Model Instruction Plan
Lesson Plan | |
|Course Title: Health Science Technology I |
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|Session Title: Measuring Intake and Output |
|Lesson Duration: 2 90 minute class periods |
|Timeline of Instructional Sequence: |
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|Day 1: 10 min.-Introduction to Intake and Output |
|25 min.- Presentation using lecture, white board and overhead projector to inform |
|students about fluid balance and imbalance and how it is monitored. |
|25 min.- Introduce I&O chart using overhead and do whole group practice to fill in the |
|first column on the chart. |
|30 min.- Students will work individually or in small groups of 2-3 to complete the rest of |
|the I&O chart. Teacher will circulate around the room to check for accuracy |
|and to insure that the students understand the lesson. |
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|Day 2: 10 min. - Quick review of I&O. |
|15 min. - Allow student to finish I&O charts. |
|40 min.- Students will be given another I&O chart and directed to proceed to each of |
|the stations in the lab area and use the information to complete the chart. |
|Student will do this activity in pairs. |
|20 min.- Students will exchange first chart with another student and the teacher will |
|provide the correct answers on a chart using the overhead projector. Students |
|mark any incorrect answers. Charts from the lab portion will be turned into the |
|instructor for grading. |
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|Performance Objective: |
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|Upon completion of this lesson, the student will be able to describe the importance of maintaining fluid balance as it is relates to a |
|patients health and wellness. The student will also be able to accurately measure and record a patient’s fluid intake and output from a |
|variety of sources using equipment and charts similar to those used at various medical facilities. |
| |
|Specific Objectives: The student will be able to: |
|Objective 1: define fluid balance and imbalance |
|Objective 2: differentiate between dehydration and edema. |
|Objective 3: chart the fluid intake and output in the appropriate category. |
|Objective 4: convert ounces to cubic centimeters using the proper equation. |
|Objective 5: measure fluids using a variety of techniques and tools. |
|Objective 6: define various medical terms used to describe body fluids. |
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|Preparation |
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|1.TEKS Correlations: |
|Health Science Technology I |
|121.3A,B,C; 12A,B,C,F; 13A |
|(3) The student documents and archives client records. |
|The student is expected to: |
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|(A) review the structure and composition of client |
|records; |
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|(B) compile and record client data; and |
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|(C) demonstrate the ability to chart and graph. |
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|12)The student knows the technology utilized in the |
|diagnostic, therapeutic, informational, and |
|environmental systems. The student is expected to: |
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|(A) identify equipment utilized in each of the |
|four systems; |
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|(B) utilize appropriate equipment in the delivery |
|of health care services; |
|(F) Knowledge and skills. |
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|(1) The student applies math, science, English language |
|arts and social studies in health science. The |
|student is expected to: |
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|(A) convert units between systems of measurements; |
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|(B) use measurement functions for client |
|assessment; |
|(F) describe biological and chemical processes |
|that maintain homeostasis; |
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|(13)The student demonstrates multi-competent health |
|care worker knowledge and skills. The student is |
|expected to: |
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|(A) assess client status and accurately determine |
|vital signs; |
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|Interdisciplinary Correlations: |
|TEKS: Algebra I 111.32. b1A; b4B; |
|b) Foundations for functions: knowledge and skills and performance descriptions. |
|(1) The student understands that a function represents a dependence of one quantity on another and can be described in a variety of ways. |
|Following are performance descriptions. |
|(A) The student describes independent and dependent quantities in functional relationships. |
| |
|(4) The student understands the importance of the skills required to manipulate symbols in order to solve problems and uses the necessary |
|algebraic skills required to simplify algebraic expressions and solve equations and inequalities in problem situations. Following are |
|performance descriptions. |
|(B) The student uses the commutative, associative, and distributive properties to simplify algebraic expressions. |
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|Instructor/Trainer: Donna Skates |
|References: Texas HSTE Curriculum web site |
|I& O charts from hospital rotation sites |
|Webster’s Medical Dictionary |
|Instructional Aids: I&O chart on overhead transparency |
|I&O worksheet (Attachment A) |
