NFDN 1200 Teaching Plan

Summarize general assessment findings in four boxes below. (NFDN 1200 Teaching Plan)

The client, D.W., is a 43-year-old female in middle adulthood. The patient is Caucasian and speaks English.

The client is experiencing headaches, vision changes, anxiety, fatigue, irregular heart rhythms. She is in constant fear and worry of when the symptoms will appear next, which increases her anxiety. The patient feels like she is unable to function properly because any time her blood pressure can rise, and she might not be able to manage her condition in the long-term.

The patient has a medical history of obesity and generalized anxiety disorder, which she has been treated. However, lately her blood pressure has been irregular, constantly rising at unpredicted times and situations, including during normal home and work activities, causing her anxiety to rise.

She is under enalapril, ramipril, Diovan, and Benicar, which have helped her manage symptoms, but seem ineffective of late.

The client lives with her family in Washington, D.C. She is a mother of two and married.

The husband is the family’s primary provider, but the client also contributes financially, although her job is not well-paying as her husband’s. The family is a middle-income family living in a gated community.

The family is the primary support system for the client.

The client has been diagnosed with obesity and generalized anxiety disorder before; therefore, utilizing therapy and nursing knowledge, communication, interventions and interactions to aid the recovery process and promote the quality of life.

The client is seeking nursing intervention to help manage her blood pressure, which has been fluctuating constantly in the last one month.

The client is willing to learn how she can improve disease management and live a more quality life.

The client needs to learn how to manage her condition without depending primarily on medications. Despite job and family responsibilities, the client should put extra effort into adopting healthier lifestyle behaviors, including a healthy diet, exercising regularly, reducing stress levels, monitoring blood pressure at home, and maintaining a healthy weight.

·         The client claims being busy with work and family duties and having almost no time to engage in patient education.

·         Hypertension is a complex condition that might seem difficult for the client to understand and enhance her knowledge of disease management.

·         Multiple competing demands and priorities make learning almost an inconvenience.

·         Schedule mismatch, where the client is free mostly in the evenings, and the healthcare provider might not be available at the time when the client is free.

·         Her constant stress, worry, and anxiety can make learning difficult.

These factors will affect the learning process because getting the client to engage in a learning activity when needed seems impossible, and the provider has to adopt to the client’s schedule, which might be difficult.

The family members, especially the husband and the first-born daughter, will be involved in the learning process. (NFDN 1200 Teaching Plan)

BROAD GOAL: The client will engage in desired and necessary activities and adopt techniques to improve activity tolerance.

SPECIFIC OUTCOMES-

Cognitive – The client will be able to learn and apply techniques that improve activity tolerance and display reduced anxiety associated with activity participation.

Psychomotor – The client will be able to demonstrate desired or necessary activity participation and completion without reporting fatigue or weakness or BP response to activity.                                                                                                                                  

To help the client improve disease management, the following are required:

1.      Reminders.

2.      Day planners, agendas, and calendars for physical activity engagement and when to take meals.

3.      Self-measured blood pressure monitoring action guide.

4.      Hypertension clinical practice guidelines for preventing, detecting, evaluating, and managing high blood pressure

5.      Guide to community preventive services to identify community-based interventions that can be suitable or helpful to the client.

6.      Upper-arm monitors for monitoring BP at home.

7.      Self-reported surveys for behavior change.

Timing and Environment Considerations: (NFDN 1200 Teaching Plan)

The client requires an environment with the following:

1.      Limited distractions

2.      Positive reinforcements

3.      Natural consequences

4.      Enough time to engage in specified activities

Individuals involved/required:

The teaching process will require the involvement of the following:

1.      Family members, including husband and two daughters.

2.      The client’s therapist

3.      Any other trusted family member or friend.

·         Appropriate and desired behavior will be communicated through demonstrations and presentations.

·         The client will engage in role-playing, supported by AV materials.

·         Learning goals, progress, and updates will be communicated and elaborated to patient and involved parties through in-person meetings and discussions.

·         Demonstrations are a great way to communicate with patients because they are more engaging, focus on the visual elements of processing information, and encourage client participation (Hranchuk et al., 2018).

·         Role-playing helps the client learn in a real-world situation, motivates, and engages the client. Moreover, it is experiential and requires no special equipment or environments (Dorri et al., 2019).

·         Discussions with client and involved parties will be used for brainstorming additional interventions and helping them process information instead of just receiving it (Ying, 2020). It will involve more practical thinking to help the client improve her activity tolerance and manage the disease more effectively.

The primary goal is improved activity tolerance, which will be indicated by the following;

1.      Ability to engage in desired or necessary activities

2.      Ability to use techniques and approaches to improve activity tolerance.

3.      Reporting a measurable activity tolerance increase.

4.      Demonstrating reduced physiological and psychological signs of intolerance, including BP changes and irregularities and increased anxiety.

These achievements will be used to assess whether the learning outcome was met.

The nurse will continue to monitor BP changes during weekly follow-ups until the patient achieves an optimal blood pressure and learns to manage the disease.

The teaching plan is objective and simple to understand. The goals are achievable, measurable, and borrowed from the client’s perspectives and learning needs to ensure a client-centred learning process and strategies tailored to the patient’s needs. The strategies selected are straightforward, and parties involved in the teaching and learning process need no special training or elaboration to understand them or what is required of them. The equipment and resources needed to facilitate the learning process are affordable, readily available, and do not require special maintenance to make it easier for the client and family members to utilize. Learning resources like the self-reported measures and community guidelines are available online on CDC website, hence easily accessible. However, if further assessment indicates increased severity of hypertension symptoms, this teaching plan will be simplistic and require adjustment to ensure effectiveness. This case is a unique learning experience, and I will build on it for future practice. It offers insights into the challenges high blood pressure patients face daily and how managing the disease is challenging and exhausting for patients. It also shows the lack of sufficient knowledge on disease management strategies, and many people rely primarily on medication. (NFDN 1200 Teaching Plan)