Abstract

This essay focuses on a knowledge deficit a patient may have regarding their illness. The educational topic as well as why it was chosen will be discussed. The student nurse will analyze the patient’s readiness to learn and address any factors that will facilitate or hinder the learning. The method of implementation, rationales for why the method was chosen, and the teaching tools used will be discussed. The student nurse will also explore how and when the teaching will be implemented to the patient. Finally, the student nurse will evaluate how much of the knowledge the patient retained.

Teaching Plan

When a patient is recently diagnosed with an illness, they can often be under informed or misinformed. This can result from a myriad of reasons such as not understanding how to research information, not understanding the illness fully, forgetting to ask their primary health providers question, or not being able to retain information due to the shock of the recent diagnosis. This essay will focus on MC, a 46-year-old female admitted to the hospital for an exacerbation in her Crohn’s disease, and her knowledge deficit regarding her recent Crohn’s diagnosis.

Educational Topic

The educational topic chosen for MC was learning healthy habits to prevent Crohn’s disease exacerbations. Crohn’s disease is a chronic relapsing inflammatory disease; this inflammation can lead to malnutrition because it impairs the body’s ability to absorb vitamins, water, electrolytes, and other nutrients (Huether & McCance, 2017).  Crohn’s disease does not currently have a cure, thus, learning healthy habits is a vital role in managing the illness. For instance, certain foods can create exacerbation in the illness while other foods can relax the bowel, supporting nutrition absorption. Learning healthy habits of what foods to eat will help manage the disease (Huether & McCance, 2017). MC claimed she was recently diagnosed with Crohn’s disease a few months ago and is, “learning as [she] goes.” MC also stated she wants to minimize as much flare ups of her Crohn’s disease because it is, “painful and annoying.” This education topic of preventing Crohn’s flare ups will improve her quality of life and prevent possible bowel obstructions.

Patient Assessment

As mentioned, MC is a 46-year-old female who has no cognitive deficits; this facilitates learning because she is able to understand information and retain it without having to overcome an intellectual disability. MC graduated high school and attended beauty school to be a licensed esthetician; this facilitates learning because she is used to grasping ideas and learning new techniques. She also reported she is a visual and auditory learner. As for MC’s health belief, she is very firm on a holistic approach to the illness; she understands medications must be taken, however, she refuses to fully rely on them. This facilitates learning because adjusting the diet to treat her Crohn’s disease will match her holistic beliefs. When it comes to MC’s physical condition, she only has deficits in her gastrointestinal system caused by her Crohn’s disease. This will facilitate learning because she is able to listen, see, and actively participate in learning without compromising her body systems. MC claims she is close with her parents and recently moved back to help them around the house. MC also claims she is close with a few of her coworkers and has a wine night with them once a week. This facilitates learning because a positive support system can encourage MC to learn and manage her Crohn’s disease. MC is a middle class American women; this facilitates learning because she is fluent in English, and can thus read and learn from articles and graphs. Also, the American culture does not prohibit certain foods from being eaten, allowing MC to eat meats and fish. Since MC is middle class, it also facilitates her learning because she is able to experiment with what types of groceries she can buy without budgeting too tightly. The main learning barrier MC will have to overcome is her anxiety and depression disorder. When these items are not managed effectively, MC claims she loses motivation to learn and has trouble retaining and focusing on information. Currently MC takes Ativan and goes to counseling; she claims the disorders are being managed effectively with this treatment. Currently, the patient’s mood is neutral. She is receptive to the idea of learning and has verbalized her interest. She claims her main reason for wanting to learn is to prevent as much pain caused from the Crohn’s disease as possible.

Implementation with Tools

The patient stated earlier she is a visual and auditory learner, thus, the implementation will follow these learning styles. The teaching will occur for the rest of the patient’s duration at the hospital. Educating the patient should not be done when the patient has awakened or right before bed; this is because the patient has verbalized she is less inclined to learn during these times. The teaching should be implemented during the peak of the patient’s Ativan; this is to ensure the patient’s anxiety will not interfere with retaining or learning the information.

