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321 Intro Health Promotions kyle notes > mod 2 ch 25 teaching and education > Flashcards

mod 2 ch 25 teaching and education Flashcards

1
Q

stages of grief

A 
denial/disbelief
anger
bargaining
resolution
acceptance
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2
Q

denial/disbelief

A

Pt BX:
avoids discussion, withdraws from others, suppresses and distorts info

Learning implications for RN/Family

  • empathy, careful of all procedural explanations
  • be accessible for discussion
  • as RN, explain situation to family/others
  • teach in resent tense

rationale:

  • pt not prepared to deal
  • any attempt to convince pt will be more withdrawal or anger
  • provide only absolute required info
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3
Q

anger

A

BX:
- pt blames or directs anger to rn or others

learning implications:

  • do not agree w/pt, listen to concerns, good eye contact
  • teach present tense
  • reassure family this pt anger is normal

rationale:
pt need op to express anger, still not prepared to face it

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4
Q

bargaining

A

pt bx:
pt offers live better life in exchange for promise better health

learning implications:
- introduce reality only and teach present tense

rationale:
pt still unwilling to accept limitations

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5
Q

resolution

A

pt bx:
pt expresses emotions opening, illness created change and asks questions

learning:
encourage express feelings, what wants to learn, and share info for future and make formal discussion times

rationale:
perceive need for assistance and ready for responsible learning

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6
Q

acceptance

A

pt bx:
recognized reality, pursues info and strives for independence

learning:
teach future skills/knowledge and present occurrences, involve family in teaching

rationale:
more easily motivated, reflects willingness to deal w implications

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7
Q

domains learning

A

cognitive - gains info to further develop understanding
- done by discussion (one-on-one, or group), lecture, questions/answer, role play, independent projects

affective - expression of feeling and emotions and develops values, attitudes and beliefs.. attach emotion to learning

  • role play, discussion (one-on-one, group)
  • receiving, responding, valuing, organizing, characterizing

psychomotor - manual physical skills
done by demonstration, practice, return demonstration, independent projects, games
Hierarchy
- fundamental - simpler components for complex action
- perception - coordinated bodily movements
- guided response - imitation and demonstration
- complex overt response - smoothy and accurate performance
- adaption - skills well developed and modified when unexpected problem occurs
- origination - create new with current knowledge

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8
Q

motivation to learn

A

influenced by belief of need to know something, knowledge for survival
motivation must come from pt rather than hcp

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9
Q

motivational interviewing

A

counseling and ed technique focus on pt goals and goal directed and pt centered
change must come from pt not HCP

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10
Q

self-efficacy

A

person’s perceived ability to accomplish a task, when they believe they can, they’re more likely to perform bx consistently and properly
improves lifestyle choices

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11
Q

cultural factors (6 ACCESS)

A
  1. Assessment: pt lifestyle, health beliefs, cult traditions, health practices
  2. communication: awareness of many variations in verbal/nonverbal responses
  3. cultural: negotions and compromises encourages awareness of pt culture and one’s own biases
  4. establishment respect for pt cultural beliefs and values – caring rapport
  5. sensitivity: pt from diverse backgrounds perceive care needs and patterns of comm the use
  6. safety: enables pt feel culturally secure avoids disempowerment for cultural identity
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12
Q

instructional methods

A
  1. verbal one-on-one - most common, share info directly w/pt, done informally allows pt to ask questions, not effective for full understanding
    - – USE EDUCATE Model
  2. group instruction - multiple pts able to interact and learn from others’ experiences, both lecture and discussion, shows higher knowledge grasp, longer retention
  3. preparatory instruction- provide info about procedures, gives pt knowledge and sense of control, reduces anticipatory anxiety (reappraisal)- reframing emotional event in less emotional terms
  4. demonstration - use w psychomotor skills and use return demonstration
  5. analogies - supplement verbal ed with pictures or ideas - makes info real and understandable
  6. role-playing - learn required skills and feel more comfortable performing them
  7. simulation - teaching problem-solving, application
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13
Q

teaching pt w literacy or learning disability

A
  • establish trust
  • face pt, eye level
  • speak slowly and encourage questions
  • simple terminology
  • keep teaching short and to point, incremental
  • provide written materials/visual aides plain language 5th grade or lower
  • relate to personal experience or real-life situations
  • ask pt for feedback, return demonstrations
  • reinforcement most important at end
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14
Q

