Module 3 Flashcards
like routines
* Separation anxiety is
also characteristic of this
stage of development
Toddlers
- Patient education for infancy through toddlerhood
need not be illness related.
True
2.Preschool children continue with development of
skills learned in the earlier years of growth.
3.The nurse’s interactions with preschool children and their parents are often sporadic, usually
occurring during occasional well-child visits to the pediatrician’s office or when minor medical
problems arise.
Usually less time is devoted to
teaching parents about illness care,
and considerably more time is spent
teaching aspects of
- normal development,
- safety,
- health promotion,
- disease prevention
Parents should be present whenever possible during learning activities to allay stress,
which could becompounded by separation anxiety
Ideally, health teaching should take
place in an environment familiar to the
child,
such as the home or day-care center
When the child is hospitalized, the
environment selected for teaching and
learning sessions should be as safe and
secure as possible, such as the child’s
bed or the playroom,
to increase the child’s sense of feeling protected.
Short-Term Learning for Toddlers
- Read simple stories from books with lots of pictures.
- Use dolls and puppets to act out feelings and behaviors.
- Use simple audiotapes with music and videotapes with cartoon characters.
- Role-play to bring the child’s imagination closer to reality.
- Give simple, concrete, nonthreatening explanations to accompany visual and tactile
experiences. - Perform procedures on a teddy bear or doll first to help the child comprehend what an
experience will be like. - Allow the child something to do—squeeze your hand, hold a Band-Aid, cry if it
hurts—to channel their responses to an unpleasant experience. - Keep teaching sessions brief (no longer than about five minutes each) because of the child’s
short attention span. - Cluster teaching sessions close together so that children can remember what they
learned from one instructional encounter to another. - Avoid analogies and explain things in straightforward and simple terms because children take
their world literally and concretely. - Individualize the pace of teaching according to the child’s responses and level of attention.
Long-Term Learning for Toddlers
- Focus on rituals, imitation, and repetition of information in the form of
words and actions to hold the child’s attention. - Use reinforcement as an opportunity for children to achieve permanence
of learning through practice. - Employ the teaching methods of gaming and modeling as a means by
which children can learn about the world and test their ideas over time. - Encourage parents to act as role models because their values and beliefs
serve to reinforce healthy behaviors and significantly influence the child’s
development of attitudes and behaviors.
3–6 Years of Age
Preschooler
Preschooler (3–6 Years of Age)
- Preschool children continue with development of skills
learned in the earlier years of growth. - Their sense of identity becomes clearer, and their world
expands to encompass involvement with others external
to the family unit. - Children in this developmental category acquire new
behaviors that give them more independence from their
parents and allow them to care for themselves more
autonomously. - Learning during this time period occurs through
interactions with others and through mimicking or
modeling the behaviors of playmates and adults
(Whitener et al.,2008).
Teaching Strategies
- The nurse’s interactions with preschool children and their
parents are often sporadic, usually occurring during occasional
well-child visits to the pediatrician’s office or when minor
medical problems arise. - During these interactions, the nurse should take every
opportunity to teach parents about health promotion and
disease prevention measures, to provide guidance regarding
normal growth and development, and to offer instruction about
medical recommendations when illnesses do arise. - Parents can be a great asset to the nurse in working with
children in this developmental phase, and they should be
included in all aspects of the educational plan and the actual
teaching experience (Ryberg & Merrifield, 1984;Woodring,
2000). - Parents can serve as the primary resource to answer
questions about children’s disabilities, their idiosyncrasies, their
favorite toys—all of which may affect their ability to learn
(Hussey & Hirsh, 1983). - Children’s fear of pain and bodily harm is uppermost in their
minds, whether they arewell or ill. Because of preschoolers’
fantasies and active imaginations, it is most important for the
nurse to reassure them and allow them to express themselves
openly about their fears (Heiney, 1991) - Choose your words carefully when describing procedures.
Preschoolers are familiar with many words, but using terms like
“cut” or “knife” is frightening to them. Instead, use less
threatening words like “fix,” “sew,” or “cover up the hole.” “Band-Aids” rather than “dressings” is a much more understandable
term, and bandages are often thought by children to have
magical healing powers (Babcock & Miller, 1994). - Although still dependent on family, the preschooler has begun
to have increasing contact with the outside world and is usually
able to interact more comfortably with others.
Parents should be present whenever possible during learning activities to allay stress,
which could becompounded by separation anxietywhich could be compounded by separation anxiety.
