Patient Education Assignment Cindy Olsen, Christy Larsen, Jared Belcher, Kayla McDonald 1.

Assessment of the patients knowledge of the disease/condition and literacy level. Also consider the patients culture. (see assessment tool below)se assessment tool to determine patients knowledge of disease! ask what he knows about the disease! if he is compliant with medications and if he knows why he is taking the medications. "ind out what kind of a learner he is! what cultural barriers e#ist! and his ability to understand and apply the information given to him. $. Initial Assessment: %&' (' )).$ oral * +' ,- reg. * .' $/ * 0+' 1-1/)$ * 2$ sats' ),3 .A Assessment' * .4&+' breath sounds clear with e5ual aeration bilat.! non-labored * 6A.78A6' pale/pink! cool 9 moist skin! &1&$! no edema! pulses :; in all e#tremities * <4 .2' alert 9 oriented # * =8/= ' active 0& in all 5uads! abd. soft/non-tender! voiding without difficulty! urine clear/yellow * >8&6' skin integrity intact Diagnostic ests: * 1$ lead 4?=-reveals $mm &( segment elevation in leads 88! 888! A%" (interior! &(4>8) * (roponin ( (norm' /-/./:)' 1.$ ng/m@ * 6?/6?->0 (norm' /-1/)' :$ u/@ Physician Orders: * 6ardiac monitor- sinus bradycardia * <itroglycerin (<(=) subl. 4very ,A #:. 8f no relief and &0+ B)/ start <(= gtt. * >etoprolol , mg 8% push * Ceparin 8% gttD,///u bolus and start at 1///u/hr * A&A :$, mg po * +lavi# E// mg po

&moker-+ossibly does not understand what smoking does to the body. 8t progressed the Cyperlipidemia! hypertension! abdominal aortic aneurysm and myocardial infarction. >aybe doesnFt know what leads to an >8. ie' Cyperlipidemia and 7iabetes uncontrolled lead to C(< and leads to an AAA and leads to >8 :. he goal!s" you want to achieve' (he goal is to have the patient compliant with his care plan! he needs to understand all of the following' 7isease process! >edication (why on it! dosage! fre5uency! and instructions)! @ife-style changes necessary! &kills necessary for self-care! Ghen to notify the provider. * (he patient will state the benefits of smoking cessation and know the conse5uences of continuing to smoke. * +atient will state signs and symptoms of having an >8. * +atient will state importance of early intervention when having an >8 or 6hest +ain. * +atient will state names and >2A on medications and how to take them. * 7iet and e#ercise teaching. -. Outline that includes a. 7isease process- A heart attack results when a complete occlusion or blockage suddenly forms in the arteries that supply blood to your heart H the coronary arteries. 0lockages are caused by a disease process throughout the arteries in your body called atherosclerosis! in which pla5ue H a fatty substance H builds up in the arteries. (his pla5ue narrows the arteries! leaving less room for blood to flow. A pla5ue can be topped with a thin! fibrous cap that ruptures. Gith rupture! e#posure of atherosclerotic debris to the bloodstream can cause platelets (a component of blood that assists with clotting) and red blood cells to collect at the site of the rupture! cutting off blood flow to the artery. Alternatively! part of the pla5ue may break off and flow downstream in the blood. (his piece of pla5ue can then lodge in a narrowed portion of the artery and blood will begin to clot around it. (his blood clot (thrombosis) can partially or completely cut off blood flow through the artery. Ghen blood flow to the heart is cut off! this is called ischemia! it results in chest pain and leads to an >8 (heart attack). II after e#plaining this process! we would show a video or pamphlet on the disease process that would further e#plain how this happens so that our patient has a better understanding of what is happening to him. http'//www.youtube.com/watchJvK0@)$vtuL)nc b. Medications- 8t is important to manage your health with these medications. (his is what each one is! how and when you are supposed to take it! and what it does for you.

