Teaching and Learning
Motivation to learn
Attention Includes discomfort, anxiety and environmental distractions Behavior, attention span, tendency to ask questions, memory, ability to concentrate Health beliefs, sociocultural background Perception of the severity and susceptibility of a health problem
A nurse is educating a 4-year-old client about cast care following a tibia-fibula fracture. Which action is not developmentally appropriate to include in the nurse's teaching?
Blocking 30 minutes of time for skill teaching
Implementation Maintaining learning attention
Build on existing knowledge Use active participation Incorporate teaching in nursing care
The nurse is preparing to teach a client from Generation X about hypertension. Which teaching approach should the nurse plan to implement?
Demonstrate the MyFoodPyramid phone app, to show the best food choices on a lunch tray.
A nurse is teaching a 5-year-old boy who was recently diagnosed with type 1 diabetes. The client's mother, who is the primary caregiver, informs the nurse of having a fear of needles. What actions are appropriate for the nurse to take to ensure a successful education session? Select all that apply.
Ensuring 20 minutes of uninterrupted teaching time Using a doll to demonstrate giving an insulin injection Providing the client's mother with an informational pamphlet about insulin injection
Implementation Maintaining learning attention
Instructional methods Choose methods to meet patient's needs, the time available, the setting, the resources available. Patients perceive nurses as experts Types of instructional methods Preparatory instruction One-on-one discussion Analogies
Which developmental consideration is a nurse assessing when determining that an 8-year-old child is not equipped to understand the scientific explanation of the child's disease?
Intellectual development
Assessment
Learning needs must be identified Expectations of learning needs to be assessed Learning needs Determine what is need to know vs. nice to know Learning needs - change
A nurse may attempt to help a client solve a situational crisis during what type of counseling session?
Short-term counseling Short-term counseling would help a client solve a situational crisis. A client experiencing a developmental crisis, for example, might need long-term counseling. Motivational counseling is an evidence-based counseling approach that involves discussing feelings and incentives with the client. Professional counseling is a general term.
The nurse needs to understand the teaching-learning process when administering
educational interventions
Non-adherence
is generally a term which includes unintentional refusalby the patient (i.e. patient is overwhelmed, does not understand, helpless, confused, and/or concerned with healthcare costs). Несоблюдение
learning readiness
patient's willingness to engage in the teaching-learning process (emotional readiness) and experiential readiness to begin the challenge of learning
Formal Teaching
planned teaching based on learner objectives
cognitive learning
storing and recalling of new knowledge in the brain
informal teaching
unplanned teaching sessions dealing with the patient's immediate learning needs and concerns
The nurse is caring for a client who demonstrates a health literacy concern. The nurse adjusts client teaching in which way?
uses videos, diagrams, and pictures rather than focusing on verbal teaching
When preparing client teaching materials, how does the nurse best assess a client's preferred learning style?
Ask the client, "Do you learn best by observing, valuing, or doing?"
When deciding what information, the client needs to meet the learner objectives successfully, the nurse is formulating which part of the teaching plan?
Content
When a client says, "I don't care if I get better; I have nothing to live for, anyway," which type of counseling would be appropriate?
Motivational counseling
Nursing Diagnosis
Name diagnosis Use language that defines the Name diagnosis Use language that defines the diagnosis Demonstrates to what it is related Knowledge deficit - regarding the use of crutches - related to lack of experience
A home health nurse states to her client, "I am very proud of you. You gave your first insulin injection without a problem. You have done wonderfully and are learning fast." What technique is the nurse using to compliment the client's progress?
Positive feedback
Topics for Health Teaching and Counseling
Promoting Health Preventing Illness Restoring Health Facilitating Coping Содействие преодолению поиск эмоциональной и практической поддержки со стороны других» — как важнейшая стратегия поддержания семейной заботы о людях с деменцией.
Learning
Purposeful acquisition of new knowledge, attitudes, behaviors and skills
Which observation during the nursing assessment of a client supports the documentation of low health literacy?
The client avoids health care screenings and seeks care in the local emergency department.
Counseling
giving guidance, assisting with problem solving
compliance
act of completing what is expected of one
Which documentation example best reflects the complexity of client teaching by the nurse?
"Client and spouse taught how to use phone app to count carbohydrates; client return demonstrated carb counting for a hypothetical meal."
Which response from the client enables the nurse to determine the effectiveness of a recent medication teaching session for an older adult client who is diagnosed with tuberculosis (TB)?
"I will be taking the TB medication for at least 6 months, because it takes a long time to kill the TB germs."
Implementation Maintaining learning attention Instructional methods
Demonstrations Most useful for psychomotor skillsUse return demonstration Be organized Important learner can see step by step Review rationale and steps Encourage questions
Teaching
Interactive and deliberate process Helps individuals to gain knowledge, change attitudes, adopt new behaviors and perform new skills
affective learning
changes in attitudes, values, and feelings
A nurse is counseling several clients for depression. Four of them do not seem to be improving, which leads the nurse to suggest a referral to a psychiatric nurse practitioner. Which of these clients would be most likely to attend the scheduled appointment?
A 28-year-old female who works nights, is willing to try, and asks about insurance coverage of the appointment
Blocking 30 minutes of time for skill teaching
A 28-year-old female who works nights, is willing to try, and asks about insurance coverage of the appointment
Domains of Learning
Bloom identified three domains of learning The characteristics of each domain influence the teaching and evaluation methods chosen
The nurse is completing documentation after an education session with a client. Which statement best demonstrates detailed documentation of an effective teaching plan?
