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Module 1 > IM1-EXAM 5 Material (nutrition, caring, enteral feeding/meds, patient education) > Flashcards

IM1-EXAM 5 Material (nutrition, caring, enteral feeding/meds, patient education) Flashcards

1
Q

What are some environmental factors that influence nutrition? List 5.

A
  1. What is readily available to patients
  2. Lifestyle
  3. Work schedules
  4. Cost
  5. Lack of exercise opportunities
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2
Q

What are some developmental stages that influences nutrition? List 4

A
  1. Infants/toddlers/school-age
  2. Adolescents
  3. Young and Middle adults
  4. Older adults
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3
Q

How does the developmental need of infants/toddlers/ and school-age children influence nutrition?

A
  1. Infants– breastfed vs not breastfed
  2. Toddlers– discovering food allergies/preferences.
  3. School aged— kids become picky eaters
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4
Q

How does the developmental need of adolescents influence nutrition?

A

Puberty and hormone changes are happening so the demand for calories increase. This is also when kids are at the most risk for developing eating disorders.

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5
Q

How does the developmental needs of young and middle adults influence nutrition?

A

Calorie demand decreases, need for supplemental intake may increase, pregnancy and lactation happen among us which also changes the nutritional need of the body.

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6
Q

How does the development need of older adult’s influence nutrition?

A
  1. Slower metabolic rate
  2. Changes in oral health
  3. Age-related GI changes
  4. Chronic illness
  5. ADL (activity of daily living) decrease
    6.ADR of medications
  6. Cognitive impairment
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7
Q

How could culture aspects affect nutrition? List 3.

A
  1. Influence eating habits
  2. Harmony of hot/cold, wet/dry
  3. Some ethnicities are at greater risk for nutrition/GI related issues.
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8
Q

During the nursing process when we are doing our assessment for nutrition what are we assessing for? List 3.

A
  1. Early recognition
  2. Malnourishment
  3. Complications
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9
Q

During the nursing process who can we have screen a patient for nutritional concerns?

A
  1. Dietician
  2. Gastroenterologist
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10
Q

During the nursing process we will collect a diet and health history what will this include?

A
  1. Intake and preference
  2. Symptoms
  3. Allergies
  4. Medications
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11
Q

Make sure to look at BOX 45. 4 ON PAGE 1114.

A

MAKE SURE TO LOOK AT BOX 45.4 ON PAGE 1114

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12
Q

What are some nutritional health promotions we can educate our patients on?

A
  1. My plate
  2. Meal planning
  3. Healthy substitutes
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13
Q

What can give you botulism?
list 5

A
  1. home-canning
  2. honey,
  3. ham
  4. sausage
  5. Shellfish
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14
Q

What are the symptoms of botulism?

A
  1. Mild discomfort to death
  2. Nausea
  3. Vomiting
  4. Paralysis
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15
Q

What food sources could give you E.Coli?

A

Undercooked meat

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16
Q

What are the symptoms of E. Coli? List 4

A
  1. Cramps,
  2. Nausea
  3. Vomiting
  4. Renal Failure
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17
Q

What food source could give you listeria?

A
  1. Soft cheese,
  2. Hot dogs,
  3. Lunch meat,
  4. Unpasteurized milk,
  5. Seafood
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18
Q

What are the symptoms of Listeria? list 4

A
  1. Diarrhea
  2. Fever
  3. Meningitis
  4. Endocarditis
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19
Q

What food sources could expose you to clostridium enteritis?

A

Meat

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20
Q

What are the symptoms of Clostridium enteritis?

A
  1. Mild diarrhea
  2. Vomiting
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21
Q

What food sources could expose you to salmonella?

A
  1. Milk
  2. Custard
  3. Eggs
  4. shellfish
  5. chicken
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22
Q

What are some symptoms of Salmonella?

A
  1. Diarrhea
  2. Vomiting
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23
Q

What food source could expose you to shingella?

A
  1. Milk
  2. Seafood
  3. Salads
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24
Q

What are some symptoms of shigella?

A
  1. Cramps
  2. Diarrhea to fatal dysentery
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25
Q

What are some food sources that could expose you to staph?

A

1.Custard
2. Cream
3. Ice cream
4. Ham

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26
Q

What are the symptoms of staph?

A
  1. Cramps
  2. Vomiting
  3. Diarrhea
  4. Fever
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27
Q

What are some food safety practices you can educate your patient on? List 4

A
  1. Clean-Hands, food, surfaces
  2. Separate– wash hands and utensils between use
  3. Cook– ensure proper temperatures
  4. Chill– proper refrigeration, leftovers for only 2 days.
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28
Q

True or false: Immunity and nutrition go hand in hand with each other.

A

True– example people who are malnourished would be at higher risk for diseases

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29
Q

Who orders advancing diets?

A

Physican

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30
Q

What are ways we could promote appetite?

