Just Wanting Right Assignment Help: How to Answer This Question

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Original Question

I am just wanting to see if I am on the right track with this. I am not completely finished but close and need to make sure it is looking ok so I can turn it in as soon as I get finished with it. Can you please give feedback on this assignment. The following is background information on the case Education Assignment: Hector Martinez Patient Name: Hector Martinez DOB: 08/13/1990 Gender: M Weight: 130kg Admission Diagnosis: Left hip osteoarthritis Temp: 98.8 F HR: 60 BP: 102/56 RR: 9 O2Sat: 92% FiO2: Room air Capillary glucose: 87 Glasgow Coma Scale: 15 Nursing Bedside report: Hector Martinez is a 31 year–old math instructor, found in a hospital parking lot in a confused state. Agitated upon interaction but lethargic when left alone. States he has not eaten in several hours. Suspected drug overdose as client found with bottle of lithium tablets in his possession. Brought to the ER for triage. Preliminary background assessment information reveals that he has been treated for bipolar disorder in past (onset is 3 yrs.) but cannot adequately provide detailed information related to prescription and /or dosage of medications. Client also has a history of NIDDM recently diagnosed within the past 3 months for which he has been following dietary modifications. Bottle found with client identifies lithium carbonate: 450 mg tablets. 1 tablet in AM and one in the PM. Dispense 60 tablets. The vial has 45 tablets in it. and the prescription date is within 2 days of when it was filled. Husband is currently at the bedside. Vital signs: 102/56, pulse 60 and regular, respirations 9 and shallow, temperature 98.8 F, bowel sounds slightly hyperactive. IV of normal saline infusing @ 50 mL/hr in his right forearm. Bilateral wrist restraints applied. Level of consciousness: Rouses easily with slurred speech but remains lethargic unless stimulated by touch or verbal interaction. There is evidence of neglect of self. He has a urinary catheter in place–inserted in ER. Minimal urine output obtained, slightly concentrated urine in bottom of bag with no sediment noted. Pending lab results: CBC, CMP, thyroid, renal panel and lithium level. Bedside capillary glucose results 260 mg/dL in ER, sliding scale protocol initiated with client receiving 4 units regular insulin given in ER via subcutaneous route in left upper arm. Allergies: NKDA Past Medical History: Noninsulin dependent type 2 diabetes Insomnia Bipolar disorder Social History Client lives with husband and mother-in-law Client is a former smoker and quit almost 1-year-ago Client states he drinks socially with friends Client is Hispanic, English is not first language 7 What barriers were identified in the client chart that could prevent client teaching? How would you alter your teaching based upon these barriers? Provide at least three barriers the client may experience. (9 points) Barriers can include: -Physical (fatigue, pain, mental status, hearing/visual ability, medications) -Psychological – (anxious, afraid, depressed, defensive, denial) -Sociocultural – (occupation, financial status, living arrangement, support system, Cultural values, religious beliefs, educational level, English second language?) -Educational/Perceptual – What does the patient already know? Ready to change? Ready to learn? Can patient identify behaviors? How does patient learn best? Barriers that could prevent client teaching are as follows: Confused state Agitated upon interaction Lethargic state when left alone Not eaten in several hours – could be very hungry Suspected overdose of drugs Treated for bipolar in the past but cannot give information related to prescriptions or dosage of meds Respirations are at 9 and shallow Wrist restraints have been applied- patient could be combative or irrational Self-neglect is present English is not his first language so he may not completely understand English completely possibly Lives with husband and mother-in-law – don’t know status of their living arrangements and how they get along There could be cultural or religious beliefs that we don’t know about that could affect his learning as well. Patient is very lethargic as time goes on and may not be able to learn as well In order to teach the patient and his significant other I would need more information on different stuff like if there is a certain culture they follow and religious beliefs that they follow as well. This is so that I can alter any information according to their culture and beliefs. I would need to wait until the patient is no longer lethargic and some of the drugs he has taken is out of his system. Hopefully once the drugs are out of his system he will no longer be confused or agitated but if he is then I would need to make sure that the agitation and confusion was gone before I decided to teach him and his husband as well. I would want to make sure the patient has eaten something so he can concentrate on what is being taught to him. I would want to make sure this would be a good time to teach him and assess his understanding of the English language, so I know if I need to get an interpreter in order to teach him and him to understand what I am teaching him. I would want to make sure that everyone that needs to know