- Nevertheless, ________ in a child’s life should be
included as participants during teaching sessions.
significant adults
They can provide support to the child, substitute as the teacher
if the child is reluctant to interact with the nurse, and reinforce
teaching at a later point in time.
significant adults (mother and father)
The primary caretakers
mother and father
are the recipients of the majority of the
nurse’s teaching efforts.
mother and father
They will be the learners to assist the
child in achieving desired health outcomes (Hussey & Hirsh,1983; Kennedy & Riddle, 1989; Whitener et al., 1998).
mother and father
Short-Term Learning for Pre-school
- Provide physical and visual stimuli because language ability is still
limited, both for expressing ideas and for comprehending verbal
instructions. - Keep teaching sessions short (no more than 15 minutes) and scheduled
sequentially at close intervals so that information is not forgotten. - Relate information needs to activities and experiences familiar to the
child. - Encourage the child to participate in selecting between a limited number
of teaching–
learning options, such as playing with dolls or reading a story, which
promotes
active involvement and helps to establish nurse–client rapport. - Arrange small group sessions with peers as a way to make teaching less
threatening and more fun. - Give praise and approval, through both verbal expressions and
nonverbal gestures, which are real motivators for learning. - Give tangible rewards, such as badges or small
toys, immediately following a successful learning
experience as reinforcers in the mastery of cognitive
and psychomotor skills. - Allow the child to manipulate equipment and play
with replicas or dolls to learn about body parts.
Special kidney dolls, ostomy dolls with stomas, or
orthopedic dolls with splints and tractions provide
opportunity for hands-on experience. - Use storybooks to emphasize the humanity of healthcare personnel; to depict relationships
between child, parents, and others; and to assist with helping the child identify with particular situations.
Long-Term Learning for Pre-school
- Enlist the help of parents, who can play
a vital role in modeling a variety of
healthy habits, such as practicing safety
measures and eating a balanced diet. - Reinforce positive health behaviors and
the acquisition of specific skills.
(6–12 Years of Age)
School-Aged Childhood
children have progressed in their physical, cognitive, and psychosocial skills to the point where most begin formal training in structured school
systems.
School-Aged Childhood
They approach learning with enthusiastic
anticipation, and their minds are open to new and varied ideas.
School-Aged Childhood
- The nurse in the role of educator should explain
illness, treatment plans, and procedures in simple,
logical terms in accordance with the child’s level of
understanding and reasoning. Although school-aged
children are able to think logically, their ability for
abstract thought remains limited.
Therefore, teaching
should be presented in concrete terms with step-by step instructions (Pidgeon, 1985).
It is imperative that you observe children’s reactions
and listen to their verbal feedback to confirm that
information shared has not been misinterpreted or
confused. To the extent feasible, parents should be
informed of what their child is being taught. Teaching
parents directly is encouraged so that they may be
involved in fostering their
child’s independence,
providing emotional support and physical assistance, and giving guidance regarding the correct techniques or regimens in self-care management
should also be considered as sources of support (Hussey & Hirsh, 1983). In
attempting to master self-care skills, children thrive
on praise from others important in their lives as
rewards for their accomplishments and successes.
Siblings and peers
is most likely to occur in the school system through the school nurse, but the parents as well as the nurse outside the school setting should be
told what content is being addressed.
Education for health promotion and health
maintenance
is in an excellent
position to coordinate the efforts of all other providers so as to avoid duplication of teaching content or the
giving of conflicting information as well as to provide reinforcement of learning.
school nurse
Short-Term Learning for School-Aged
- Clarify any scientific terminology and medical jargon used.
- Use analogies as an effective means of providing information in meaningful
terms, such as “A chest x-ray is like having your picture taken” or “White
blood cells are like police cells that can attack and destroy infection.” - Use one-to-one teaching sessions as a method to individualize learning
relevant to the child’s own experiences and as a means to interpret the
results of nursing interventions particular to the child’s own
condition.
Provide time for clarification, validation, and reinforcement of what is being
learned. - Select individual instructional techniques that provide opportunity for
privacy, an increasingly important concern for this group of learners, who
often feel quite self-conscious and modest when learning about bodily
functions. - Employ group teaching sessions with others of similar age and
with similar problems or needs to help children avoid feelings of
isolation and to assist them in identifying with their own peers. - Prepare children for a procedure well in advance to allow them
time to cope with their feelings and fears, to anticipate events,
and to understand what the purpose of a procedure is, how it
relates to their condition, and how much time it will take. - Encourage participation in planning for procedures and events
because active involvement will help the child to assimilate
information more readily. - Provide much needed nurturance and support, always keeping
in mind that young children are not just small adults.
Long-Term Learning for School-Aged
- Help school-aged children acquire skills that they can
use to assume self-care responsibility for carrying out
therapeutic treatment regimens on an ongoing basis
with minimal assistance. - Assist them in learning to maintain their own well-being and prevent illnesses from occurring
(12–18 Years of Age)
Adolescence
marks the transition from childhood
to adulthood. During this prolonged and very changeable
period of time, many adolescents and their families experience
much turmoil.
Adolescence
How adolescents think about themselves and the world significantly influences many healthcare issues facing them, from anorexia to diabetes.
Adolescents
Teenage thought and behavior give insight into the etiology of
some of the major health problems of this group of learners (Elkind, 1984).
