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Teaching PlanJessica Francis & CharleahNFDN 1002NorQuest CollegeJody MisunisFebruary 26, 2015Assessment of Client and Client Learning NeedsClient background:J.B. is a fifty three year old widowed male he was diagnosed with type two diabetes in 1998, he is taking Lantus(Basal- long lasting)?subcutaneously as prescribed. He has recently changed careers and is now working as a trucker. J. B. transports things locally spending eight to twelve hours a day on shift. He spends his evenings at home by himself or with his children and thier families. He is of Aboriginal descent and his diet consists of high protein and carbohydrate intake, with a low fluid and fiber consumption. He is experiencing high blood sugar levels due to his inactivity and poor nutritional intake. According to Potter & Perry (2104) J.B. is in the stage of Generativity vs. Self- absorption of Erikson’s Developmental Stages. We feel that this is an accurate portrayal of J.B. as he is currently reassessing his life goals related to his career and overall health and wellness, he also maintains a healthy relationship with his children and grandchildren.Client Barriers to Learning:Our client has a learning barrier with changes and transitions related his change in careers which also affects his lifestyle habits including diet and exercise (Potter & Perry, 2014, p. 304). This creates a time barrier for him to be able to spend time learning about how to best control his diabetes in regards to his diet and lifestyle requirements.Client’s Learning Style:According to Potter & Perry (2014) a kinesthetic learner learns best with hands on training. Our client has expressed that he learns best in manner, so we will modify our teaching style to accommodate his needs. ?Nursing Diagnosis, Goal and Learning OutcomesActual Nursing Diagnosis:Imbalanced nutrition (r/t) poor nutritional intake (aeb) high blood glucose levels.Potential Nursing Diagnosis:Impaired skin integrity (r/t) decreased activity (aeb) career change.Wellness Nursing Diagnosis:Readiness for enhancing decision making (r/t) dietary changes (aeb) seeking advice.Client centered goal:Client will improve blood glucose levels by adhering to meal plans as shown by us using the American Diabetic Association’s (1940) meal planning guide as well as the Canadian Diabetes Association’s Glycemic Index (2015). He will be keeping logs of his blood glucose levels which will enhance his understanding of his diet and blood sugar relationship. This will reinforce his adherence to a healthy diabetic diet. The client will also show an understanding and familiarity with how to use the Accu-Chek Compact Plus blood glucose monitoring system which the client has recently purchased as a way to track his blood glucose levels. The client will display an understanding of how to use the Lantus insulin injection pen as well as demonstrate when to use the pen.Learning Outcomes:Client will display understanding of necessary diet changes by using meal plans set out by the American diabetes Association (1940). He will demonstrate by keeping logs of his blood sugar levels. Blood glucose levels will consistently remain within the normal range of 4-9. He will also increase his activity level to further enhance his control over his blood sugar levels by taking a walk for a half hour to an hour four times a week. The client will also do a return demonstration of how to properly use the Accu-Chek Compact Plus blood glucose monitoring system. Teaching Strategies and RationaleWe have chosen to introduce J.B. to the American Diabetic Association’s (1940) website to promote independence in establishing a healthy diabetic lifestyle (Lipe & Beasley, 2004). The website contains information regarding diet and exercise recommendations for the older adult with type two diabetes. It also provides users with fitness goals, recipes and tools for meal planning which will help J.B. establish new life patterns to cope with his diabetes (Lip & Beasley, 2004). We have also provided J.B. with a glycemic index to assist him with meal planning and a diabetic log sheet from the Canadian Diabetes Association(2015) website so he can track his progress. Evaluation and ReflectionAccording to Lipe & Beasley (2004) we have provided J.B. with a self-directed style teaching plan. We felt that this best suited our client as he has a busy lifestyle and can learn at his own pace and it will allow him to update his knowledge and skills without difficulty attending meetings or classes to facilitate his learning. It is also a cost effective strategy approach (Lipe & Beasley, 2004). The weakness in this approach would be client procrastination and decreased opportunity for questioning (Lipe & Beasley, 2004).We also used journals as a learning tool to effectively track blood sugar levels it also provides a good mechanism for feedback to our client (Lipe & Beasley, 2004). The drawback to this method is that it can be time consuming and the client may choose not to participate (Beasley, 2004). An alternative tracking method is an android app, Diabetes Journal, it can be installed on J.B’s smartphone which would allow him to track his glucose levels daily. J.B uses his phone every day and he is familiar with how to use a smartphone.Implications for Using Teaching Plan in Future PracticeWe feel that this teaching plan has aided J.B. in facilitating a healthier lifestyle on his own schedule with little to no supervision. He has improved his diet with meal planning and increased his exercise levels to improve his blood sugar level and overall health which is evidenced by the journal he has kept of his glucose levels.Conclusion: Our teaching plan was successful as our client’s glucose levels have improved leading to better long term health and lessening the possible complications associated with uncontrolled diabetes.References from, diabetes.ca: retrieved from, Lipe S. K. & Beasley S. (2004). Critical thinking in Nursing; A cognitive skills workbook. Philidelphia, PA: Lippincott Williams & WilkinsPotter, P. A. & Perry, A. G. (2014). Canadian fundamentals of nursing (5th ed.). Toronto, ON: Elsevier Canada from, from, from, play. ................
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