Exam #5 Study Guide
As you study for Exam 5, don’t just memorize the terms. Ask yourself, what does this
look like in a clinical setting, what does the nurse assess, what are the teaching needs,
what complications should we be looking for? It’s all about application! Good luck!
Patient Education: Chapter 25
Domains of Learning: teaching and learning in these domains and how do we
evaluate?
o Most effective learning takes place when all 3 are utilized…
o Cognitive (understanding): When an individual gains information to further
develop his or her intellectual abilities, mental capacities, understanding and
thinking processes
Requires thinking
Knowledge patient needs to acquire
Teaching methods:
Discussion (group or one-on-one)
Lecture
Question-and-answer session
Role play, discovery
Independent project (computer-assisted instruction), field
experience
o Affective (attitudes): the expression of feelings and emotions and the
development of values, attitudes, and beliefs
Acceptance of attitudes, opinions, or values
Teaching methods:
Role play
Discussion (group or one-on one)
o Psychomotor (motor skills): development of manual or physical skills, such as
learning how to walk or type on a computer
Integration of mental and muscular activity
i.e. demonstration – like using a glucometer
Motivation/Self-Efficacy/Internal and External Locus of Control
o Motivation: internal state (e.g. idea, emotion, physical need) that helps direct,
arouse, and sustain human behavior
Desire or willingness to learn
Motivation to learn influenced by belief of the need to know something
Many people become motivated when disease is perceived as a threat,
can overcome barriers to changing health practices, and see benefits of
adopting new behavior
Attentional set: mental state that allows the learner to focus on and
comprehend a learning activity
o Self-efficacy: concept included in social learning theory
, Person’s perceived ability to successfully complete a task – when they
think they can achieve a particular behavior, they are more likely to
perform the behavior consistently and correctly
Strong predictor of healthy behaviors
Many interventions in patient education improve self-efficacy, resulting in
improved lifestyle choices
o Internal locus of control: belief that one can influence events and their outcomes
o External locus of control: Belief that what happens is in the hands of fate,
chance, luck, or is determined by people in authority
o Learning occurs in the acceptance stage of grieving – patients need to accept
situation and where they are in their journey
Teaching Methods for Different Ages: Box 25-3 page 349
Box 25.3 Teaching Methods Based on Patient’s Developmental Capacity
Infant
• Keep routines (e.g., feeding, bathing) consistent.
• Hold infant firmly while smiling and speaking softly to convey sense of trust.
• Have infant touch different textures (e.g., soft fabric, hard plastic).
Toddler
• Use play to teach procedure or activity (e.g., handling examination equipment, applying
bandage to doll).
• Offer picture books that describe story of children in hospital or clinic.
• Use simple words such as “cut” instead of “laceration” to promote understanding.
Preschooler
• Use role play, imitation, and play to make learning fun.
• Encourage questions and offer explanations. Use simple explanations and
demonstrations.
• Encourage children to learn together through pictures and short stories about how to
perform hygiene.
School-Age Child
• Teach psychomotor skills needed to maintain health. (Complicated skills such as
learning to use a syringe take considerable practice.)
• Offer opportunities to discuss health problems and answer questions.
Adolescent
• Help adolescent learn about feelings and need for self-expression.
• Use teaching as collaborative activity.
• Allow adolescent to make decisions about health and health promotion (safety, sex
education, substance abuse).
• Use problem solving to help adolescent make choices.
Young or Middle Adult
• Encourage participation in teaching plan by setting mutual goals.
, • Encourage independent learning.
• Offer information so adult understands effects of health problem.
Older Adult
• Teach when patient is alert and rested.
• Involve adult in discussion or activity.
• Focus on wellness and person’s strength.
• Use approaches that enhance patient’s reception of stimuli when he or she has a
sensory impairment (see Chapter 49).
• Keep teaching sessions short.
o Teaching adults…
tend to be self-directed, but can be dependent in new situations
consider the patient’s level of physical development and physical health –
need to have strength, acuity, and coordination to return demonstrate
schedule teaching for time when patient is fresh and not fatigued
Evaluation: Teach-Back and Demonstrate-Back
o Have patient teach you and demonstrate to you
Sleep: Chapter 43
Sleep hygiene: promoting sleep, role of CNA
o Relax patients in preparation for sleep
o Go to sleep when feel tired or sleepy
o Bed time routine helps younger children
o Adults – avoid excessive stimulation before sleep
o As nurse, promote sleep by synchronizing medication, treatment, and vital signs
schedule
o Practices that promote sleep:
Sit next to window 30-60 mins each morning – helps maintain 24-hour
circadian cycle
Discourage daytime napping – interferes with sleep
Decrease fluid 2-4 hours before sleep – mitigates nocturia
Plan rigorous exercise at least 2-3 hours before bed time
o CNA delegation…
CNA cannot:
Assess the patient
Educate the patient
Administer medications or blood
CAN can:
Ambulate
Assist with ADL’s – bathe, feed, dress, grooming/hygiene, etc.
