Running head: TEACHING PLAN

Teaching Plan
Catherine Fedoruk
NPRT 2102-001
NorQuest College
Courtney P.
June 17, 2016

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Assessment of Client and Client Learning Needs
Client Background
M.S is a forty-five year old single female who is three days post op Roux-En-y procedure
for obesity. She will be going home tomorrow with a post op JP drain, until her output has
reached 30ml in 24 hours. She has also been recently diagnosed with non-insulin dependent
diabetes. She has a university degree in education, with no cognitive delays. She works in an
office where the majority of her day (7-8 hours, on average) is spent sitting. She spends her spare
time helping raise her nieces and working in the family bakery. She is experiencing
hyperglycemia due to inactivity and poor nutritional intake. She is of Chilean descent, and her
diet consists of high protein, fat, and carbohydrate consumption. Based on Eriksons
Developmental Stages, she is experiencing Generativity vs. Self-stagnation, during this time
adults strive to create or nurture things that will outlast them often by parenting children or
contributing positive changes that benefit other people. I believe this is an accurate portrayal of
her situation since she has stepped into the parental role of her nieces and works within the
family unit. She also shows this developmental stage by making a positive change in her health
by opting to have gastric bypass surgery.
Client Barriers to Learning
M.S. barrier to learning would be poor concentration stemming from fatigue related to
post operative pain. When M.S. is experiencing pain she may have difficulty concentrating fully,
teaching should be done when her pain is managed. Managing her pain before teaching will have
the best outcome for the patient. Our clients learning barrier is lack of time (Potter & Perry,
2015, p. 304). This creates a time barrier for her to be able to plan meals and spend time on her
daily journal in regards to promoting a healthier lifestyle.

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Clients Learning Style
According to Potter & Perry, a kinesthetic learner learns best with hands-on training and
incorporating an interactive teaching style (2014). Our client has expressed that she learns best in
this manner, so we will modify our teaching style to accommodate her needs. We will also
provide a brochure to take home with her so she may refer back to it if she has any questions.
Nursing Diagnosis, Goal and Learning Outcomes
Actual Nursing Diagnosis
Knowledge deficit related to JP drain secondary to new condition
Potential Nursing Diagnosis
Increased risk for being invaded by pathogenic organisms related to poor JP maintenance
Wellness Nursing Diagnosis
Readiness to improve overall health related to dietary changes as evidenced by seeking gastric
bypass.
Client Centered Goal
Client will keep a daily record of her JP output, noting the time, amount and color of
drainage. She will be able to demonstrate how to properly drain and re-prime the JP drain before
her discharge tomorrow in the morning.
I have also suggested she keep a journal of her blood glucose levels, and dietary intake.
By keeping a journal, it will help her understand the relationship between the dietary intake and
blood glucose levels. I have also recommended planning meals in accordance with the Canadian
Diabetes Associations Glycemic index to help her make better dietary choices. Using both these
strategies it will help reinforce the importance of a healthy diabetic diet. The client will also
demonstrate an understanding and familiarity with checking their own blood glucose.

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Learning Outcomes
The client will do a return demonstration of how to properly cleanse and maintain the JP
drain. She will also be able to positively identify two signs of infection for her JP drain site.
Teaching Strategies and Rationale
I have chosen to use hands on approach for teaching M.S. to cleanse and empty her JP
drain. I will first demonstraight the proper technique for cleansing and emptying the drain, then
have M.S. empty and cleans the drain herself. I will provide guidance and adjust her technique to
minimize risk of infection. This will allow her to feel comfortable with emptying and cleansing
her JP drain before she is discharged; allowing her the time alleviate any concerns she has for it.
I have also chosen to promote a healthier lifestyle with M.S. and provided her with a
glycemic index to help her with meal planning and her journal. I have provided M.S. with the
web address of the Canadian Diabetes Association (2015). The web page has information
regarding diet, exercise and small adjustments to daily lifestyle to make healthier decisions. This
will promote independence in establishing a healthy diabetic lifestyle.
Evaluation and Reflection
Due to the client being discharged tomorrow, I felt this was the best way to implement
proper teaching of her JP drain. She can learn, through a kinesthetic technique as she stated she
learns best this way. I also feel due to the clients busy lifestyle, it was best to use a self-directed
teaching plan in which the client is able to learn at her own pace in regards to dietary changes.
This way, the client can learn in the comfort of her own home as time allows. This is also a costeffective approach (Lipe & Beasley, 2004). The downside to this approach is the potential for
client procrastination and decreased opportunity for questioning (Lipe & Beasley, 2004).

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Journals are used as a learning tool to track blood glucose levels and create a foundation
of understanding to show how certain meals will affect glucose levels. There are drawbacks with
this method, such as time constraints and a willingness to continue the journals (Lipe & Beasley,
2004). Alternatives can include apps used on smart phones, such as Diabetes Journal or MyPlate,
to track glucose levels and dietary intake. The use of these apps would reduce the time spent
making entries into the journals.
Implications for Using Teaching Plan in Future Practice
I feel that this teaching plan will be beneficial in future practice, the hands on approach
will allow patients to attempt the cleansing and emptying of their JP in the hospital, and be able
to alleviate any concerns they may have before going home. However, a weakness of this
technique may create a problem for those with movement disorders of the hands as they may find
it difficult to perform the tasks related to the maintenance of the JP drain. I also feel the dietary
journal will be beneficial in future practice as well to allow patients post gastric bypass to
understand what they eat in a day to ensure they adhere to bariatric dietary guidelines.

Conclusion
The teaching plan was successful, as evidenced by the clients ability to demonstrate the proper
technique for draining and cleaning her JP drain.

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References
Canadian Diabetes Association. (2015). The glycemic index. Retrieved from http://www.dia
betes.ca/diabetes-and-you/healthy-living-resources/diet-nutrition/the-glycemic-index
Google Play. (2015). Diabetes journal. Retrieved from https://play.google.com/store/apps/details
?id=com.suderman.diabeteslog&hl=en
Lipe, S. K. & Beasley S. (2004). Critical thinking in nursing: A cognitive skills workbook.
Philidelphia, PA: Lippincott, Williams & Wilkins.
Potter, P. A. & Perry, A. G. (2014). Canadian fundamentals of nursing (5 ed.). Toronto, ON:
th

Elsevier Canada
Roche Diagnositics. (2015). Accu-Chek Compact Plus. Retrieved from https://www.accu-chek.
ca/ca/products/metersystems/compactplusgt.html
Sanofi. (2015). How to use your Lantus SoloStar pen. Retrieved from https://www.lantus.com//media/ems/conditions/diabetes/brands/lantus/consumer/lantus-solostar-pen-guide.pdf

www.cc.nih.gov/ccc/patient_education/pepubs/jp.pdf