Introduction

Client education is one of the foundations of nursing practice. "A nurse must ensure that
clients, families, and communities receive the information needed to maintain optimal health"
that is done through client teaching (Gregory et al., 2015, p. 181). Mr. Robin is 73 years old who
recently admitted to continuing care after having several falls at home. Robin had a hearing test
done and requires a hearing aid. He has a history of eczema and currently has patches of red,
flaky skin on elbows and knees. Robin uses a medicated cream and applies it sporadically. Robin
is originally from Nova Scotia and was a fisherman by trade. He has a grade six education.
Teaching is most effective when it is responsive to the learner's needs; therefore, the client
should be an active participant in the teaching plan. In the following teaching plan, I will talk
about Mr. Robin, who is 73 years old that presently is in moderate health. The teaching focus
ultimately is to improve her quality of life, maintain medication compliance, increase mobility
with a cane, nutrition plan to improve muscle weakness, hearing aid care, and instruction. An
achievable, specific goal with instructions on medication, increasing mobility, and improving
diet will hopefully result in an improved overall health and wellness state.

Learning Need 1 and Assessment Data

Mr. Robin, who just moved to continue care, has a history of eczema and currently has patches
of red, flaky skin on elbows and knees. Evaluate the patient's strength to move, like shift weight
while sitting, turning over in bed, and moving from bed to chair to prevent further skin
breakage.

The patient's awareness of the sensation of pressure: Usually, individuals change position off
pressure areas every few minutes; these occur automatically, even during sleep. Patients who
are unaware of sensation tend to do nothing, resulting in prolonged pressure on skin capillaries
and eventually in skin ischemia.

Learning Need 2 and assessment Data

Hearing aid
Priority Learning Need and Diagnosis
Nursing Diagnosis: Impaired skin integrity R/T eczema evidenced by patches of red, flaky skin on
elbows and knees.
Goal:
• As a nurse, we want Robin to have moist skin on bony prominent and medication on
eczema regularly.
• As a nurse, I want Robin to walk without falling.
Expected Outcome (SMART Criteria) :
• Client will apply his medicated cream twice a day, and his eczema will get better in 2
weeks.
• Client will apply sent less and moisture once a day on bony prominent to avoid pressure
ulcer.
• Client will do mobility exercise 4 to 5 days a week for 15 min to 30 min to keep him
moving around and making his bone strong.
Domains of Learning :
1. Affective Learning:
As a nurse, I will have a one-on-one discussion about eczema to take care of the skin before
further damage, and I will keep sessions short to get his full attention. I will make sure he felt
comfortable in his skin.
As a nurse, I will have a group discussion with Mr. Robin and a dietitian to improve Mr. Robin's
health by inspecting liquid and solid food portions consumed, and that was we can make
changes to make his bone stronger, and we can control his fall.
2. Psychomotor Learning:
Robin had a hearing test done and requires a hearing aid. As a nurse, I will demonstrate how to
take care of the hearing aid and apply it correctly. A nurse will do that by showing him videos
and practice them. Mr. Robin has to return a demonstration that was a nurse knows he
understands.
Client Barriers

• Patients can be embarrassed or frustrated by their skin conditionate. A patient might

refuse to get treated, leading to lesion or pleasure ulcer because of Mr. Robin's mobility. The
nurse should encourage counseling. Talking with a therapist or other counselor may help.
• Education and Awareness Barriers Language will affect Mr. Robin's learning because he
only has grade six education. He won't be able to write or read, so we have to teach him
through activity or showing videos as a nurse.
• If Mr. Robin's hearing aid is not active, he won't be able to listen and understand
anything, which can alter his health by miscommunication.
• Mr.Robin'ss continuing fall can lead to transportation barrier, in begging there has to be
a nurse with him all the time because of his fall history.

Teaching Plan
Educational Content
• Educate the patient about the causes of pressure and proper skincare: This information
can help the patient find methods to prevent skin breakdown.
• Communicate with a dietician as appropriate: The dietician can aid the patient and
family in food preferences to meet adequate nutritional and hydration goals.
• Reinforce the importance of turning, mobility, and ambulation: These will enhance their
sense of efficacy and improve compliance with the prescribed interventions.

Teaching Methods
• Encourage the patient to change position every 15 minutes and change chair-bound
positions every hour: During a sitting, the pressure over the sacrum may exceed 100 mm Hg.
The pressure needed to close capillaries is around 32 mm Hg; any pressure above 32 mm Hg
leads to ischemia
• Discourage the patient or caregiver from elevating the head of the bed repeatedly.
Encourage the use of lifting devices like trapeze or bed linen to move the patient in bed:
Common causes of impaired skin integrity is friction, which involves rubbing heels or elbows
toward bed linen and repositioning the patient up in bed without the use of a lift sheet. A
common cause of shear is elevating the patient's bed's head: the body's weight is shifted
downward onto the patient's sacrum.
• Clean, dry, and moisturize skin, particularly bony prominences, twice daily or as
indicated by incontinence or sweating. Avoid hot water. If a powder is desirable, use medical-
grade cornstarch; avoid talc: Smooth, supple skin is more resistant to injury. These measures
prevent evaporation away from the skin. Avoid talc, which may cause lung injury.

Teaching Resources:
• IfRobin'ss willing to have a family member involved in the teaching plan and care.
• Family's willingness and ability to participate in care, a family member, must be
responsible, willing, and able to assist in care activities such as bathing or administering
medication.
• Teaching tool, including brochures, audiovisual material, or posters, painted material
should present current and easy undersetting information that matches that will help Robin put
medication on properly and move around in bed.

Evaluation of learning
Teaching plan strength is daily monitoring of medication administration; it is easy to follow and
acts as a reminder for a client. This patient is now medication compliance with his eczema
medications. Robin's eczema is better than putting medicines on time and thoroughly because
of teaching resources. Changing his position every one h will avoid having pleasure ulcer. By
doing exercise 3 to 4 days a week, Robin gained his bone strength.

Analysis of the Teaching process

Why Teaching is Important, I believe that this teaching plan is essential, that we highly regarded
and utilized the patient's needs. In teaching, we also considered the client's learning needs, and
thus, we were able to increase the client's mobility and skin integrity without putting too much
strain and stress on the client.
Strengths and Challenges
Patients co-operation (strength): The experience of making this teaching plan will significantly
influence my future practice. I learned that including your client in formulating the steps,
actions, and goals can positively impact the result and the client itself. By doing the teaching
plan together with the client, we made a plan that would specifically suit his needs, increasing
the benefits and decreasing any complications that may arise.
Patient education (challenges): Mr. Robin cannot read-write and is unable to hear, so it would
take longer to communicate with him.
Benefits:

Conclusion
The teaching plan is one of the most critical steps in the nursing process. It is a vital process
used to achieve the best quality of client centered care by comprehending the client's health
status and stabilizing, preventing, and minimizing any complication or illness that may arise. In
this teaching plan, I formulated a skin impaired diagnosis that we worked on more challenging
to develop a plan that we will follow through to decrease any complication that may harm the
patient health and improve his health literacy. Helping this patient gain a clear understanding of
the importance of lifestyle can significantly impact his health positively in the long run because
he will be able to maintain an active and healthy lifestyle in the future independently.