Health and medical help needed on discharge teaching

The focus
of this assignment is identifying patient’s needs and analysis and synthesis of
details within the written client record and planning an appropriate discharge
plan with necessary patient teaching of the disease process. You will identify
the patient needs and provide the technique used for teaching the content to
the patient. You must also provide the rationale for the teaching technique.

Discharge Teaching
Plan Case Study

Week 2: Sherman “Red”
Yoder

Directions

This case study provides information you will need to know
to complete the Discharge Teaching Plan Assignment. Please see the guidelines
in Doc Sharing for more details and grading rubrics for this assignment. After
you read the case study, obtain the Discharge Teaching Plan form from Doc
Sharing and document your teaching plan for Mr. Yoder.

Case Study

Continuing our story of Mr. Red Yoder, our elderly diabetic
patient:

Two weeks later, Red misses his Monday morning coffee at the
local VFW. He has also missed church for the past four Sundays. He usually has
a few whiskey sours a day and needs to take something for sleep (Benadryl). Jon
(Red’s son) gets “irritated with me over my beer and whiskey habits and yells
pretty loud” at times. His friends “worry about him.” “I know it’s only 20
miles to the VFW, but I just haven’t felt like eating the last couple of days;
maybe I’ve got the flu that’s going around.”

Red does not like to cook and usually picks up whatever is
convenient, such as cake and donuts and some fast food. He also loves bacon! The
home health nurse wanted to make sure he didn’t get an infection in that toe
and now she is back to change the bandage. Red relates to the home health nurse
“I’m not sure if I should take my insulin because I’m not eating, but my blood
sugar was 203 when I poked my finger this morning. How can my sugar be that
high when I’m not eating much? I just took off my sock to check on my sore and
my whole foot is red and big. I haven’t looked at it for a few days; it was
just a little pink the last time I checked it. I should have paid closer
attention to those pills I was supposed to take, that antibiotic. “

Red requires admission to the hospital for sepsis of the
wound.

Admission notes:

Today’s
Date
: [assume it is today]

Brief Description of Client:

Name: Sherman
“Red” Yoder

Gender: Male   Age: 80  Race:
Caucasian

Weight: 109 kg (240
pounds)

Height: 183cm (72
inches)

Religion:
Protestant

Major Support:
Jon (son)  Phone: 869-555-3452

Allergies: no
known allergies

Immunizations:
Influenza last fall; tetanus 4 years ago

Attending
Physician/Team:
Dr. Frank Baker

Past
Medical History:
Diabetes Type 2 diagnosed June 2 (last year).

History of Present illness:

Patient developed an ulcer on his big toe that was treated
at home for 2 weeks. Son brought patient to ER 6 days ago and patient was
treated for sepsis with IV antibiotics.

Social History:

Widower; son (Jon) lives nearby

Primary Medical Diagnosis:

Sepsis

Surgeries/Procedures & Dates:

L4-5 laminectomy – 25 years ago;

Transurethral resection of the prostate – 6 years ago

Nursing Diagnoses:

· 
Impaired Walking;

· 
Impaired Skin Integrity;

· 
Ineffective Health Maintenance;

· 
Ineffective Self Health Management

One week later, Red is being discharged home with home
health for wound care. Please prepare a discharge teaching plan for Mr. Yoder
and his care takers.

Purpose: The focus of this
assignment is identifying patient’s needs and analysis and synthesis of details
within the written client record and planning an appropriate discharge plan
with necessary patient teaching of the disease process.

Points: This assignment is worth a total of 100 points.

Directions:
Please refer to the Discharge Teaching Plan Guidelines found in Doc Sharing for
details about how to complete this form. Remember
there is a 6 page maximum limit on this assignment.

Type your answers on this form. Click “Save as” and save the
file with the assignment name and your last name, e.g., “NR305_Discharge_Teaching_
Plan_Form_Smith” When you are finished, submit the form to the Teaching Plan
Dropbox by the deadline indicated in your guidelines. Post questions in the Q &
A Forum or contact your instructor if you have questions about this assignment.

Look at the EXAMPLE
in the first assessment area. This is NOT an all-inclusive response and you will need to add your responses
as well. Please be sure to review your guidelines.

Assessment area

Need(s) identified.

Teaching technique or approach to problem identified.

Describe content.

Rationale for choosing this technique/approach.

Example:

Special/ age related needs

These are some ideas, there may be others that you
identify.

· 
Age,
lives alone, is non-compliant with diet.

· 
Expected
aging changes such as decreased hearing, visual difficulties.

· 
Red
appears to not understand his
glucose numbers and how that relates to his diet and insulin administration.

· 
Home
health nurse to assist Red and family in proper insulin management and
administration

Ideas for teaching methods/approach based on the
scenario and problems noted. You may have identified others.

· 
Teach
importance of diet and insulin management to Red and family and how to better
manage his diabetes.

· 
Use
videos, audio and teach back methods. It may even be helpful to assure proper
reading of the glucometer and administration of the insulin by Red or his
family.  

Provide a brief rationale on why you chose these
particular technique/approaches.

For example, Red may have
poor eyesight due to the diabetes and needs audio and demonstration with
return demonstration. He may not be able to see the lines on the insulin
syringe.

Cognitive issues

Physical barriers

Medications

Nutrition

Roles and Relationships

Self-concept

Wound care

Resources/ referrals needed

Expert Solution Preview

Introduction:
The Discharge Teaching Plan Case Study focuses on identifying patient needs, analyzing and synthesizing details within the written client record, and planning an appropriate discharge plan with necessary patient teaching of the disease process. The scenario involves an elderly diabetic patient, Sherman “Red” Yoder, who requires admission to the hospital for sepsis of the wound and later being discharged home with home health for wound care. The assignment requires the identification of patient needs, the technique used for teaching the content to the patient, and the rationale for the teaching method.

Answer:
Assessment area: Cognitive issues
Need(s) identified: Mr. Yoder appears to have difficulties in understanding his glucose numbers and how they relate to his diet and insulin administration.
Teaching technique or approach to problem identified: To address Mr. Yoder’s cognitive issues, the home health nurse should use simple language that Red can understand and break down the teaching into smaller parts. It would be helpful to use visual aids like diagrams and drawings to illustrate the concepts involved.
Rationale for choosing this technique/approach: Mr. Yoder may have difficulty understanding the medical terminology and the relevance of various interventions and procedures to his recovery process. Therefore, breaking down the concepts into simple language would enable him to understand the information and apply them to his health management. The use of visual aids would reinforce the learning and enhance Mr. Yoder’s comprehension of the concepts involved in diabetes management.

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