the information I am teaching can be present at the time I am going to be teaching him. Prepare a presentation that addresses the client’s educational needs once the client is stabilized for the client and his partner. Remember to provide thorough, factual information that is relevant to the client and their specific needs. Attach presentation materials below. (65 points). Present educational materials to the clinical group through FlipGrid. Present based upon the client education needs, age, and level of understanding. Presentation should be 5-10 minutes in length. See rubric below for distribution of points. Needs: Education on Diabetes and blood sugar control Education on Bipolar Disorder Education on Lithium Carbonate (drug prescribed to him for bipolar disorder) Lithium Carbonate may take 1-3 weeks for it to start working or make any difference in the way it makes you feel. Do not take more than the physician has prescribed to you because the medication does not seem to be working. Your physician will adjust this medication as they do follow up appointments with you after the time it takes for the medication to start working. You should let your physician know if you are taking or start taking a diuretic so you can be monitored closely for side effects of the two together. Be sure you physician is aware of other medication that you are taking including vitamins, supplements, and non prescription medications so they can monitor if any of them will affect the medication and watch for side effects the medicaitons together may produce. Let your physician know if you have or have ever had heart or kidney disease. Tell your physician if you have ever had thyroid disease or organic brain syndrome or any fainting without explanation. Tell your physician if you are pregnant, plan to become pregnant or are breastfeeding as lithium can be harmful to the fetus. This medication can cause drowsiness so do not drive or operate machinery while taking it. You should alert your doctor or dentist if you are having surgery that you are taking lithium. If you take too much of your medication you should immediately call poison control helpline to see what needs to be done. Needs diabetic nutritional counseling Describe how you will evaluate evidence of learning and/or the need for further education (5 points). I would ask the patient and his family members that are present if they have any questions that I can answer for them. I would also ask them questions about the things they had just learned and have them explain to me what they just learned so that I know that they have understood what I have explained to them. I would use hand-outs to assist in the learning process and have them show me on the hand-outs things that they may have learned as well. The client is provided with education prior to being discharged from the acute care facility. How could this environment effect client teaching? What are some ways to adapt the environment to ensure client teaching? List at-least 6 examples (12 points). The environment could affect the teaching due to many reasons. Some of these reasons could be: Distractions – would need to make sure to go to a room away from people that could distract from the teaching Phones – cell phones could distract away from teaching so make sure they are put away or turned off so that there is not a call that comes through or a text message that comes through to distract away from the teaching Family members – some family members can distract – be sure that only family members that do not distract away from the teaching are present. If someone distracts away from the teaching they should be taken out of the equation so that teaching and be accomplished. Television – if there is a television nearby, be sure it is turned off so that it doesn’t distract away from the teaching If the patient is working on anything else such as a puzzle or game, make sure they are not working on this during the teaching Distractions outside the window- if there is anything going on outside that can distract the patient make sure there is not a window to look out near where the teaching is going to take place so that this distraction is not there to prevent learning. Put a do not disturb sign up on the door of the room the teaching is to be taken place at to make sure no one disturbs the teaching Make sure the patient is at a good place to learn at the time of the teaching List at-least 5 local and/or national resources available to the client. Be specific and state how each resource will help the client be successful. (5 points). Utilization of 7th edition APA format to cite all resources utilized. With the use of resources, uses medical terminology and abbreviations appropriately; demonstrates professional communication that is adherent to legal requirements of nursing documentation; avoids plagiarism and upholds academic integrity. (4 points). References Ignatavicius, D. D., Workman, M. L., & Rebar, C. R. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care (9th ed.). Elsevier. Sole, M. L, Klein, D. G., Moseley, M. J., Makic, M. B. F., & Morata, L. T. (2021). Introduction to critical care nursing (8th ed.)Elsevier. Vallerand, A. H., & Sanoski, C. A. (2021). Davis’s drug guide for nurses (17th ed.). F.A. Davis.

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