EDUCATE

A 
E - enhance comprehension and retention
D - deliver pt-centered education
U - understand the learner
C - communicate clearly and effectively
A - Address health literacy and cultural competence
TE - teaching and educational goals
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15
Q

EDUCATE

E - enhance comprehension and retention

A
  • use question list so pts can use to ask questions
  • repeat most important info
  • ask pts to repeat info
  • provide info in several ways for full understanding
  • use teach-back
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16
Q

EDUCATE

D - deliver pt-centered education

A
  • talk to, not at
  • practice empathetic skills
  • ask pt about life, pay attention to pt worries and fears
  • ask pt to state goals
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17
Q

EDUCATE

U - understand the learner

A
  • find out pt knowledge first
  • be aware nonverbal messaging
  • determine pt barriers to health literacy
  • include family in education
  • realize pt may not be aware they don’t understand what being communicated to them
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18
Q

EDUCATE

C - communicate clearly and effectively

A
  • requires practice
  • present most important info first
  • use easy to understand language
  • pt must be given opp to ask questions before discharge
  • consider audio recording of pt consult to improve pt recall
19
Q

EDUCATE

A - Address health literacy and cultural competence

A
  • ask, do you need help understanding
  • have verbal ed w/written and visual materials
  • use interpreter if needed
  • consider using scripter tool for clear and understandable ed
  • do not just ask, do you understand…
20
Q

EDUCATE

TE - teaching and educational goals

A
  • PREPARE
  • effective tools
  • overcome learning barriers
  • teach as interactive process
  • assessment of learning
21
Q

purpose pt education

A

primary goal- help indiv, family, or communities achieve optimal levels of health through active participation and decision making to provide safe pt-centered care

helps reduce health care costs for indiv

22
Q

cognitive learning

A

6 bxs:
- remember (knowledge) - recognize and recall
- understanding (comprehension)- use in activities
- apply- execute and implement
- analyze- break materials into parts, see how they relate and interrelate
- evaluate- evaluation
create (synthesis)- making whole, creating new processes with info, producing

23
Q

attentional set

A

mental state allows learner to focus on and comprehend learning activity
- before learning, pt must be able to pay attention to or concentrate on info to be learned

24
Q

ability to learn

A

pt’s developmental level and cognitive and physical capabilities influence the ability to learn

25
Q

health literacy

A

cognitive and social skill determine abiity of indiv gain access to, understand, and use info in ways to promote and maintain good health, results in unsafe health is literacy low
- low health literacy can lead to more ED visits, along with more admissions and readmissions

26
Q

teaching approaches: telling

A

used when limited time, pt is highly anxious but vital for info, simple instructions must follow

27
Q

teaching approaches: participating

A

set objectives and become involved in process together.

opportunity for feedback, discussion, goal setting, and revision.

28
Q

teaching approaches: entrusting

A

give pt opp for self-care

provides knowledge and skill that enables pt to accept responsibility to perform tasks

29
Q

teaching approach: reinforcement

A

use stimulus to increase desired response before and after desired learning bx
timing is essential!