Lisino#ril H is for your high blood pressure. 8t helps the vessels of the heart rela# to allow more blood get to the heart. 8t also helps the efficiency of the heart. Mou take 1/ mg! twice a day. Mou should always take it at the same time each day! so that you get yourself into the habit of taking it. (ake it in the morning when you wake up and at night before you go to bed. Mou should always take your blood pressure and heart rate before taking your medication. H 7o not take it if your systolic pressure! which is the top pressure! is less than )/. >ake sure that you change positions slowly! like when getting out of bed or standing up! so that you dont get light headed. Mou may develop a dry cough. ?eep your regular 7r.s appointments to have labs drawn for monitoring G06! Cyperkalemia! =". and liver function. Atenolol H is also for your C(<! you take $, mg! twice a day! take it Lust like your lisinopril! same instructions. Mou can take it at the same time that you take your lisinopril. 62<(.A8<786A(47 8n 6C"! bradycardia of heart block...use in caution in diabetes! liver disease. 72 <2( stop taking this drug abruptly. (alk to your 7r. if you have any concerns. $ly%uride- is for your diabetes. Mou need to take , mg pill once daily! (ake medication at the same time every day! take missed dose as soon as remembered unless close to ne#t dose. 2bserve for &9& of hypoglycemic reactions! which include! lightheadedness! diNNiness! sweating! headaches. 0eta blocker therapy may have very subtle &9& of hypoglycemia. &igns and symptoms of hypoglycemia include irritability! confusion! shaking! headache! nervousness! and fatigue. A&A H this is because of your >8. (his helps FthinF your blood and helps your heat not have to work as hard. Mou take one pill of 11 mg daily. >ake sure you take it with a full glass of water and remain upright for 1,-:/ minutes after. .eport tinnitus (ringing in your ears)! bleeding of gums! bruising! black! tarry stools! fever longer than : days. Avoid alcohol because of liver to#icity and avoid ginger because it also thins the blood. &tay on a sodium restricted diet!. Prilosec- =4.7 caused by A&A - $/ mg daily- this is for your heartburn! taken with or without food! assess for epigastric/abd pain and blood in stool or vomiting. &im'astatin - Cyperlipidemia H (his is your high cholesterol medication. &tatins also decrease inflammation. +atients with inflammation have an increased c-reactive protein level which makes you more prone to another >8. (ake $/ mg daily! at night! with or without food. 8t is important that you keep your 7r.s appointments so that you can have labs drawn to monitor liver inLury/damage (A&( 9 0ili) if 6+? is elevated discontinue use. c. Li(e)style changes necessary)

8t is important that you manage your diet and e#ercise. A huge risk factor of >8 and A67 is smoking. 8t would be a good idea to 5uit. Ge have several options available for you if you are interested in smoking cessation. (he 7A&C diet is a good heart healthy diet that you should follow. All of the information about this is in our pamphlet. After damage to a heart is sustained it is more likely to turn into heart failure. 4specially with uncontrolled C(<! uncontrolled diet! and a sedentary lifestyle. http'//intermountainhealthcare.org/e#t/7cmntJncidK,1/E1O-/ d. &*ills necessary (or sel()care) ?nowing his medications and the &9& to watch for. e. +hen to noti(y the #ro'ider, H 8f heFs having chest pain or if he is having a reaction to one of his medications. 8f you are given nitroglycerin! take that and then call )11. Also! keep all appointments. ,. &#eci(y ho- you -ill teach (hands on! 5uestion/answer! written! video! group discussion) Ge will teach using pamphlets! and talking/discussing! 5uestions and answers. Also the family that is with him the most often should be taught about his medications and how they can help him and what signs and symptoms they can observe for regarding the >8 &9& and the Cypoglycemia &9&. +atient education starts the minute the patient is admitted and is continually reinforced until discharged. (hings are soon forgotten after a visit to the hospital. 8 would find papers e#plaining each med and give it to the patient with some important things highlighted. E. Determine ho- you -ill assess the #atient.s learning !'er%ali/ation0demonstration) (he patient will need to repeat back to the nurse the things he has heard to ensure he understands the teachings. 8f he has any 5uestions! we will answer them at this time (including any concerns about se#uality). Ge will also make him a calendar that shows all of the medications he takes and at what time so that he can get into the habit of taking them. Ge will show him and his loved one how to take his blood pressure and heart rate and have him demonstrate back how this is done.

2ur pamphlet attached is the 8ntermountain Cealth 6are >AG7&/C" teaching pamphlet for those who are discharged from the 6% floor after a hospital stay. 8t is an e#cellent teaching tool. http'//intermountainhealthcare.org/e#t/7cmntJncidK,$/,11:,1