Developmental teaching plan

Running head: TEACHING PLAN 1

John Doe

West Coast University N110

May 15, 2020

Running head: TEACHING PLAN 2

Situation

Ms. Maria Ramirez is a 59-year-old female that was admitted to the hospital after found

home unresponsive and unarousable. She was diagnosed with DKA, patient was not aware she

was diabetic and will need extensive education before discharge and follow up with home health

because of a non healing wound to her left foot.

Background

The patient is 5”2” and weights 163 pounds, she lives home with her only son age 36

who works all day and comes home late. She lives in an apartment building in the 3rd floor and

often takes the stairs because the elevators don’t work. She admits that she has not visited a PCP

in the last couple of years due to her economic circumstances. She has a history of HTN and

hyperlipidemia and currently is not compliant with medications. Maria has been unemployed due

to her inability to perform activities for a long period of time. She mentioned she becomes SOB

when performing minimal activity like walking or standing too long. Lives a sedentary lifestyle

and poor nutrition over the last years.

Needs Assessment

Maria is very anxious regarding her current diagnosis and is afraid that if she continues

with her lifestyle, she will develop certain complications. Upon admission to the hospital a

consult with a diabetic specialist, endocrinologist (Levine,2015) and physicians were arranged.

The patient would have to be evaluated with PT in order to better understand the endurance with

physical activity. Social worker has been consulted to assist patient with medical coverage

through a charity program because patient stated monetary problems increased her anxiety.

Patient will also be sent home with home health that would provide wound care to the non-

Running head: TEACHING PLAN 3

healing wound due to her diabetes. Maria will ne educated while in the hospital on the severity of

her diagnosis and the importance to learn how to self-administer and measure insulin. Ms.

Ramirez will be educated to check blood glucose levels before each meal (<120) and keep a log

for her provider. Visual demonstrations will be provided for better understanding along with

written instructions that are easy to comprehend. Maria only attended 7th grade and reads at a 3rd

grade level. Maria will also be prompted to include exercise and promote a good diet in order to

modify weight and decrease cholesterol levels<200. Maria has communicated with the nursing

staff that she tends to concentrate better after breakfast. Therefor teaching should be conducted

after morning meal. Patient and son are eager to learn how to cope better with the new diagnosis

and make positive lifestyle changes that can benefit over all condition.

Learning styles

Ms. Ramirez enjoys visual learning as she enjoys doing arts and crafts to ease boredom,

she enjoys reading comic books which tends to read on free times. Maria enjoys hands on

activities such and baking and pottery. The appropriate leaning style would be visual along with

written instructions that are easy to understand.

Goal development

Provide patient with diabetes education on how to measure blood glucose levels (<120)

before meals (Levine,2015). Demonstrate how to self-administer insulin before being discharge

from hospital. Teach patient on proper nutrition to normalize blood sugar levels. Diminish the

intake of carbs to <40% and intake more protein base foods along with vegetables. Provide an

exercise routine to patient and encourage exercise for at least 30 min daily (ODC,2010).

Encourage family to integrate in the care of the patient to allow better compliance.

Running head: TEACHING PLAN 4

Learning outcomes

By following a strict regimen and compliance patient would be able to control blood

sugar levels and normalize readings. Promotion of exercise will help with obesity, HTN, and

high cholesterol levels that were present. Encouraging Maria to promote exercise will benefit

diabetes and insulin resistance. Lower blood glucose levels will help with the non-healing

wound. Evidence based research showed that increased blood glucose levels tend to make

leukocytes rigid and stiff, making these useless to fight any infection (Levine,2015). As well as

tissue perfusion decreases when there is an uncontrolled blood glucose reading.

Teaching content

Running head: TEACHING PLAN 5

Instructional methods

1. Check blood sugars daily before eating meals

2. Blood sugar levels targeted are <120

3. If necessary, administer insulin follow regimen table provided.

4. To administer insulin carefully measure insulin units and administer in fatty areas

like abdomen, back of the arm and always rotate sites.

5. Always eat a balanced meal

6. Exercise at least 30 min daily

7. Take medications prescribed

8. Increase activity levels.

9. Follow with PCP in 3 months to re check A1C levels. Target is to be at least 7%.

Time and resources

Maria Ramirez would undergo a strict insulin regimen along with increased activity after

wound heals in order to stabilize glucose levels. Within 3 months Maria A1C levels would be

reevaluated, the social worker would be working with Maria to find places that she can attend as

an outpatient physical therapy center. All this will be under charity and Maria will be encouraged

to find a health insurance that fits her needs and accommodates to her low income. Ms. Ramirez

would have services from a wound care nurse to take care of the wound in her foot to accelerate

proper healing. Resources are available upon request if patient needs further assistance to obtain

goals.

Running head: TEACHING PLAN 6

Evaluation

Patient was reevaluated after 3 months; wound has healed properly with no deterioration

of mobility to that extremity. Blood glucose levels have continued to drop and Maria’s A1C is at

8.4% which is not ideal but is great improvement compared to previous readings of 10.4%.

Patient is currently taking medications as ordered, family has become vital part of the

achievements since they encourage patient to eat healthy and take measures on disease process

seriously. Marias weight decreased and is now 148lbs and no longer complains of SOB. Patient

currently taking Lipitor, Novolog, Lantus, Metoprolol (ODC,2010).

Running head: TEACHING PLAN 7

References

“Diabetes: Symptoms, Causes, Treatment, Prevention, and More.” Accessed March 19, 2020.
https://www.healthline.com/health/diabetes.

Levine, Michelle. Diabetes. Mankato, MN: Amicus High Interest, 2015.

“Organization of Diabetes Care: Diabetes Specialist Nursing, Diabetes Education and General
Practice.” Handbook of Diabetes, 2010, 224–28.
https://doi.org/10.1002/9781444391374.ch31.