A
  1. Oral Hygiene
  2. Mealtimes
  3. Assisting with meals
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31
Q

What are types of hospital diets? list 14

A
  1. NPO- nothing by mouth
  2. Clear liquid- jello, juices, broth etc..
  3. Full liquid– clear liquid but allowed to add cream
  4. Dysphagia– usually purred food
  5. Mechanical soft– usually purred food
  6. Soft/Low residue–
  7. High Fiber- oatmeal
  8. Low sodium– low salt
  9. Low cholesterol
  10. Diabetic–balancing carbs, proteins and sugars
  11. Gluten Free
    12.Heart Healthy
  12. Renal
  13. Regular
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32
Q

When you have patients with GI diseases what might be some things you educate them on in regards to nutrition?

A

Education on when and what they can eat

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33
Q

When you have patients with Diabetes Mellitus what might be some things you educate them on in regards to nutrition?

A

Making sure the patient understands the dietary needs/requirements

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34
Q

When you have patients with Cardiovascular disease what might be some things you educate them on in regards to nutrition?

A

How to eat heart healthy meals

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35
Q

When you have patients with cancer and/or receiving cancer treatments what are some of the things you educate them on in regards to nutrition?

A

Patients with cancer and or/receiving cancer treatments have an increased metabolic need and these patients will require more calories.

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36
Q

When you have patients with HIV/AIDS what are some things you educate them on in regards to nutrition?

A

Pts with HIV/AIDs are prone to body wasting . They have a high metabolic demand and are more at risk for water diseases.

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37
Q

What is the universal phenomenon that influences the way we think, feel and behave?

A

Caring

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38
Q

How long have nurses been studying caring?

A

Since Florence Nightingale

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39
Q

True or false: Caring is at the heart of a nurse’s ability to work with all patients in a respectful and theraputic way.

A

True

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40
Q

Benner’s caring, Leininger’s Transcultural caring, Watson’s transpersonal caring and Swanson’s theory of caring are all types of ______?

A
  1. Theoretical views on caring
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41
Q

Summary of theoretical views in caring include? List 5

A
  1. Nursing caring theories have common themes
  2. Caring is highly relational
  3. Caring theories are valuable when assessing patient perceptions of being cared for in a multicultural environment.
  4. Enabling is an aspect of caring
  5. Knowing the context of a patient’s illness helps you choose and individualize interventions that will help the patient.
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42
Q

As a nurse what are some ways to help make the patient feel like we care? List 3

A
  1. Connecting with them and their families.
  2. Being present– take time to actually listen instead of trying to multitask constantly
  3. Respect their values, beliefs, and health care choices
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43
Q

True or false: Part of ethics in caring is that in any patient encounter the nurse must know what behavior is ethically appropriate?

A

True

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44
Q

True or false: An Ethic of care is unique, so professional nurses do make professional decisions based solely on intellectual or analytical principles. So instead, an ethic of care places caring at the center of decision making.

A

False- Should be

An ethic of care is unique, so professional nurses DO NOT make professional decisions based solely on intellectual and analytical principles. Instead, an ethic of care places caring at the center of decision making.

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45
Q

True or false: You do not always have to be your patients advocate?

A

False– You should always be your patients advocate.

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46
Q

True or false: As you deal with health and illness in your practice, you grow in your ability to care and develop behaviors.

A

True

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47
Q

True or False: Caring is one of those human behaviors that we can give and receive

A

True

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48
Q

True or false: It is important to recognize the importance of self care?

A

True

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49
Q

Should we use caring behaviors to reach out to our collogues and care for them as well?

A

Yes.

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50
Q

How can you provide your presence?

A
  1. Eye contact
  2. Body language
  3. Tone of voice
  4. Listening
  5. Positive and encouraging attitude.
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51
Q

How is “touch” a part of caring for you patient?
list 2

A
  1. Provides comfort
  2. Creates connection
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52
Q

What are the types of touch? List 5

A
  1. Noncontact touch- example staying with a patient and just talking during a difficult time
  2. Contact touch– physical touch
  3. Protective touch– helping a patient from harming themselves
  4. Task-oriented touch– taking vitals
  5. Caring touch- hand squeeze
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53
Q

How does listening affect our care?

A
  1. It creates trust
  2. Opens lines of communication
  3. Creates a mutual relationship
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54
Q

True or false: Knowing the patient develops over time?

A

True

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55
Q

Is knowing the patient a part of the process of clinical decision making?

A

Yes

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56
Q

Aspects of knowing the patient include– List 3.

A
  1. Responses to therapy, routines, and habits
  2. Coping resources
  3. Physical capacities and endurance
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57
Q

What is spiritual caring?

A
  1. Spiritual health is achieved when a person can find a balance between his life, values, goals and belief systems and those of others.
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58
Q

What can spirituality offer a patient?

A
  1. A sense of intrapersonal, interpersonal and transpersonal connectedness
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59
Q

What are ways we can relieve symptoms and suffering?

A
  1. Performing caring nursing actions that give a patient comfort, dignity, respect and peace.
  2. Providing necessary comfort and support measures to the family and significant others
  3. Creating a physical patient care environment that soothes and heals the mind, body and spirt.
  4. Comforting through a listening, nonjudgmental, caring presence
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60
Q

What are some of the challenges of caring?

