NFDN 1002 Nursing Foundations II Basic Nursing Teaching Plan Assignment #2 Template V1.24 NorQuest C

NFDN 1002 Nursing Foundations II: Basic Nursing Teaching Plan; Assignment #2 Template V1.24 NorQuest College

Teaching Plan; Assignment #2

NorQuest college

NFDN 1002

Lola Palmer

Jaylin Symington

Mr Klein Is forty-five-year-old man who Is a father to two teenage daughters and a husband to Mrs. Klein. His family owns a small ranch which he works extremely hard on for long hours doing hard physical labour. Mr Klein was a very social active, often meeting friends for coffee and playing cards weekly prior to his surgery. Mr Klein was diagnosed with Crohn’s disease twenty years ago which has lead him to have his large bowel removed and have a right upper quadrant Ileostomy, that he was discharged from two weeks ago. Mr Klein has limited access to water and/or washroom when working In the fields.

He came for a follow-up check up today where he expressed that he finds his stoma repulsive, and his ostomy pouch has been falling off everyday. He believes It Is because his stool Is too watery, so he has been avoiding drinking water and taking lomotil. He describes his stool as pasty brown like watery oatmeal. He also avoids emptying his pouch until It Is full.

Mr. Klein skin Is dry, lips cracked and skin tugor Is a sign of dehydration. Vital signs are T- 37.1, pulse Is 104bpm weak and regular, BP 90/58, resp- 20bpm, 02- 97% RA. Mrs. Klein said that Mr. Klein refuses help with his stoma care or to talk about his feelings about it and thinks the stoma Is temporary and will be reversed. She also said that he has been with drawling from his social life and that he has a minor learning disability

Assessment Data and Learning Needs (complete template below) Learning Need #1 Ostomy care and maintenance

The client has just recently gotten a RUP Ileostomy that keeps falling off and he does not empty until full.

Teaching the client how to properly apply the pouch and to empty It before It gets full will be beneficial, so he is not having to reattach it everyday

Learning Need #2 The client’s skin is dry, lips are cracked, and skin was tugor.

Teaching the client the importance of staying hydrated and the signs of dehydration will help to keep him hydrated and healthy Priority Nursing Diagnosis ( See instructions) Deficient knowledge related to Ostomy care and maintenance as Managing stool consistency and Hydration

evidenced by inadequate self-care practices and ostomy bag falling off everyday.

Goal Statement (See instructions) Mr Klien will be able to do his Ileostomy care independently and confidently and staying hydrated consistently for two weeks Expected Learning Outcome (Smart Criteria) (see instructions) After two weeks Mr. Klien will be able to correctly apply his ostomy pouch by himself so that It does not fall off until he removes It when It Is 1/3 full.

Domain of Learning #1 (Includes Rationale and Literature Support) Psychomotor.domain Psychological ability is the It is essential for Mr. Klein To

ability to control motor actions

develop physical skills through

proceeding a psychological

practice to apply the ostomy

process (Including brain

pouch correctly and to empty it.

activity). Psycho motor

Demonstrations and repeated

objectives are those specific to

practice will work better for him

discrete physical functions,

than verbal instructions to

reflex actions, and interpretive

overcome his learning disability

movements

Domain of Learning #2 (Includes Rationale and Literature Support) Literature Support Cognitive Domain The cognitive domain is essential

The cognitive domain contains

to understand the ostomy care

learning skills predominantly

concepts that are not able to be

related to mental (thinking)

taught physically Like the

processes. Learning processes in

importance of consistency and

the cognitive domain include a

emptying the pouch, nutrition,

hierarchy of skills involving

and hydration. Mr. Klein

processing information,

struggles with verbal teaching so

constructing understanding,

things that could help him are

applying knowledge, and solving

teachback, written instructions,

problems. (Hogue, 2016, pg.46)

and repetition Client Barriers 1. A Significant barrier to Mr. klein's learning Is Mr. Kleins mild learning disability. The disability makes it difficult for him to process and learn new information especially when the information

is given verbally. This would mean that It would be difficult for him to understand the ostomy care just through verbal instruction, he will need assistance learning tools like visual aids.

2. Mr. Klein's emotional state and resistance to accept His new way of life Is another significant barrier. This change Can be hard to accept in his lifestyle and can Cause hesitant to get engaged in the learning process. This can be evidenced by his refusal to discuss his feelings

Teaching Plan ( Using APA 7) Educational Content Mr. Klein will be taught how to properly apply and secure the ostomy pouch to prevent leaks, then empty the pouch correctly at the appropriate time when it is 1/3 full. First verbally and then physical demonstrations of all these steps will be done, then repeating the steps with him and finally asking him to re demonstrate It by himself. Mr. Klein will be further educated on ostomy care and maintenance to avoid skin irritation, and infection.