|I&O charts for class completion (Attachment B) |
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|Materials Needed: IV bag; bedpan; urinal; orange juice glass; milk glass; soup bowl; emesis basin; foley catheter bag; food coloring; urine |
|cup; ice cubes; |
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|Equipment Needed: calculators |
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|Learner: HST I student |
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|Introduction |
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|Introduction : |
|Can any on tell me what fluid balance might be and why it is important in the human body? |
| |
|Imagine your 2- year old sister has been ill for two days with diarrhea and vomiting. She becomes very lethargic and has a high temperature. |
|Your mother takes her to the hospital emergency room where they begin IV therapy with D5/NS and medication to control the vomiting and |
|diarrhea. Within just a couple of hours her fever has dropped and she is again full of energy. What happened? How could this happen so fast? |
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|For the next two class periods we will be discussing the causes of both dehydration and edema. You will be able to tell me in detail why your |
|little sister got so sick. |
|As medical professionals, we all need to know a great deal about fluid balance and imbalance. To care for our patients we have to know how to |
|monitor and accurately measure the various fluids that go in and out of a patient. In this lesson, we will explore the causes of fluid |
|imbalance and how it is monitored. You will learn how to record the intake and output of your patients. We will also be learning how to |
|accurately measure the different body fluids that you may encounter during your hospital rotations. |
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|Learning Style: Auditory |
|Outline |
| | |
|1. Fluid Balance |Learning Style: Auditory, Visual and |
|A. Homeostasis |Psychological. |
|1. define and discuss importance to good health |This first part of the lesson uses auditory |
| |and visual learning modalities. There are |
| |several questions being asked and places for |
| |class discussion to bring in the interactive |
| |mode to the lesson. |
| | |
|2. Fluid Imbalance |1. Notes for Objective 1 |
|A. Define imbalance |Have student think about how they feel when |
|I. Dehydration |they get too thirsty or have exercised too |
|Causes |vigorously? What makes |
|Diarrhea |them feel better? Why? |
|Vomiting | |
|Bleeding | |
|Excessive perspiration (diaphoresis) | |
|Poor fluid intake |Notes for Objective 2. |
|Symptoms | |
|Fever is present. |Have students give ideas on what they think |
|There is a decrease in urine. |the causes of dehydration might be. How |
|Urine is concentrated. |rapidly can it occur for any person? Is there|
|Weight loss occurs. |a particular group or groups that might be |
|Membranes are dry and it is difficult to swallow. |more susceptible to dehydration? |
|Tongue is coated and thickened. | |
|Skin becomes hard and cracks and is dry and warm | |
|II. Edema | |
|A. Causes |Briefly give examples and discuss why the |
|High salt intake |different symptoms occur during dehydration. |
|Infections |Have them think of any personal experiences |
|Injuries or burns |they may have had with dehydration either |
|Certain kidney diseases |through illness or perhaps heat and exercise |
|Certain heart diseases or heart inefficiencies |in the summer. |
|Sitting too long in one position | |
|Infiltration of IV fluid | |
|Symptoms | |
|Decrease in urine output | |
|Gain in weight | |
|Puffiness or swelling |Discuss why some of these things cause edema.|
|Sometimes shortness of breath | |
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| | |
| | |
| | |
| |Give students examples of edema that they may|
| |have seen, such as an elderly relative with |
| |swollen feet. |
| | |
| |Relate hospital experience of how sometime |
| |patients that are overloaded will literally |
| |leak fluid through their skin. |
| |Give examples of why these things happen and |
| |how doctors attempt to correct them with |
| |medication. Discuss shortness of breath due |
| |to fluid in the lungs and how it is drained |
| |out. |
| |Learning style: Kinesthetic, Visual and |
|3.Show example of I&O chart on overhead |Emotional. |
|A. Describe methods used to fill out chart |The charts provide the students with hands-on|
|1. define terms on chart |interaction. The student also has to stay on |
|2. explain how IV fluids are measured |task to complete the activity. |
| | |
|Practice filling in one row as a group |3. Notes for Objective 3 |
|C. Have the students complete the chart. This |Do the first column of the chart together as |
|should be done as an individual task, not in a |a class. Make sure different students provide|
|group. |answers to each item. |
| |Learning Style: Visual |
|4. Demonstrate equation to convert ounces to cubic centimeters (cc). |4. Notes for Objective 4 |
|30 X (number of ounces) = number of cc’s |Show students several examples of this |
| |equation and work them together as a group. |
| | |
| |Learning style: Kinesthetic, Sociological |
| |and Physiological |
|5. Have students, working in pairs, measure various labeled body fluids as they fill out a |Sections 5 allows for a great deal of |
|second chart. |hands-on learning by the students. The small |
| |group interactions allow them to talk about |
| |what is happening to reinforce the learning. |