Transport
Take stable, routine vital signs – must report to RN if anything is
unstable
Document I&O – must report to RN if anything is abnormal
As you study for Exam 5, don’t just memorize the terms. Ask yourself, what does this
look like in a clinical setting, what does the nurse assess, what are the teaching needs,
what complications should we be looking for? It’s all about application! Good luck!
Patient Education: Chapter 25
Domains of Learning: teaching and learning in these domains and how do we
evaluate?
o Most effective learning takes place when all 3 are utilized…
o Cognitive (understanding): When an individual gains information to further
develop his or her intellectual abilities, mental capacities, understanding and
thinking processes
Requires thinking
Knowledge patient needs to acquire
Teaching methods:
Discussion (group or one-on-one)
Lecture
Question-and-answer session
Role play, discovery
Independent project (computer-assisted instruction), field
experience
o Affective (attitudes): the expression of feelings and emotions and the
development of values, attitudes, and beliefs
Acceptance of attitudes, opinions, or values
Teaching methods:
Role play
Discussion (group or one-on one)
o Psychomotor (motor skills): development of manual or physical skills, such as
learning how to walk or type on a computer
Integration of mental and muscular activity
i.e. demonstration – like using a glucometer
Motivation/Self-Efficacy/Internal and External Locus of Control
o Motivation: internal state (e.g. idea, emotion, physical need) that helps direct,
arouse, and sustain human behavior
Desire or willingness to learn
Motivation to learn influenced by belief of the need to know something
Many people become motivated when disease is perceived as a threat,
can overcome barriers to changing health practices, and see benefits of
adopting new behavior
Attentional set: mental state that allows the learner to focus on and
comprehend a learning activity
o Self-efficacy: concept included in social learning theory
, Person’s perceived ability to successfully complete a task – when they
think they can achieve a particular behavior, they are more likely to
perform the behavior consistently and correctly
Strong predictor of healthy behaviors
Many interventions in patient education improve self-efficacy, resulting in
improved lifestyle choices
o Internal locus of control: belief that one can influence events and their outcomes
o External locus of control: Belief that what happens is in the hands of fate,
chance, luck, or is determined by people in authority
o Learning occurs in the acceptance stage of grieving – patients need to accept
situation and where they are in their journey
Teaching Methods for Different Ages: Box 25-3 page 349
Box 25.3 Teaching Methods Based on Patient’s Developmental Capacity
Infant
• Keep routines (e.g., feeding, bathing) consistent.
• Hold infant firmly while smiling and speaking softly to convey sense of trust.
• Have infant touch different textures (e.g., soft fabric, hard plastic).
Toddler
• Use play to teach procedure or activity (e.g., handling examination equipment, applying
bandage to doll).
• Offer picture books that describe story of children in hospital or clinic.
• Use simple words such as “cut” instead of “laceration” to promote understanding.
Preschooler
• Use role play, imitation, and play to make learning fun.
• Encourage questions and offer explanations. Use simple explanations and
demonstrations.
• Encourage children to learn together through pictures and short stories about how to
perform hygiene.
School-Age Child
• Teach psychomotor skills needed to maintain health. (Complicated skills such as
learning to use a syringe take considerable practice.)
• Offer opportunities to discuss health problems and answer questions.
Adolescent
• Help adolescent learn about feelings and need for self-expression.
• Use teaching as collaborative activity.
• Allow adolescent to make decisions about health and health promotion (safety, sex
education, substance abuse).
• Use problem solving to help adolescent make choices.
Young or Middle Adult
• Encourage participation in teaching plan by setting mutual goals.
, • Encourage independent learning.
• Offer information so adult understands effects of health problem.
Older Adult
• Teach when patient is alert and rested.
• Involve adult in discussion or activity.
• Focus on wellness and person’s strength.
• Use approaches that enhance patient’s reception of stimuli when he or she has a
sensory impairment (see Chapter 49).
• Keep teaching sessions short.
o Teaching adults…
tend to be self-directed, but can be dependent in new situations
consider the patient’s level of physical development and physical health –
need to have strength, acuity, and coordination to return demonstrate
schedule teaching for time when patient is fresh and not fatigued
Evaluation: Teach-Back and Demonstrate-Back
o Have patient teach you and demonstrate to you
Sleep: Chapter 43
Sleep hygiene: promoting sleep, role of CNA
o Relax patients in preparation for sleep
o Go to sleep when feel tired or sleepy
o Bed time routine helps younger children
o Adults – avoid excessive stimulation before sleep
o As nurse, promote sleep by synchronizing medication, treatment, and vital signs
schedule
o Practices that promote sleep:
Sit next to window 30-60 mins each morning – helps maintain 24-hour
circadian cycle
Discourage daytime napping – interferes with sleep
Decrease fluid 2-4 hours before sleep – mitigates nocturia
Plan rigorous exercise at least 2-3 hours before bed time
o CNA delegation…
CNA cannot:
Assess the patient
Educate the patient
Administer medications or blood
CAN can:
Ambulate
Assist with ADL’s – bathe, feed, dress, grooming/hygiene, etc.
Transport
Take stable, routine vital signs – must report to RN if anything is
unstable
Document I&O – must report to RN if anything is abnormal
