SQ insulin based on am blood sugar
what is an example of psychomotor domain
after you demonstrate how to walk in crutches- patient knows how to do it
how can nurses address to health literacy
all written material understood at 5th grade reading level ask me 3 teach back method
brief tool to promote understanding and improve communication between patients and caregivers
ask me three
learning through hearing and discuss things and concepts- use of a tape recorder, discussions with students and teachers, lectures, and tutorials
aural learners
what are lymph nodes that drain breasts
axillary (>75% lymph in body drain into) supraclavicular infraclavicular
what happens if lymph nodes can be palpated at supraclavicular node
breast or lung cancer
what is a useful screening tool for breast cancer
breast self exam
what program can help a patient cope
cancer association
how can nurses evaluate themselves as educators
changes and revisions patient feedback
storing and recalling of new knowledge in the brain
cognitive domain
what are the three learning domains
cognitive, psychomotor, affective
family support- family place distance from help treatment at home etc
compliance (assessment)
agreement between two people for common goal
contract agreement
demonstration of techniques procedures and use of special equipment; useful in psychomotor domain of learning- perform a skill
demonstration
what is the goal of patient education
develop self care abilities to maximize their function and quality of life
what are methods of evaluation
direct questions observations return demonstrations
situation is presented and discover solution or approach; useful when teaching problem solving techniques and independent thinking
discovery
what teaching methods can be used in cognitive domain
discussion handouts readings audiovisual
two way exchange of info ideas and feelings between teacher and learner; effective when nurse is comfortable with material or one on one instruction
discussion/ panel discussion
what involving nipples may indicate CA
drainage retraction (recent change)
lymph channels blocked by CA
edema
what are alterations in breasts
edema peau d'orange areolas nipples
prefer learning based on experience- focus on wellness and personal strengths; accommodate needs
elderly
lets the nurse and patient know how well the learning objectives were met
evaluation
what is crucial in documentation of teaching
evaluation statement- must show concrete evidence that demonstrates learning occurred
how can patient education maintain and promote health
exercise programs and healthy eating
what is a main responsibility of nurses for teaching
good health behavior- breast and testicular self examination
enlargement of male breasts due to hormones in puberty/ adolescence, T deficiency, and certain meds
gynecomastia
what are atypical of metastasis
hard fixed nodes
the ability to read understand and act on health information
health literacy
how can patient education facilitate coping
helping a patient deal with permanent health alterations (provide environment to vent) adapt to assistive devices
teaching is directed toward parents
infants
what are causes of lymphadenopathy
infection autoimmune disease Malignancy
what are landmarks of breast
inner and outer quadrants
active participation and willing participate
interactive teaching- learning relationship
learning from and by experience uses their senses- field trips, lecture with real life examples, labs, simulations, and trial and error
kinesthetic learners
what are nursing diagnosis of learning
knowledge deficit R/T lack of info related to health status readiness for enhanced knowledge R/T express interest about learning of meds impaired health maintenance R/T inefficient knowledge regarding tobacco use non compliance R/T non participation in therapy
the process by which a person acquires or increases knowledge or changes behavior in a measurable way as a result of the Experience
learning
who are you teaching cultural and language barriers
learning ability (assessment)
what is an example of cognitive domain
learns about new medication- learn how and when to take it
formal presentation and can be time consuming; used for presenting to large group of patients
lecture
what groups lack health literacy skills
lower economic status minorities
enlarged lymph nodes; may be seen with cancer
lymphadenopathy
what are terms R/T breasts
lymphadenopathy gynecomastia
what are the goals of patient education
maintaining and promoting health preventing illness restoring health facilitating coping
what should you not use when teaching patient
medical jargon
why is self breast exam important
most breast cancer discovered by slef most breast lumps are benign (80%) 1 in 8 women will get breast cancer excellent chance for cure with early treatment
leads to better compliance- able and motivated to process new info and skills
motivation (assessment)
what should nurses attitude be during learning
nonthreatening interesting and enjoyable- respect simple interactive- cheerleader
what is the implementation step of nursing process in learning
nurse attitude/ effective communication environment timing teaching session length patient comfort level
what is an example of affective domain
nurse is teaching and encourages patient to discuss feelings pt wonders what kind of scar they will have after surgery
identify specific attainable measurable short term goals for patient leaning - which domain of learning is involved -prioritize -content and appropriate teaching strategies - relate the teaching content to the patients learning style - formulate a verbal or written contract with pt
outcome identification and planning
what physical state should patient NOT be in to learn
pain or discomfort
what should be included in health history of breast exam
pain, tenderness- period Hx of lumps or skin changes discharge from nipples-unless breastfeeding rashes swelling trauma family hx of breast disease surgery- if lymph nodes removed can be result in buildup self care axillary changes
what should you avoid involving timing when teaching
patient eating or expecting visitors
process of influencing the patients behavior to effect changes in knowledge skills and attitudes needed to maintain and improve health
patient education
what are qualities of a teaching- learning relationship
patient focused holistic interactive
orange peel appearance caused by metastatic disease blocking lymph nodes
peau d'orange
who is NOT at average risk for breast cancer
personal history family history genetic mutation for breast cancer chest radiation therapy before age of 30
what teaching methods can be used in psychomotor domain
physical manipulation Demonstration
how can patient education restore health
post op teaching (deep breathing after surgery)
always person to perform skill over and over again until its mastered
practice
pamphlet and brochure at no cost- assess ability to read
printed material
used independently of teacher but discuss before and after and allow time to ask questions; useful because patient can go at own pace
programmed instruction
learning a physical skill involving integration of mental and muscular activity
psychomotor domain
what should the environment be during learning
quiet slow speaking
how should students learn
read listen to instructor teach watch demonstration practice
learning through anything in print- manuals lists textbooks, take notes verbatim, and like to write as well
readers
what is indicative of pageants disease
red and crusty areolar
tumor attacks duct behind nipple pulling it in
retraction
patient watch nurse closely to copy activity ex: nurse who smoked in the past quit can be role models
role modeling
what are teaching strategies
role modeling lecture discussion/ panel discussion demonstration discovery role playing printed material programmed instruction web- based instruction
used with children; useful when reducing anxiety because child is used to these things ex: parent being patient and child doctor
role playing
what teaching methods can be used in affective domain
role playing values clarification
when should a self breast exam be done
same time every month about one week after period after menopause, check first day of every month
answer questions honestly- assess ready to learn
school age children
what steps can you take to apply client / patient centered care
start with something the learner is concerned with -discover what the learner knows -teaching simple to complex -schedule time for review of content
what four things are involved in learning
study instruction reflection practice
how can you document teaching
summary of learning need the plan Implementation of the plan evaluation result
allows patient to repeat back key concepts from teaching session to confirm understanding
teach back method
allow them in decision making
teenagers
incorporate role playing; teach to children but direct towards parents
toddlers and preschoolers
what is the site of most breast tumors
upper outer quadrant
how can patient education prevent illness
vaccines and teaching high risk individuals how to avoid illness
learning with pictures maps and graphs to explain things
visual learners
Appropriate for patient seeking info about disease process wellness interest or health promotion; useful because it can be accessed 24/7 and discuss with other patients but be sure they are reputable
web based instruction
what three questions make up ask me three tool
what is my main problem what do I need to do why is it important for me to do this
what is the step of assessment in patient education
what needs taught and how physical condition learning ability motivation compliance
how can you control patient comfort level
without pain nausea or SOB
how often should clinical breast exams happen age 40 and older
yearly