| |They have a great deal of mobility during |
| |this section as well. |
| | |
| |5. Notes for Objective 5 |
| |Skills lab: provide a variety of “fluids“for |
| |students to measure and record. |
| |Learning Style: Print and psychological |
|6. Define any and all medical terms students are not |The student will have to use research sources|
|familiar to students. |available to them and find the information. |
| |6. Notes for Objective 6. |
| |Some of the terms might be edema, IV, |
| |infiltration. Have students ask about those |
| |they don’t know. Have students use their |
| |Medical dictionaries to research the terms |
| |and share them with the class. |
| | |
|Application |
| |
|Guided Practice : |
|Complete one column of the Intake and output record as a group using the overhead projector. |
| |
|Independent Practice : |
|Have each student complete the Intake and Output Practice worksheets. |
|Set up a lab area with different examples of intake and output fluids. Have students, in pairs, rotate through the lab area and record the |
|various fluids on a second I&O record chart. |
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|Summary |
| |
|Review : |
|Briefly review fluid balance and imbalance. Define dehydration and edema. |
|As a group, review the charts the students completed. |
|Discuss how the patient in the case study may be affected by the intake or output of the various body fluids. Ask the students, is the patient|
|in the case study dehydrated or suffering from edema? How did they reach their conclusion? |
|Emphasize the importance of good record keeping. Ask students, what could have happened to this patient if the volumes had been incorrectly |
|recorded? Have them give examples of mistakes that could be made. Can the students identify whether the patient will be dehydrated or |
|edematous depending on the error that is made? |
|Have students consider experiences they or family members may have had with fluid imbalances. Could these have been avoided? How? |
| |
|Learning Style: Auditory, Visual and Interactive. |
|The students will what they learned, use their charts to help focus on the lesson and participate in oral discussions about the content of the|
|lesson. |
|Evaluation |
| |
|Informal Assessment : |
|Discuss, as a group, the correct answer for each part of the chart. Have the student’s trade papers to grade them. |
| |
|Learning Style: Visual |
|The student will observe the correct answers on an overhead chart and on their peer’s paper. |
| |
|Formal Assessment : |
|Provide the students with a different case study and I&O chart for them complete on an individual basis during another class period. This will|
|be part of a test, on various types of record keeping, at the completion of the unit. |
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|Learning Style: Visual ,Kinesthetic and Psychological |
|The student is using the chart and recording the information. They will also be analyzing the data and determining the correct placement of |
|the information onto the chart. |
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|Extension/Enrichment :The student will research a disease or disorder that affects fluid balance and predict how intake and output may be |
|affected. |
ATTACHMENT A:
Recording Intake and Output Practice
Mrs. Jane Black is a client who had a gastrectomy (removal of the stomach). A nasogastric tube is in site to drain all fluids. It is connected to suction and irrigated at times. Intake is limited to sips of Sprite and ice cubes.
Instructions: Chart the following information on the I and O record. Record all 8 hour and 24 hour totals.
1. Water intake
8AM- 2 Tbsp
2 PM- 1 Tbsp
5 PM- 3 Tbsp
12 MN- 2 tsp
2 AM - 1 tsp
2. Sprite
2 AM- 1 tsp
8AM- 1 water glass
11AM- ½ juice glass
4PM -1 cup
8PM -1 ounce
12 MN- 2 ounces
2 AM- 1 tsp
3. Ice cubes (Note: 1 cube = 5 cc)
1 ice cubes at 9AM, 12N, 3PM, 11PM, and 3AM
4. IV
7AM -500 cc
2PM -450 cc
6PM -500 cc
10 PM- 400 cc
3 AM- 400 cc
6 AM- 500 cc
5. Emesis
6PM- 100 cc clear liquid
9PM- 130 cc reddish brown liquid
2AM- 200 cc golden green liquid
6. Urine
11 AM- 450 cc
4PM- 300cc
8PM- 250 cc
11PM- 300 cc
3AM- 200 cc
6AM- 300cc
7. Brown liquid stool
10AM- 750 cc
2PM- 200 cc
6AM- 200 cc
8. NG suction
2PM- 700 cc brown liquid
10PM- 650 cc brown liquid
6AM- 425 cc brown liquid
9. NG irrigation
8AM- 30 cc
10AM- 30 cc
2PM- 30 cc
6PM- 45 cc
1AM- 60 cc
4 AM -25 cc
ATTACHMENT B:
Intake and Output Record
| |Measurements |Large glass 240cc |Coffee pot 240cc |
| | |Water glass 180cc |Cup 120cc |
|Patient’s Name __________________________________ | |Juice glass 100cc |Soup bowl 200cc |
| | |Small bowl 120cc |Jell-O 120cc |
|INTAKE |OUTPUT |
Time |Oral | IV |Irrigation |Remarks | BM |Emesis |Urine |Irrigation |Remarks | |7 AM | | | | | | | | | | |8 | | | | | | | | | | |9 | | | | | | | | | | |10 | | | | | | | | | | |11 | | | | | | | | | | |12N | | | | | | | | | | |1PM | | | | | | | | | | |2 | | | | | | | | | | |3 | | | | | | | | | | |TOTAL | | | |8 Hr
Intake | | | | |8 Hr
Output | |4PM | | | | | | | | | | |5 | | | | | | | | | | |6 | | | | | | | | | | |7 | | | | | | | | | | |8 | | | | | | | | | | |9 | | | | | | | | | | |10 | | | | | | | | | | |11PM | | | | | | | | | | |TOTAL | | | |8 Hr
Intake | | | | |8 Hr
Output | |12MN | | | | | | | | | | |1AM | | | | | | | | | | |2 | | | | | | | | | | |3 | | | | | | | | | | |4 | | | | | | | | | | |5 | | | | | | | | | | |6AM | | | | | | | | | | |TOTAL | | | |8 Hr
Intake | | | | |8 Hr
Output | |TOTALS | | | |24 Hr
Intake | | | | |24 Hr
Output | |
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