These psychomotor Learning samples listed above will be done so Mr. Klein will be able to manage his ostomy independently with the necessary skills as explained in Colwell, & Beitz (2017)

Managing Stool Consistency and Hydration Mr. Klein will be taught about the importance of staying hydrated, especially for patients with a Ileostomy. The signs of dehydration he needs to be aware of are cracked lips and dry skin turgor. He can increase fluid intake by eating more fiber, and taking in more fluid besides tea and coffee. This involves the cognitive domain of learning and relates to the expected outcome of Mr. Klien keeping himself hydrated for two weeks.

Coping Strategies Mr. Klein is extremely uncomfortable with his ostomy bag and that is shown by his reluctant Ness to have conversation about his feelings, avoidance of emptying the ostomy bag and losing his social life. Mr. Klein should be shown that his feelings are normal, and many people go through this. Mrs. Klein should be encouraged to join in on the care so that Mr. Klein gets more comfortable with it

Teaching Methods Cognitive domain: The setting would be at home, so he Is comfortable and there are no distractions. A 20-minute individual interactive education session will be done three times a week. The patient will be shown visual aids like videos explaining how his

Ileostomy works, and the key points. Important Information should be repeated and to encourage Mr. klein's active partition ask questions to verify understanding. He will be provided with a pamphlet explaining nutrition and hydration for maintaining stool consistency Psychomotor Domain: This setting would be Mr. klein's bathroom either at home or in a hospital setting. This would be 40 minute sessions, three times a week for two weeks and hands on training and practice. Mr. Klein will be shown a physical demonstration of how to correctly apply and remove the ostomy pouch going slowly while clarifying with him. A re demonstration will be expected from him as well as feedback will be provided on his technique.

Affective Domain: The setting would be in a private counseling room or if he feels uncomfortable a quiet room at his house. This would be at least 1/2 an hour session once a week but can be more if he wants. It would be one-on-one sessions that provide him counseling and support. It would give him the ability to express his feelings and concerns and would be taught techniques in order to feel more comfortable with his new life an emotional state. His feelings will be validated through empathetic listening.

Teaching Resources

Psychomotor Domain: Mr. Klien will be shown a physical demonstration along with this video he will be provided with to watch at home. https://www.youtube.com/watch?v=JrtO2KkLZsQ Affective Domain: Mr. Klien will be told several different stress reliving techniques In person and then given this article to look back on If he forgets. https://www.uakron.edu/armyrotc/ms1/14.pdf Cognitive domain: Mr. Klien will be provided with Info on how to stay hydrated along with this video https://www.youtube.com/watch?v=khWTCIiuLgg

Evaluation of learning To evaluate the cognitive domain the role-playing discovery method encourages patients to actively apply knowledge in controlled situations and the teach back method will be a good method to evaluate the learning of patience (Astle & Duddleby, 2024). To evaluate psycho motor, I will observe his demonstration and provide constructive feedback on the skill (Astle & Duddleby, 2024). Finally for affective domain a one-on-one discussion is always the best method for evaluating the feelings (Astle & Duddleby, 2024).

Analysis of the Teaching process In the nursing care of Mr. Klein, teaching is very critical to educate him on how to care for his ostomy independently. Effective teaching can help Mr. Klein to develop necessary skills to do it by himself which will also help his self-confidence and his feelings towards the stoma. This also will encourage emotional well-being if he is more confident with himself and his new change in his life. overall, all of these techniques will help to change his lifestyle, embrace his social life and to cope better with his ostomy care and maintenance

Reflection -Strengths and Challenges The strengths of this approach Is using other teaching methods like the physical demonstrations help to overcome his learning barrier. Using the teach-back method also ensures that he fully understands to his capabilities when and how to apply his ostomy pouch. Using all domains Including psycho motor, affective and cognitive give multiple angles to approach this learning barrier.

We also focus on not only his physical education but his but also the emotional support, so he Is open to understanding these concepts.

The challenge of this teaching Is overcoming his emotional resistance and denial that the Ileostomy is going to be long term.

Overcoming this Is going to take a lot of support and time since he feels so uncomfortable about it. Mr. Klein also Is a very hard working man on his ranch so that will take up time and may also lower his energy while doing the teachings and his therapy sessions.

Conclusion This teaching plan will be overall beneficial for Mr. Klien because It will not only help his knowledge of his Ileostomy but also his feelings towards It. It will help him holistically not just focusing on one part of him. It will provide knowledge about pouch removal and reattachment, emptying It, hydration, nutrition, and emotional support. This will also help me when doing future teaching plans, critical thinkings and thinking about the whole person not just the physical goal.

References Colwell, J.C., & Beitz, J.M. (2017). Ostomy and Care management: A comprehensive review. Journal of Wound, Ostomy and Continence Nursing, 44(1), 58-65 Astle, B.J., Duggleby, W., Potter, P.A., Stockert, P.A., Perry, A.G., & Hall, A.M. (Ed’s.).

(2024). Canadian fundamentals of nursing (7th ed.) Elsevier.

Hoque, E. H. (2017, January). Three domains of learning: cognitive, affective and psychomotor. https://www.researchgate.net/publication/330811334_Three_Domains_of_Learning _Cognitive_Affective_and_Psychomotor.