A
  1. Task-oriented biomedical model
  2. Institutional demands
  3. Time constraints
  4. Reliance on technology, cost-effective strategies and standardized work processes.
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61
Q

True or false: If health care is to make a positive difference in patient’s lives, health care must become more holistic and humanistic

A

True

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62
Q

What are the key points in caring?

A
  1. Caring is specific and relational for each nurse-patient encounter
  2. Caring involves a mutual give-and-take
  3. Caring involves “being there” and “being” with the patients
  4. Touch
  5. Listening
  6. Truely knowing the patient.
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63
Q

What is famiy durability?

A

System of support and structure within a family that extends beyond the walls of the household

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64
Q

What is family resiliency?

A

Ability to cope with expected and unexpected stressors

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65
Q

What is family diversity?

A

Uniqueness of each family unit

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66
Q

In healthcare what is the concept of family?

A
  1. Families represent more than a set of individuals
  2. A family is more than a sum of individuals members
  3. Families are diverse.
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67
Q

What is family?

A
  1. The family can be defined biologically, legally, or as a social network with personally constructed ties and ideologies.
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68
Q

True or false: No two families are alike; each has its own strengths, weaknesses, resources, and challenges

A

True

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69
Q

Describe the nuclear family?

A
  1. Mom, dad and child
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70
Q

Describe the extended family?

A
  1. Mom, dad and a couple of kids, plus grandparents and great uncle, cousins….
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71
Q

Describe single-parent family….

A

Only 1 parent… and child

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72
Q

Describe blended family….

A

Mom, Dad, Kids and step parents

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73
Q

Describe alternative family…

A

adoptive patient, foster patient, same sex family, grandparents

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74
Q

What are some current “family” trends

A
  1. People are marrying later
  2. Women are delaying childbirth
  3. Couples are having fewer children or none at all
  4. Remarriage results in blended families
  5. Single-parent families are stabilizing
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75
Q

Changing economic status are affecting the family how?

A
  1. Inadequate health insurance coverage
  2. Increasing number of children living below the poverty leel
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76
Q

Changes in economic status are affecting the patient/family how?

A
  1. Inadequate health insurance coverage
  2. Increasing number of children living below the poverty level
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77
Q

True or false: More families with children are experiencing homelessness?

A

True

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78
Q

True or false: Domestic violence does not occur across all social classes.

A

False- it does occur across all social classes

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79
Q

Can domestic violence effect long-term physical and emotional consequences?

A

Yes

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80
Q

True or false: Education is key to decreasing a acute/chronically ill patients stress?

A

True

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81
Q

In terms of “caring” what should we anticipate from a patient who has experienced a trauma?

A

Family/pt may be hysterical and now would not be the time to build relationship/educate

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82
Q

What is the best intervention of care for a pt receiving end of life care?

A

Being present for pt and family

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83
Q

Review in detail slides 27-28 on approaches to family nursing. ( caring lecture)

A

Review in detail slides 27-28 on approaches to family nursing- ( caring lecture)

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84
Q

Review in detail slides 27-29 on approaches to family nursing. (caring lecture)

A

Review in detail slides 27-29 on approaches to family nursing- (caring lecture)

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85
Q

What is the nursing process for “family caring”

A
  1. Assessing the needs of a family
    • Cultural aspects
    • Discharge
    • Family focused care
  2. Nursing diagnoses
    • Identify actual and at-risk nursing diagnoses
  3. Planning care
    • Plan care that members clearly understand and agree to follow
      -Set goals and outcomes that are realistic, compatible with family developmental stage, and acceptable to family members and their lifestyle
    • Collaborate with other disciplines
    • Support communication among family members
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86
Q

How can we implement family centered care?

A
  1. Family caregiving
    • The routine provision of services and personal care activities for a family member by spouses, siblings, friends, or parents
    • Activities including finding resources, providing personal care, monitoring for complications or side effects, providing instrumental activities of daily living and ongoing emotional support and decision making
  2. Health promotion
    • Choose health promotion behaviors that are tied to the families developmental stage
    • Help the family focus on their strengths instead of problems and weaknesses
    • Refer families to health promotion programs that meet their needs
  3. Acute care
    • Be aware of the implications of early discharge from hospital for patients and their families
    • Help the family identify methods to maintain open lines of communication with you and the health care team.
  4. Restorative and continuing care
    • Try to maintain patient’s functional abilities within the context of the family.
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87
Q

What are the key points of caring for families?

A
  1. Family members influence one another’s health beliefs, practices and status
  2. The concept of family is highly individualized
  3. Measures of family health involve more than a summary of individual member’s health
  4. Cultural sensitivity is vital to family nursing
  5. Family caregiving is an interactive process
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88
Q

What is enteral nutrition?

A

Nutrition given directly to the stomach or small intestine

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89
Q

What are 3 types of tubes used for enteral feedings?

A
  1. NG tube
  2. PEG Tube
  3. Button
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90
Q

What are the two types of enteral nutrition?

A
  1. Closed system
  2. Open system
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91
Q

What is closed system enteral nutrition?

