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Aitken-Cuthbert Teaching Plan
Aitken-Cuthbert Teaching Plan
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Abstract
This teaching plan was designed for a 62 year old woman with Rheumatoid Arthritis. The patient was diagnosed and prescribed
Prednisone seven days ago. This nurse met with patient and taught the patient most aspects of taking Prednisone at the initial
appointment. The patient was advised to get a pill organizer which would be easier to open than a normal medication bottle and this nurse
helped the patient set up alarm reminders, on the patients cell phone, for when to take the medicine daily. Due to some possible serious
side effects, the patient was asked to return after one week of taking the medicine, for a follow up meeting. She has come back into the
office for some additional medication teaching and to address any new issues. One issue not covered in the teaching plan, but was a
concern for the patient, was the cost of medicine. Patient stated at the first appointment that she had to discontinue Embrel due to high
cost (approximately $1,500 a month.) This nurse called the pharmacy and informed the patient that Prednisone would cost approximately
$10 per month and she should call the health care provider for exact costs.
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NUR 314 Pharmacology Teaching Plan
Student Name
Sara Aitken
Shawnee Cuthbert
Nursing Diagnosis(s): Activity intolerance related to altered dexterity as evidence by inability to open pill bottles (Doenges,
Moorhouse, & Murr, 2013, p.39); Pain, chronic related to physical disability (RA) as evidence by patients statement of pain 7 out
of 10 during office visit (Doenges et al., 2013, p. 555); Imbalanced nutrition, more the body requirements related to steroid use as
evidence by 5lb. weight gain in 5 day period (Doenges et al., 2013, p. 533); Fluid volume, excess related to steroid use as evidence
by +1 peripheral edema (Doenges et al., 2013, p. 333); Impaired oral mucous membrane related to pharmacological side effects as
evidence by patient statement of xerostomia (Doenges et al., 2013, p.545); Self-care deficient related to musculoskeletal impairment
as evidence by patients statement of inability to button shirt (Doenges et al., 2013, p. 664); Disturbed body image related to
inability to perform activities of daily living as evidence by patients statement My hands are so gnarled, I cant do anything
anymore (Doenges et al., 2013, p. 100)
Assessment of Learner:
Patient has difficulty seeing small print.
Patient has difficulty with memory.
Patient has previous knowledge of
diabetes due to family history.
Patient is well educated, retired teacher.
Patient has social support with large
family in close proximity.
Patient has economic concerns about cost
of medication.
Patient has impaired hand mobility.
Assessment of Environment:
Turn the lights all the way up for better
vision.
Talk in office for increased comfort and
privacy.
Turn off phones and other noise to
decrease distractions.
Meet at patients preferable time to
increase focus and patient adherence.
Keep office door closed to decrease noise.
Learning Resources:
Medication pamphlets
Watch short film on RA
Refer to social services (insurance issues),
dietician (weight gain/diabetes), and
physical therapy (decreased dexterity) to
address additional needs
Give number to nursing hotline to address
questions after hours
Long Term Goal: Patient will maintain current hand dexterity by attending physical therapy twice a week for one year. Patient will
appear relaxed, able to sleep, and participate in activities at nine month follow up. Patient will verbalize increased confidence and
ability to cope with disease at nine month follow up. Patient will be within ten pounds of her current weight at one year follow up
through diet and exercise. Patient will continue with monthly checkups to monitor renal function, glucose, bone density, and
electrolytes for the duration of steroid use. At one year appointment patient will report 2 or less out of 10 on pain scale by adhering
to medication regimen. Patient will verbalize side effects of Prednisone and report any symptoms to the office.
Nursing Interventions:
Scientific Principles:
Evaluation
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References
ATI (2013). Pharmacology for Nursing, Edition 6.0: Content Mastery Series Review Module. USA: Assessment Technologies Institute,
LLC.
Doenges, M.E., Moorhouse, M.F., & Murr, A.C. (2013). Nursing diagnosis manual planning, individualizing, and documenting client
care. Philadelphia, PA: F.A. Davis Company.
Ignatavicius, D.D., & Workman, M.L. (2013). Care of patients with arthritis and other connective tissue disease. Medical-surgical
nursing patient-centered collaborative care (pp. 318-355). St. Louis, MO: Elsevier Saunders.
Kee J.L., Hayes, E.R., & McCuistion, L.E. (2015). Pharmacology a patient-centered nursing process approach. St. Louis, MO:
Elsevier Saunders.
Kirwan, J.R. and Buttgereit, F. (2012). Symptom control with lose-dose glucocorticoid therapy for rheumatoid arthritis. Oxford
Journals: Rheumatology, 51 (4), pages 14-20. http://rheumatology.oxfordjournals.org/content/51/suppl_4/iv14.full
MedlinePlus (2014). Prednisone. U.S. National Library of Medicine National Institutes of Health. Retrieved from
http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601102.html
Vallerand, A.H., Sanoski C.A., & Deglin, J.H. (2013).Corticosteroids (Systemic). Daviss drug guide for nurses (pp. 363-370).
Philadelphia, PA: F.A. Davis Company