The first item to implement in the patient’s learning is referring her to a dietician who specializes is inflammatory bowel diseases. Although there are an abundance of resources MC can access through the web, referring her to a registered dietician is most important. This is because a registered dietician can customize a diet plan to match MC’s needs and lifestyles. Consulting with a dietician who specializes in inflammatory bowel disorder is also imperative because they will know in depth knowledge about the pathophysiology and be able to understand which foods impact the disease the most (Zibdeh, 2019).

The next item to implement into MC’s education is a basis of what foods to eat and avoid. It is important to educate the patient right now because she may not be able to meet with a dietician right away. In order to do this, the student nurse will provide a brochure; brochures are best to give the patient because they condense the information, allowing patients to skim and learn the information that is prevalent to them. The student nurse will provide a brochure from the Crohn’s & Colitis Foundation. This brochure covers an array of topics such as what Crohn’s disease is, what foods to avoid, and what foods to consume when a flare up occurs (Crohn’s & Colitis Foundation, 2018). The graphs and picture will tailor to MC’s learning style.

The next item to implement into MC’s education is food journaling. Although it may seem simple, this is an imperative skill to learn. Tracking what kinds of foods were eaten and documenting the symptoms will help MC know which foods trigger a flare up. It can also help the patient and the dietician understand which foods are helping her most. MC states she has her phone on her at all times, so teaching her to use an app called YouAte is appropriate. YouAte is a free mobile app that allows the user to track foods eaten, set reminders of diet restrictions, track time between meals, and answer journal prompts of how a meal made the user feel (Moore, 2017).

The last item to be implemented into MC’s teaching is educating her on support groups in the city. Although MC will get support from her parents and friends, it is imperative to teach her about support groups. This is because she can learn from people with the same illness on how they manage the disease and prevent flare ups. It can also benefit MC’s mental health because she can talk with another person about any feelings of anxiety, frustration, sadness, etc. that may be caused by the illness. The brochure from the Crohn’s & Colitis Foundation has information about support groups and how to attend them.

Evaluation

After teaching and providing educational materials to MC is done, it is imperative to evaluate how much knowledge she has learned. In order to do this, a demonstration will occur. In this demonstration, MC will order lunch from the hospital menu. When she orders the lunch, she will explain to the student nurse what foods she will eat that will not cause a Crohn’s flare up. The student nurse will then ask for rationales as to why a specific food was picked. After MC eats her meal, she will then be asked to demonstrate how to document the meal and any symptoms into the YouAte app. After closing the app, MC will also need to demonstrate how to access past logs.

If MC is unable to complete this demonstration, revisions to the education plan will be needed. If MC is unable to order the correct food from the menu, additional brochures or charts should be provided to her. The Crohn’s & Colitis Foundation has an array of quick food sheets one can reference from their phone (2018). If the patient is unable to use the app, additional time will be dedicated to show her how to navigate the app. Return demonstration will be implemented after each section of the app is taught. For example, if the student nurse taught MC how to access past logs, MC will be required to show the student nurse how to access this from the main menu. Once this demonstration has been completed, MC will be asked how and why it is important for her to have access to support groups. If she is unable to verbalize the importance of group therapy, the student nurse will show her educational videos from the Crohn’s & Colitis Foundation about how support groups help people every day.

Conclusion

In conclusion, there are an array of healthy habits MC can incorporate into her life to prevent exacerbation of her Crohn’s disease. It is vital for the nurses to be able to assess a patient’s knowledge on their illness. These assessments will show the nurse what teachings are needed. Although some nurses are too busy to teach patients, it is vital to learn these skills in order to inspire patients to live and manage their illness to the fullest.

References

• Crohn’s & Colitis Foundation. (2018). Living with Crohn’s disease. [PDF file]. New York, NY: Spin4. Retrieved from https://www.crohnscolitisfoundation.org/sites/default/files/legacy/assets/pdfs/living-with-crohns-disease.pdf.
• Huether, S. E., & McCance, K. L. (2017).
  
  Understanding pathophysiology.
  
  St. Louis, MO: Elsevier.
• Moore, M. (2017). YouAte. Retrieved from https://foodandnutrition.org/may-june-2017/youate-version-1-0-2/.
• Zibdeh, N. (2019). Crohn’s disease and diet. Retrieved from https://www.eatright.org/health/wellness/digestive-health/crohns-disease-and-diet.