A
  1. Nutrition solution added during manufacturing system cannot be opened
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92
Q

How long can a closed system enteral feeding safely hang?

A

24 to 36 hours but some agencies allow 48 hours.

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93
Q

True or false: A closed system enteral nutrition is more common than open systems?

A

True

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94
Q

What is an open system enteral nutrition?

A

Nutrition solution prepared by nurse at the bedside

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95
Q

True or false: Both Closed and Opened enteral nutrition systems are administered via an enteral nutrition pump.

A

True

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96
Q

What are the 4 types of infusions (tube feeding)

A
  1. Continuous
  2. Cyclic
  3. Intermittent
  4. Bolus
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97
Q

What is continuous nutrition?

A
  1. A feeding that is administered over 24- hour period using an enteral pump.
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98
Q

What do we need to know about continuous nutrition?

A
  1. Initial dose full strength at slow rate
  2. Rate increased every 8 to 12 hours until goal reached
  3. HOB up to 30 degrees at all times to prevent aspiration
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99
Q

What is cyclic nutrition?

A
  1. Continuous feeding administered in less than 24 hours. Often administed at night
100
Q

What do we need to know about cyclic nutrition

A
  1. Patient may eat during the day
  2. HOB remains at least 30 degrees
  3. Flush with 30 mL of sterile water when finished
101
Q

What is intermittent nutrition

A
  1. Feeding usually begin full strength at specified volume (mL)/kg, 5-8 feeding per day.
  2. Usually administered over at least 3o minutes via enteric pump or syringe
102
Q

What do we need to know about intermittent nutrition

A
  1. Goal is to provide needed calories and volume in 4-6 feedings a day.
  2. Keep HOB up at least 1 (one) hour after each feeding
103
Q

What is bolus nutrition?

A

1.A syringe is used to deliver the formula into the stomach by gravity
2. Raising or lowering syringe regulates flow

104
Q

What do we need to know about bolus nutrition?

A
  1. Delivered more rapidly than intermittent feeding
  2. Keep HOB 30 degree for at least 1 hour
  3. Flush w/ 30 mL of sterile water
105
Q

Patients recieving enteral nutrition are at high risk for….

A
  1. Diarrhea
  2. Nausea/vomiting
  3. gas/bloating/cramping
  4. Constipation
  5. Dehydration
  6. Hyperglycemia
  7. BIGGEST RISK:ASPIRATION
106
Q

What are the signs and symptoms of aspiration?

A
  1. Cough
  2. SOB
  3. Gurgling
  4. Raspy voice
107
Q

If you suspect your patient is aspirating what should you do 1st?

A
  1. Immediately stop the feeding. You want the least amount of nutrition possible in the area where the pt is aspirating.
108
Q

What should you do if aspiration is suspected?

A
  1. Stop the feeding
  2. Make sure the bed is elevated
  3. Turn patient on their right side
  4. Notify the physician
  5. Check placement with order
109
Q

What are some abdominal signs and symptoms of tube feeding intolerance?

A
  1. Distention
  2. Firm
  3. Tense
  4. Guarding
  5. Discomfort
  6. Hold feeding, check for constipation, notify provider
110
Q

What should we do if our patient receiving tube feeding is experiencing nausea?

A
  1. Antiemetics
  2. Minimize narcotics
  3. Check for constipation
  4. Notify provider
111
Q

What should we do if our patient receiving tube feedings is vomiting?

A
  1. Hold feeding
  2. Check for constipation
  3. Notify provider
112
Q

Gastric residual checks may be useful in what patient populations? list 5

A
  1. Critically ill surgery patients
  2. Critically ill trauma patients
  3. Head injury
  4. Postop abdominal surgery
  5. Obtunded/vegetative state
113
Q

If you need to check the patients gastric residual volue what is the first thing you should do?

A

Put patient on right side for 20 minutes, while maintaining patient backrest elevation of >30 degrees. Check GRV per ordered frequency

114
Q

When should you discontinue GRV (gastric residual volume) checks?

A

after 48-72 hours if < 500 mL, and no abdominal signs present

115
Q

Before proceeding with a feed what should you do?

A
  1. Assess the patients GI system:
    - bowel sounds, presentation of abdomen
    -Location of enteral tube - correct label?
  2. Is the HOB at 30 degrees.
  3. Is the prepared feeding at room temp?
  4. Is the tubing primed?
116
Q

What are the steps of checking a tube feeding placement?

A
  1. Verify tube placement– by xray
  2. Aspirate to assess tube patency/gastric contents (like CVAD) if patient is symptomatic
    –Exception– NOT jejunostomy tube
    – NOT levine/dobhoff tubes
  3. Measure contents and return– see protocol
  4. Flush with 30 mL sterile water
  5. Document findings
117
Q

Do not proceed with feeding if residual volume is…

A

If > 500 mL residual
- Return residual & flush 30 mL sterile water
- Recheck in 4hrs
– If still > 500mL, hold tube feedings- notify dietician and primary care physician (PCP)

118
Q

During a gravity feeding what degree should the HOB be?

A

30 degrees

119
Q

How many mL of sterile water should we flush with after a gravity feeding?