Adolescence
are known to be among the nation’s most at-risk populations (American Association of
Colleges of Nursing, 1994).
Adolescents
For patient education to be effective,
an understanding of the
characteristics of the adolescent phase of development is
crucial
potential threats to their well-being, ________ use medical services the least frequently of all age
groups. Compounding this problem is the realization
that adolescent health has not been a national priority and their health issues have been largely ignored by the healthcare system (American Association of
Colleges of Nursing, 1994).
adolescents
ADULTS LEARN BEST WHEN:
Principle #1 Learning is related to an immediate need,
problem, or deficit.
Principle #2 Learning is voluntary and self-initiated.
Principle #3 Learning is person centered and problem
centered.
Principle #4 Learning is self-controlled and self-directed.
Principle #5 the role of the teacher is one of facilitator.
Principle #6: Information and assignments are pertinent.
Principle #7: New material draws on past experiences and
is related to something the learner already knows.
Principle #8: The threat to self is reduced to a minimum in
the educational situation.
Principle #9: The learner is able to participate actively in
the learning process.
Principle #10: The learner is able to learn in a group.
Principle #11: The nature of the learning activity changes
frequently.
Principle #12: Learning is reinforced by application and
prompt feedback.
Basically, three categories describe the general
orientation of adults toward continuing education
(Babcock & Miller, 1994):
- Goal-oriented learners
- Activity-oriented learners
- Learning-oriented learners
- Teaching strategies must be directed at
encouraging
young adults to seek information that expands their knowledge base, helps them control their lives, and
bolsters their self-esteem. Whether they are well or ill, young adults need to know about the opportunities
available for learning
- Making them aware of health issues and learning
opportunities can occur in a variety of settings, such as:
In all cases, these
educational opportunities must be convenient and
accessible to them in terms of their lifestyle with
respect to work and family responsibilities
physicians’ offices, community clinics, outpatient
departments, or hospitals.
- they tend to be very self-directed in their approach to learning, young adults do well with ____________ and _____________that allow them to independently self-pace their learning.
written patient education materials and audiovisual tools
is an attractive method for teaching
and learning because it provides young adults with the
opportunity to interact with others of similar age and situation, such as parenting groups, prenatal classes,
or marital adjustment sessions
Group discussion
- Although assessment prior to teaching will help to determine the level at which to begin teaching, no matter what the content, the______ to make
learning easier and more relevant is to present
concepts logically from simple to complex and to
establish conceptual relationships through specific application of information.
enduring axiom
is the transition period between young
adulthood and older adulthood.
midlife
During _____________
many individuals have reached the peak in their
careers, their sense of who they are is well developed,
their children are grown, and they have time to pursue
other interests. It is a time for them to reflect on the
contributions they have made to family and society and
to reexamine their goals and values.
middle age,
When teaching members of this age group,
the nurse
must be aware of their potential sources of stress, the health risk factors associated with this stage of life, and the
concerns typical of midlife.
Common misconceptions among middle adult
physical changes such as menopause
may interfere with their ability to learn or may stimulate
them to seek the help of healthcare providers. Those who
have lived healthy and productive lives are often motivated
to make contact with health professionals to ensure
maintenance of their healthy status.
Stress
It is an opportune time on the part of the nurse educator
- Many
need and want information related to chronic illnesses that
can arise at this phase of life.
to reach out to assist these middle-aged adults in coping
with stress and maintaining optimal health status.
Adult learners need to be
reassured or complimented on
their learning competencies.
is internalized and serves to reward them for their efforts.
Reinforcement for learning
Teaching strategies for learning are similar to those instructional methods and tools used for the _____learner, but the content is different to coincide with the concerns and problems specific to this group of learners.
young adult
Most older persons suffer from at least one chronic
condition, and many have multiple conditions.
On the average, they are hospitalized longer than persons in other age categories and require more teaching overall
to broaden their knowledge of self-care
True
is the capacity to perceive
relationships, to reason, and to perform abstract
thinking. This kind of intelligence declines as
degenerative changes occur.
Fluid intelligence
The decline in fluid
intelligence results in the following specific changes:
- Slower processing time
- Persistence of stimulus
- Decreased short-term memory
- Increased test anxiety
- Altered time perception
- Learning in older adults can be affected by such
sociological and psychological factors such as
retirement,
economics,
and mental status.
- Understanding older persons’ developmental tasks
will allow nurses to alter how they approach both well and ill individuals in terms of
counseling,
teaching, and
establishing a therapeutic relationship
Nurses must be aware of the fact that older patients
will frequently delay medical attention.
True
may lead to
decreased cognitive functioning and perhaps prevent early disease detection and intervention.
Social isolation,
loneliness, and
sensory deprivation
Health education for older persons should be directed
at promoting their involvement and changing their
attitudes toward learning (Weinrichet al., 1989; Ahroni,
1996).
should be cultivated
in which they are made to feel important for what they once were as well as for what they are today.
A climate of mutual respect