30
Q

older adult education

A
  • teach when well rested and alert
  • casual and relaxed env
  • short term goals
    lighting
  • avoid blues and greens
  • present info slowly and clearly
  • encourage use of prosthetics and ensure proper fit
  • relate to past experiences
31
Q

teachback

A

closed-loop comms assesses pt retention of into during teaching session

32
Q
  1. A patient asks a nurse to provide instruction on how to perform a breast self-exam. Which domains are required to learn this skill? (Select all that apply.)
A
  1. Cognitive domain

5. Psychomotor domain

33
Q
  1. A patient suddenly experiences a severe headache with numbness and decreased movement in the left arm. The emergency room physician suspects a stroke and is going to have the patient undergo an emergent angiogram to remove the clot. Which teaching approach is most appropriate?
A
  1. Telling approach
34
Q
  1. A nurse is caring for a young patient who has been told he has multiple sclerosis. The nurse has planned time to conduct a teaching session that will focus on the disease and principles of management. The nurse chooses to use the EDUCATE model to proceed with instruction. Which of the following are components of the model? (Select all that apply.)
A
  1. Repeat the most important information.
  2. Practice empathetic skills.
  3. Be aware of nonverbal messages.
35
Q
  1. A nurse is teaching an older adult patient about ways to detect a melanoma. Which of the following are age-appropriate teaching techniques for this patient? (Select all that apply.)
A
  1. Speak in a low tone.
  2. Begin and end the session with the most important information regarding melanoma.
  3. Provide specific information in frequent, small amounts for older adult patients.
36
Q
  1. A 55-year-old adult male has been in the hospital over a week following surgical complications. The patient has had limited activity but is now finally ordered to begin a mobility program. The patient just returned from several diagnostic tests and tells the nurse he is feeling quite fatigued. The nurse prepares to instruct the patient on the mobility program protocol. Which of the following learning principles will likely be affected by this patient’s condition?
A
  1. Readiness to learn
37
Q
  1. A patient recovering from open heart surgery is taught how to cough and deep breathe using a pillow to support or splint the chest incision. Following the teaching session, which of the following is the best way for the nurse to evaluate whether learning has taken place?
A
  1. Return demonstration
38
Q
  1. A patient’s cultural background affects the motivation for learning. Using the ACCESS model, match the nursing approach with the correct model component.
A
  1. Assessment
    - E. Learn about the patient’s health beliefs and practices.
  2. Communication
    - B. Remain aware of verbal and nonverbal responses.
  3. Cultural
    - D. Become aware of your patient’s culture and your own cultural biases.
  4. Establishment
    F. Show respect by creating a caring rapport.-
  5. Sensitivity
    - C. Be aware of how patients from diverse backgrounds perceive their care needs.
  6. Safety
    - A. Help patients feel culturally secure and able to maintain their cultural identity.
39
Q
  1. A 63-year-old woman is a family caregiver for her 88-year-old mother who has dementia. The caregiver asked the home health nurse how to manage her mother when she becomes confused and violent. The best instructional method a nurse can use for this situation is:
A
  1. Role-playing
40
Q
  1. A nurse is preparing to teach a patient who has sleep apnea how to use a CPAP machine at night. Which action is most appropriate for the nurse to perform first?
A
  1. Set mutual goals for the education session.
41
Q
  1. Which of the following scenarios demonstrate that learning has taken place? (Select all that apply.)
A
  1. A patient describes how to set up a pill organizer for newly ordered medicines.
  2. A patient demonstrates how to take his blood pressure at home.
42
Q

Affective domain?

A

The “feeling” domain

Includes values, beliefs, feelings and attitudes association with information received
Begins with receiving and responding to information
Willing to listen, discuss feelings
Moves to client attaching worth to information - shown by choosing a particular action from among alternatives
Higher levels - integrates value into everyday life and changes lifestyle

43
Q

Psychomotor domain?

A

The “skill” domain

Includes physical and motor skills
Uses cues from the environment
Must have physical, mental, & emotional readiness
Performance of skill moves from imitation to creation of new way to perform skill

44
Q

Cognitive domain?

A

The “thinking” domain

Ability to make sense of and use information
Begins with acquiring knowledge - memory & recall
Move to comprehending and applying knowledge - understanding, repeat back own words, abstract ideas applied to a situation, i.e. call when have symptoms of adverse effect
Higher levels - able to analyze, synthesize, and evaluate based on knowledge obtained

321 Intro Health Promotions kyle notes (9 decks)

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