Demonstrated cord care to mother, who stated understanding and performed return demonstration using correct technique.
Implementation
Focus on older adults Begin and end each session with most important Present critical information - emphasize concrete material Repeat information Relate information to life experience Build on existing knowledge Allow clients to progress at their own speed
Standards for Patient Education
Requires: Assessing patient for needs Providing education Collaboration among health professional Considering patient's psych-social, spiritual, cultural values and desires to participate
A nurse is writing learner objectives for a client who was recently diagnosed with type 2 diabetes. Which statement best describes the proper method for writing objectives?
The nurse writes one long-term objective for each diagnosis, followed by several specific objectives.
positive reinforcement
affirmation подтверждение of the efforts of patients
negative reinforcement
an ineffective teaching strategy that uses criticism or punishment
A nurse is trying to encourage a client with paraplegia who is depressed and not adhering to the treatment program to join a support group. Which statement by the nurse is most appropriate?
"What do you know about support groups?"
Assessment
Ability to Learn Physical capability Client's level of physical development or skill Assess client's size, strength, coordination and sensory acuity Any condition that depletes energy
The nurse must instruct a 35-year-old client with Down syndrome about the use of an albuterol rescue inhaler. Which documentation demonstrates appropriate individualization of the education plan for this client?
Assessed the client's understanding of illness; assessed motor skills and developmental stage; provided clarification
Integrating the Nursing and Teaching Process
Assessment-Determine the client's health care needs Diagnosis-The need for education will lead to a nursing diagnosis Implementation- Providing information or learning activities Evaluation-Evaluating the teaching activities and the learning
A client newly diagnosed with insulin dependent diabetes mellitus is preparing for discharge. The nurse prepares a teaching plan.
Cognitive Domain: The client will identify the signs of hypoglycemia, The client will explain the importance of accurate and timely blood sugar monitoring Affective Domain: The client will verbalize concerns regarding insulin administration Psychomotor Domain: The client will demonstrate how to inject insulin
Domains of learning
Cognitive learning: Intellectual behaviors Affective learning: Expression of feelings and acceptance of attitudes, opinions, or values Psychomotor learning: Involves acquiring skills that require the integration of mental and muscular activity
Evaluation
Completes the learning process Purpose of evaluation Reinforces correct behavior Change incorrect behavior Determines adequacy of the teaching Documentation is legally required Meets standards Promotes third-party payments
The parents of a school-age child are meeting with the nurse for health promotional education for their child. The child has the following assessment data: a 7-year-old male with diabetes mellitus type 1 with a hemoglobin A1C level of 8.3%, a body mass index (BMI) of 31.7, and a BMI percentile of 99. What are the most appropriate learning diagnoses for this first session?
Deficient Knowledge: Imbalanced nutrition: more than body requirements, and ineffective health maintenance.
Planning
Develop teaching plan and determine goals Goals and outcome Include the patient and family Nurse sets the minimum criteria for success Setting influences the plan
Purposes of Patient Education
Goal: Assist individuals, families and communities to achieve optimal health Maintenance and promotion of health and illness prevention Nurse is a resource Allows patients to assume more responsibility for their health Greater knowledge results in better health maintenance habits
Patient Education
Health Education often involves -- Changing attitudes and values that are not easy to change by simply providing information or facts
Which statement made by a client who was recently admitted to the medical unit with a diagnosis of pneumonia indicates a physical inability to learn?
I am having difficulty breathing
What is the most appropriate teaching strategy for the nurse to use for a 1-hour presentation on the prevention of osteoporosis to a group of 30 college-age women?
Lecture/discussion
The nurse is preparing discharge teaching for a client with diabetes. Which information should the nurse include? Select all that apply.
Meal planning Community resources Appropriate use of a glucometer Instructions to follow up with the health care provider
Assessment
Motivation to Learn Psychosocial adaptation to illness Changes in health are difficult to accept Patients often need to grieve The process of grieving takes time Readiness to learn is related to the stage of grieving
Assessment
Resources for learning Patient's willingness to have family members and significant others involved Family members' perceptions and understanding Family's or significant other's willingness and ability to participate in care Resources - including financial
Purposes of Patient Education
Restore health Information and skill to help patients regain or maintain level of health Family needs to be included or at least assessed Cope with impaired functioning Patients Families Chronically ill patients often need psychosocial support
The nurse is conducting a community health promotion class and has developed scenarios that will involve active participation by the class attendees. What type of education strategy is the nurse incorporating into this class?
Role-playing
The nurse is providing instructions to a client about performance of breast self-examination. What learning outcome would be most appropriate regarding this education?
The client will be able to perform proper breast self-examination for breast cancer detection and prevention.
Andragogy
andragogy: the study of teaching adults
The nurse is discharging several clients from an acute surgical unit on the same day. The nurse will prioritize discharge teaching based on how much time is required for each client. Place the clients in order, from the client requiring the longest teaching time to the shortest teaching time. Use all options.
client who is learning to draw up and inject insulin for the first time client who indicates the live-in partner is a registered nurse client who is being discharged to a long-term care facility client who is being transferred to another unit in the hospital
contractual agreement
pact made between two persons or parties for the achievement of mutually set goals
adherence
the act of doing something according to a particular rule, adherence standard, agreement