A

30 mL

120
Q

How long should we keep HOB up after gravity feeding?

A

1 hour

121
Q

True or false: During gravity feedings you should connect device and administer via gravity flow— slowly

A

True

122
Q

During a pump feeding what degree should the HOB be?

A
  1. Ensure HOB > or equal to 30 degree at all times
123
Q

What should we ensure has been done prior to administration of pump feedings?

A
  1. Connect primed pump tubing
  2. Ensure pump rate as ordered
  3. Open clamp and start infusion
124
Q

How often should we monitor pump feedings?

A

Every 4 hours IF THERE ARE signs of intolerance

125
Q

How my mL of sterile water should you flush after a pump feeding?

A

30mL

126
Q

Why might metoclopramide (reglan) be given?

A
  1. Gastroparesis
  2. GERD
  3. Nausea and vomiting
127
Q

Why might ondansetron (zofran) be given?

A

Nausea and vomiting

128
Q

What are some nursing interventions/care techniques for enteral feedings? list 8

A
  1. Monitor constantly for signs of intolerance
  2. Monitor intake and output
  3. Monitor daily wait
  4. Perform oral care
  5. Monitor accu-checks carefully.
  6. Always assess tubes for correct placement and properly labels
  7. Change prepared feedings every 8 hours and closed enteral feedings every 24 hours or when empty. Never let tubing run dry
  8. Be aware of tubes when transferring or changing pt position.
129
Q

How can we prevent skin irritation and infection with enteral feedings

A
  1. Thin gauze or external disk (bumper)
  2. Clean site regularly
  3. Monitor skin for
    • Irritation/breakdown
    • Drainage/bleeding
      -Candida (yeast) infection
    • Need to rotate/replace bumper
130
Q

What are some key points of enteral feedings?

A
  1. ALWAYS look for s/s aspiration
  2. ALWAYS look for s/s of intolerance
  3. ALWAYS keep patient properly positioned
  4. Hold feeding if residual is > 500 mL after two (2) consecutive checks at least 4 hours apart and contact dietician & Physician
    remember to return contents and flush
131
Q

What is the destination of a nasogastric (NG) tube?

A

Stomach

132
Q

What is the destination of a Dobhoff (NG) tube?

A

Stomach

133
Q

What is the destination of a Nasoduodenal Tube?

A

Small intestine

134
Q

What is the destination of the Nasojejunal tube?

A

Small Intestine

135
Q

What is the destination of the gastrostomy (Peg) tube?

A

Stomach

136
Q

What is the destination of the jejunostomy (J) tube-

A

Small intestine

137
Q

True or false: Peg tubes and J tubes are surgically inserted?

A

True

138
Q

What does PEG tube stand for?

A

Percutaneous Endoscopic Gastrostomy Tube Placement.

139
Q

What would be some reasons a patient may have a PEG tube?

A
  1. Dysphagia
  2. Cancer/Radiation affecting GI tract
  3. Neurological deficits
  4. Bowel diseases/dysfunction
  5. Cranio-facial abnormalities, trauma
  6. Malnutrition concerns
140
Q

Are PEG tubes long term/short term?

A

Long term.

141
Q

True or false: Xray is the gold standard for initial confirmation of tube placements

A

True

142
Q

The nurse also must assess & document what findings when it comes to enteral meds/administration

A
  1. Tube length (all nasal tubes)
    -Compare measurement to previous assessments before every administration
  2. Deviations
    • increase in length possibilities
      1. From intestines into stomach
      2. From stomach into esophagus
      3. Into lung
        -Decrease in length possibilities
        1. From stomach into intestines
143
Q

Before administering enteral meds you should assess for what?

A
  1. Bowel sounds and GI assessment- To make sure that the stomach is working properly.
  2. S/S of intolerance
144
Q

Enteral meds must be in what form?

A

Liquid or powder

145
Q

How can you make a pill into a powder form?

A
  1. Mortar/pestle or pill crusher
146
Q

What PO meds can we NOT crush?

A
  1. EC
  2. SR/SA/TR/CR/XL/XR
  3. SL
  4. Buccal
147
Q

True or false: It is not important to know what drugs are on the DO NOT crush list?

A

False

148
Q

What is the 1st rule in med preparation?

A
  1. Know your meds
    • What, why, how, where is it going?
      1. In order for any drug to have bioavailability (be able to be absorbed and used), it must be delivered to the correct part of the gastrointestinal tract.
      2. Can this tube be used? for all meds?
  2. Always ask patient allergies
149
Q

True or false: If spansule type medications or liquid gelatin capsules are the only form available, you can open into a medication cup and mix accordingly.

A

True

150
Q

How do you prepare your enteral medication?

A
  1. In the med room prepare each crushed/liquid medication(s) in their individual medication pkg (label), sleeve or cup- may have syringe from pharmacy
  2. Take med sleeve(s) and/ or pill package, etc. with you for verifying scanning
  3. At the bedside, you mix each med individually with 15 mL sterile water.
151
Q

How do you administer you enteral med?

