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Patient Education and Drug Therapy
Chapter 6 Patient Education and Drug Therapy Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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The Domains of Learning
Cognitive domain Affective domain Psychomotor domain Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Patient Education: Assessment
Adaptation to any illness Age Barriers to learning Cognitive abilities Coping mechanisms Cultural background Developmental status Education, including literacy level Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Patient Education: Assessment (cont’d)
Emotional status Environment Folk medicine, home remedies, alternative/complementary therapies Family relationships Financial status Health literacy Psychosocial growth and development Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Patient Education: Assessment (cont’d)
Health beliefs Information patient understands about past and present medical conditions Language(s) spoken Level of knowledge about current medications Misinformation about drug therapy Limitations (physical, psychologic, cognitive, motor) Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Patient Education: Assessment (cont’d)
Current medications, including over-the-counter and herbal medications Mobility Motivation Nutritional status Past and present health behaviors Past and present experience with drug regimens and other therapies Race and/or ethnicity Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Patient Education: Assessment (cont’d)
Readiness to learn Religious beliefs Self-care ability Sensory status Social support Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Classroom Response Question
The nurse is caring for an 85-year-old patient in the hospital and teaching him how to use an inhaler. His 84-year-old wife attends the teaching sessions, and their daughter comes in to visit in the evenings. The patient is having trouble remembering the steps. The nurse should provide the package insert that comes with the medication for the patient to read. focus the teaching sessions on the patient’s wife. provide small amounts of information at a time, repeating information frequently. wait until the daughter comes in and teach the daughter instead. Correct answer: C Rationale: Providing small amounts of information at a time and repeating information frequently are appropriate educational strategies for an elderly patient who may be having trouble with short-term memory. Written instructions should also be provided, but they should be in a format that the patient can easily read. The package insert may contain small lettering. Family members should be included if possible. Copyright © 2014 by Mosby, an imprint of Elsevier Inc. Elsevier items and derived items © 2009, 2005, 2001 by Saunders, an imprint of Elsevier Inc.
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Patient Education: Nursing Diagnoses
Deficient knowledge Impaired memory Ineffective self-health management Readiness for enhanced self-health management Noncompliance Risk for falls Risk for injury Sleep deprivation Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Classroom Response Question
A patient with newly diagnosed type 1 diabetes mellitus has completed a diabetes education program. One month later, the patient confesses at a follow-up appointment that he “just didn’t feel like” giving himself the insulin injections. Which nursing diagnosis will the nurse assign the patient? Deficient knowledge Noncompliance Impaired memory Sleep deprivation Correct answer: B Rationale: Deficient knowledge differs from noncompliance in that the latter occurs when the patient does not take the medication as prescribed or at all—in other words, the patient does not comply with or adhere to the instructions given about the medication. Noncompliance (also called nonadherence) is usually a patient’s choice. Copyright © 2014 by Mosby, an imprint of Elsevier Inc. Elsevier items and derived items © 2009, 2005, 2001 by Saunders, an imprint of Elsevier Inc.
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Patient Education: Planning
Goals and Outcome Criteria Measurable Realistic Based on patient needs Stated in patient terms Time frame Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Patient Education: Implementation
Teaching-learning sessions Consideration of age-related changes Consideration of language barriers Safe administration of medications at home Return demonstration with equipment For adults, it is recommended that materials be written at an 8th grade level Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Classroom Response Question
A nurse is providing patient teaching for a community health center that serves a primarily Portuguese population. The nurse would best serve this patient population by learning Portuguese. always using interpreter services. using the family member interpreter the patient provides. finding a job in a different setting. Correct answer: A Rationale: The nurse should communicate with the patient in the patient’s native language if at all possible. If the nurse is not able to speak the patient’s native language, then a professional translator should be hired. It is best to avoid family members as translators, if possible, because of issues with bias, misinterpretation, and potential confidentiality issues. Copyright © 2014 by Mosby, an imprint of Elsevier Inc. Elsevier items and derived items © 2009, 2005, 2001 by Saunders, an imprint of Elsevier Inc.
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Patient Education: Evaluation
Validate whether learning has occurred Ask questions Have the patient provide a return demonstration Behavior, such as compliance and adherence to a schedule Occurrence of few or no complications Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Patient Education: Evaluation (cont’d)
Develop and implement new plan of teaching as needed for: Noncompliance Inadequate levels of learning Copyright © 2014 by Mosby, an imprint of Elsevier Inc.
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Classroom Response Question
After providing education regarding medications to a patient who has been newly diagnosed with type 2 diabetes mellitus, the nurse would use which part of the nursing process to assess whether the patient understands these new instructions? Assessment Diagnosis Implementation Evaluation Correct answer: D Rationale: The nurse would evaluate the effectiveness of the teaching session and look for areas where the patient needs reinforcement. Copyright © 2014 by Mosby, an imprint of Elsevier Inc. Elsevier items and derived items © 2009, 2005, 2001 by Saunders, an imprint of Elsevier Inc.
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