A
  1. Confirm tube patency by flushing the gastric tube with 15 mL of sterile water
  2. Pinch or clamp proximal end of the gastric tube each time the syringe is removed to prevent air from entering the stomach
  3. Remove the plunger from the syringe and attach the syringe to the feeding tube
  4. Pour dissolved/diluted medication into the syringe tube, raise syringe and allow to flow by gravity
  5. Flush with 5-10 mls of water between each medication to prevent potential drug interaction and incompatibilities
  6. After administrating the final med, flush the tube with 15-30ml of water
  7. Leave head of bed elevation for 30 mins to facilitate flow and prevent esophageal reflux.
152
Q

True or false: DO NOT MIX multiple enteral medications together.

A

True– could cause a chemical reaction

153
Q

True or false: it is okay to mix meds directly into tube feedings.

A

False

154
Q

If we have a patient receiving a tube feeding and need to give enteral feedings what should we do?

A

Stop the feeding

155
Q

How can we prevent infection in feeding tubes?

A
  1. Initially thin gauze between G-tube or J-tube
  2. Clean site regularly
  3. Monitor skin for irritation, breakdown, drainage, bleeding, candida infection, rotate bumper.
156
Q

Why is patient education important?

A
  1. It is an essential component of safe, patient-centered care
  2. Standard for professional nursing practice
  3. Falls within the scope of nursing practice
157
Q

What do we teach patients? (Patient education)

A
  1. Health analogies
  2. Restoration of health
  3. Coping with impaired functions
  4. Promotion of health illness prevention
158
Q

What is teaching?

A

Transmission of intentionally structured and sequenced information to a recipient

159
Q

What is the purpose of teaching our patients?

A
  1. Produce a change in behavior
160
Q

True or false: Teaching that utilizes an interactive process promotes learning?

A

True

161
Q

What is learning?

A
  1. Purposeful acquisition of measurable factors through an experience or external stimulus
162
Q

What are factors of learning?

A
  1. New knowledge
  2. Attitudes
  3. Behaviors
  4. Skills
163
Q

The beginning of teaching and learning starts with….

A

A person identifying a need for attaining knowledge or acquiring an ability to perform a task.

164
Q

What are the nurses actions when it comes to patient education?

A
  1. Determine what patients and families need to know
  2. Identify patients existing knowledge, learning preferences and readiness to learn.
  3. Provide the time to teach
  4. Teach need information to the patient and family
165
Q

What are some information essentials when it comes to patient education and nursing actions?

A
  1. Accurate and complete information
  2. Relevant to the patient’s needs, language and literacy
  3. Timely– when the patient and family are ready.
166
Q

What are nursing goals when it comes to patient education?

A
  1. Assist the patient in making informed decisions regarding their care
  2. Promote the patients understanding. Help the patient see the positive effects of change through education.
167
Q

What is the description of cognitive learning?

A
  1. Includes intellectual behaviors
  2. Requires thinking & storage/recall of information
168
Q

What are some tools that promote cognitive learning?

A
  1. One-to-one instruction
  2. Written material
169
Q

What is an example of cognitive learning?

A
  1. Learning facts about hypertension
170
Q

What is the description of affective learning?

A
  1. Expression of feelings
  2. Development of attitudes, opinions, or values
171
Q

What are tools to promote affective learning?

A
  1. One-to-one counseling
  2. Role Play
172
Q

What is an example of affective learning?

A
  1. Changing a belief about the dangers of smoking
173
Q

What is the description of psychomotor

A
  1. Acquisition of skills
  2. Requires coordination and integration
    • mentally & physically
  3. Hands-on skill (kinesthetic learning)
174
Q

What are some tools to help promote psychomotor learning?

A
  1. Demonstration/return demonstration
  2. Practice
175
Q

What is an example of psychomotor learning?

A
  1. Self-admin of insulin
176
Q

What are the principle of learning? list 4

A
  1. Stimulus to learn
  2. Readiness to learn
  3. Ability to learn
  4. Learning environment
177
Q

If a person does not want to learn it is ______ that learning will occur

A

Unlikely

178
Q

What is “the force” in the motivation (stimulus to learn)

A
  1. Acts on or within a person to cause the person to behave in a particular way.
179
Q

How is theory used as a stimulus to learn?

A
  1. Matches a person’s learning needs and personal preferences
  2. Enhances motivation and learning.
180
Q

What is social learning theory?

A
  1. It considers the characteristics of the learner their behavior patterns and environment.
181
Q

What is a major concept of the social learning theory?

A
  1. Self-efficacy – person’s perceived ability to successfully perform a task
182
Q

What does the social learning theory provide us?

A

Provides guidance to the educator to develop an effective teaching plan

183
Q

It is important to remember that when it comes to culture and the stimulus to learn that we should…..

A
  1. Respect the patients identity and needs
    REGARDLESS of
  2. Age
  3. Religious practices
  4. Social and/or socioeconomic status
  5. Physical appearance
184
Q

How does active participation help in our stimulus to learn?

A
  1. Implies an eagerness to acquire a knowledge or skills
185
Q

How much information do we retain when we read something?

A

10%

186
Q

How much information do we retain when we speak and do?

A

90%

187
Q

True or false: Readiness to learn relies on us being mentally and physically prepared to learn

A

true

188
Q

What are some positive factors that can help our readiness to learn?

A
  1. Comfortable environment
  2. Presence of family may be useful
189
Q

What are some obstacles that can affect our rediness to learn?

A
  1. Physical discomfort
  2. Anxiety - high
  3. Environmental discomfort
  4. Presence of family
190
Q

Review slide 26 on patient education– wasnt sure how to make into slide.

A

Readiness to learn:
Psychosocial adaptation
1. Process
-Assists the patient after an incident
1. Illness
2. Injury
3. Both

191
Q

Part of psychosocial adaptation is grieving. What does this allow the patient to do?

A
  1. Accept the reality of their illness or injury
  2. Adapt to the new normal
192
Q

Emotions are part of the psychosocial adaptation. How can this affect patient education?

A
  1. Severe anxiety, stress or emotional pain can interfere with learning.
  2. A mild level of anxiety can enhance learning, provides motivation
193
Q

How does developmental capability affect the ability to learn?

A
  1. Cognitive development affects the person’s ability to learn.
  2. Without proper physiological, motor, language and social development– many types of learning cannot take place
194
Q

How does age affect the ability to learn in children?

A
  1. The developmental stage of a child determines the capability to learn and the types of behaviors that a child can learn
195
Q

How can we promote the ability to learn in infants?

A
  1. By holding the infant firmly while smiling and speaking softly to convey sense of trust
196
Q

How can we promote the ability to learn in toddlers?

A
  1. Use play to teach procedure or activity
  2. Utilize simple words
197
Q

How can we promote the ability to learn in preschoolers

A
  1. Use simple explanations and demonstrations
198
Q

How can we promote the ability to learn in school aged children?

A
  1. Teach psychomotor skills needed to maintain health
  2. Offer opportunities to discuss health problems and answer questions
199
Q

How do you promote the ability to learn in adolescents

A
  1. Use teaching as collaborative activity
  2. Allow adolescents to make decisions about health and health promotions
200
Q

Slide 33 on patient education– review unsure how to make into flash card

A
  1. Self-directed
    • able to critically think
    • able to direct their own learning
  2. Patient- centered
    • able to collaborate with adults on topics and goals.
201
Q

How do you promote the ability to learn in young and middle-aged adults?

A
  1. Offer information so adult understand effects of health promote
  2. Encourage participation in teaching plan by setting mutual goals
202
Q

How do you promote the ability to learn in older adults?

A
  1. Teach when client is alert and rested
  2. Involve adult in discussion or activity
  3. Indiviualize to the person
203
Q

What are other factors in our ability to learn?

A
  1. Physically capability
    -influences the level of personal involvement, physical health and energy.
  2. Neurosensory issues
    • feel -see
    • hear - grasp
  3. Health literacy
    • Affects the patients ability to understand basic healthcare information that is needed to make appropriate health care decisions
  4. Other literacy issues
    • patients ability to read, write and speak the same language as the health care provider
204
Q

True or false: Our learning environment plays no part in our ability to pay attention to instruction.

A

False- Our learning environment affects a person’s attention to instruction.

205
Q

What is an ideal “learning environment”?

A
  1. Well lit room
  2. appropriate furniture
  3. Quiet
  4. Private
  5. Good ventilation
  6. Comfortable temperature
206
Q

When educating our patient we should limit the amount of people/groups to…..?

A

6 or fewer– this will help promote the learning enviroment

207
Q

True or false: You want the right sized room– not to big, not to small when educating your patient?

A

True

208
Q

True or false: Verify all participants can see and hear one another when educating the patient

A

True

209
Q

What are some challenges a nurse could face when trying to educate her patients?

A
  1. Conflicting schedules- Either with the nurses schedule or the patients availability
  2. Lack of space and privacy
  3. Teaching not seen as a priority either by the nurse or organization
  4. There is no 3rd party reimbursement for teaching
210
Q

What are some challenges a patient might face when trying to be educated by the nurse?

A
  1. Illness
  2. Fatigue
  3. Other physical conditions
  4. Anxiety
  5. Personal Stress
  6. Provider/nurse uses medical jargon and technical terms
  7. Overwhelming amount of behavior change needed
  8. Does not perceive a need for the information.
  9. Lack of support from family/caregiver
211
Q

What are some technology-based learning issues?

A
  1. Lack of social interaction
  2. Poor learner motivation– lack of interest or complicated material.
  3. Technical difficulties- with devices or software
  4. Lack of access to the internet
212
Q

What are teaching strategies?

A
  1. Method(s) used to present the information being taught
213
Q

What is the content (in terms of teaching)

A
  1. All the information needed to reach the intended goal.
214
Q

What is the “goal” when educating a patient?

A

Change behaviors to improve patient outcomes

215
Q

One element to teaching is scheduling and sequencing. Scheduling and sequencing recommend we present our information….. how?

A
  1. Simple before complex information
  2. Nonthreatening before complex information
  3. Verify enough time for the topic
  4. Present in short time frames
216
Q

We should always verify that there is enough ____ for the topic (scheduling and sequencing)

A

Time.

217
Q

What is instructional material?

A

Tool that are used to introduce information and reinforce learning

218
Q

True or false: We should select our instructional material based off of our patients learning style?

A

True

219
Q

What are some teaching tactics?

A
  1. Keep the patient actively involved to support their attention and learning
  2. Build on current knowledge
  3. Teach while performing nursing care
220
Q

One teaching tactic is “telling” what is this?

A

Instructions are given, such as preparing a patient for a procedure

221
Q

One teaching tactic we can use is “participating” what is this?

A
  1. Cooperative effort by the nurse with the patient to learn the best process
222
Q

Entrusting is a teaching tactic— what is this?

A
  1. Nurse becomes an observer as the patient performs a skin
223
Q

Reinforcing is a teaching tactic– what is this?

A
  1. The nurse offers a smile or words of affirmation
  2. With children a nurse may give them a sticker or prize
224
Q

What is one-to-one education and when is a good time to utilize this technique?

A
  1. One teacher presents to an individual patient
    2 As a part of this type of education, teach while nursing care is provided
225
Q

What is group education and what are some thing to consider when utilizing this technique

A
  1. Efficient- more than one student
  2. Students can interact with on another
  3. Most effective/ least distractions- 6 or fewer students
226
Q

What is the preparatory technique?

A

This provides information prior to a procedure
1. guidelines–
-Describes physical sensations and their cause
- Prepares the patient for common experiences
- As applicable, verifies the patient knows when results will be available and who will contact them

227
Q

What is the demonstration/return demonstration technique

A
  1. Most effective when the patient observes the nurse and then, during a return demonstration, the patient has a chance to practice the skill
228
Q

What is the analogy technique?

A
  1. Familiar images make complex ones understandable

general principles
1. Be knowledgeable about the concept
2. know the patients background, experience and culture
3. Keep the comparison simple and clear

229
Q

What is the simulation technique?

A
  1. Problem-solving, application, and thinking
    • A situation is presented for a patient to solve a problem or make appropriate choices
230
Q

What is printed materials technique?

A
  1. Patients literacy must be assessed beforehand
    • The information is available in the form of fact sheets, discharge instructions, or detailed booklets.
231
Q

What is digital teaching technique?

A

Sources of information with
1. Video or flash format
2. Computer animations
3. Audio clips online
4. CD/DVD
5. film/slides
6. Computer-generated material

232
Q

When using digital teaching you should follow up with reinforcemnt how?

A
  1. Question and answer session
  2. Discussion of the material
  3. Printed material
233
Q

What is the Online teaching technique

A

Information
1. Presented via credible listing and websites such as the CDC, MAYO clinic and others.

sources
1. Multiple electronic platforms
-multimedia
- search engines
- electronic libraries
- others

234
Q

True or false: Dr. Google is reliable

A

False

235
Q

Unique situation requires adaptations based on the special need. What is the nurses role here?

A
  1. Nurse needs to have theoretical knowledge about the condition
236
Q

When teaching in a unique situation the teaching should include who and why?

A
  1. Family members
  2. Caregiver
  3. Other significant persons

These individuals can reinforce learning and assist with implementation of presented education

237
Q

How can we build/establish trust while teaching a patient?

A
  1. Speak slowly
  2. Encourage questions
238
Q

Short sessions in teaching are… and help what

A
  1. To the point, simple terminology
  2. Minimize distractions
  3. Use visual aids
239
Q

True or false: Most important information should be shared at the beginning of the session?

A

True

240
Q

True or false: It is okay and sometimes really beneficial to teach in increments?

A

True

241
Q

True or false: Observing and evaluating a patients ability to perform desired behaviors can tell us how effective our teaching was?

A

True

242
Q

What can the teach back method tell us

A
  1. The use of the teach back determines patients and family caregiver’s level of understanding of the understanding of instructional topic
243
Q

What should you do if the teach back method is not working?

A
  1. Always develop a plan for revised patient teaching if patient and/or family is not able to teach back correctly.
244
Q

“I want to make sure I explained everything clearly” or “ If you were trying to explain to your husband how to take this medicine, what would you say?” Are examples of what?

A

Questions you could ask in “Teach Back”

245
Q

What are some guidelines when teaching older adults?

A
  1. Allow sufficient time to process and comprehend new information
  2. Only present the most significant information to avoid overwhelming the learner
  3. Use repetition to reinforce content
  4. When giving instructions or teaching a new skill give concise step-by-step directions
  5. provide regular positive reinforming
  6. Assess understanding of each step before moving ahead
  7. Keep teaching sessions short
  8. Allow for frequent breaks
  9. Conclude with a brief summary and allow sufficient time for questions/feedback
  10. Schedule follow up sessions to ensure learning with additional time.
246
Q

What are some guidelines for older adults and printed materials

A
  1. Direct and clear information.
  2. Two or three main points
  3. Simple steps
  4. Times new roman font
  5. Large font
  6. White space rests the eyes

Module 1 (20 decks)

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