University of San Agustin

General Luna St., 5000 Iloilo City, Philippines

www.usa.edu.ph

COLLEGE OF HEALTH AND ALLIED MEDICAL PROFESSIONS - DEPARTMENT OF NURSING

Name: Red Angela O. Dinson Course & Section: BSN 1-B

Case Application:

 Mr. Grey is a 60 year old man who has diabetes for five years and has not followed the
prescribed treatment regimen. He has a non-healing wound on his right foot which
prompted him to go to the hospital to have it checked. His attending physician scheduled
him for a right leg below the knee amputation (cutting of a part of the body) to prevent
further complication.
 His past health history revealed that physical examination had been infrequent. He also
reported that he did not adhere to the lifestyle changes and medication regimen that was
prescribed. He smokes approximately two packs of cigarettes per day for the past 10
years. The client claims to drink alcoholic beverages occasionally.
 He has done well after surgery though he complains of pain in the operative site with a
scale of 8 out of 10. He was referred to the physical therapist in the Rehabilitation Center
to be taught the proper use of the crutches before discharge.
 During discharge, the nurse discusses to Mr. Grey the importance of rehabilitation, strict
drug compliance & lifestyle changes as well as the care of the wound.
Answer the following questions:

1. One of the important aspect of care that nurses give to patients in terms to continuity
of care is through patient education. As Mr. Grey is about to be discharged, there are a
lot of areas to focus on in terms of the proper health teachings to be given to avoid
complications at home. If your are the student nurse in-charge of Mr. Grey, what will you
consider first before giving the instructions to him and family?.

As a student nurse, I need to consider the patient’s literacy or the patient’s ability to
receive, process, and comprehend fundamental health information and services in order to
make informed health choices. It is important to know first their capacity to think and process
information. Because it is your first step to plan out and recognize the patient’s ability to function
in a certain health teaching that you instilled in them. It is important to assess the patient’s
literacy because it is for us, nurses, to know what could be the best health information for the
patient. This health information will know if the patient education that will be given to them is
effective or it could be useless. If the patient has low literacy, it is important to choose what
could be the lesser and simplest health education that could be implemented to them. As a
nurse, you can always plan a simple or basic information that is useful and relevant to enable
the patient to comprehend effectively the concepts and design teachings depending on the
patient's capacity to think and act.

Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403

 University of San Agustin
General Luna St., 5000 Iloilo City, Philippines
www.usa.edu.ph

COLLEGE OF HEALTH AND ALLIED MEDICAL PROFESSIONS - DEPARTMENT OF NURSING

2. What important areas (focus of health teaching) will you discuss to Mr. Grey and his
family for the continuity of care at home and eventually for his full recovery. Cite 3 and
give the reason why these are important.

1. Promotion of Health

 Promotion of Health is important because in Mr. Grey's case he doesn’t follow any
prescribed medication that was advice to him before that made his situation worse.
Health promotion is a crucial principle of nurses to enhance the effectiveness of our
practice. Promotion of health must be adhered correctly in order for a specific patient to
gradually progress its own well being. Some of these promotions of health are increasing
the person's level of wellness, nutrition and exercise where the nurse can promote active
learning through educating Mr. Grey to take a proper sleep at the right time, eat a proper
diet and exercise everyday. We can promote active learning here since throughout these
activities Mr. Grey is able to gain and conserve its own energy and be healthy
throughout the day. Mr. Grey can also participate actively in this kind of activities
because it is simple but it can enhance its own health through step by step process
where the nurse could also ask the patient to manage his stress and focus on its
hygiene after Mr. Grey accomplishes the first three that the nurse educates him to do.  
2. Restoration of Health

 Mr. Grey must focus on his healing not only physically but also emotionally and
psychologically. It is hard to re-establish our own identity after how many health
challenges that occur. Through this restoration of health will give the patient’s family
involvement to the patient's self care needs. Because Mr. Grey has below knee
amputation that makes him disable or lessen the activities that he can do. It is important
to have its own family’s involvement in its restoration of health after his discharge to give
him help and support to improve its own wellness. Nurses can also enhance
technological medications or restoration since Mr. Grey is in need of tools or equipment
for its amputation.  
3. Adapting to altered health functions

 It was obvious that Mr. Grey’s was slightly hard-headed and stubborn because in 5
years he didn’t follow any prescribed treatment to him. As a nurse, adapting to altered
health functions can be a way to change his behaviors and habits to result in better
health outcomes. Mr. Grey may also experience a weak self-image due to his below
knee amputation. Adapting to his own altered health functions can help him adjust to its
present situation. In this way it can help him accept and regain its confidence in the
changes that altered his health. Also through this health teaching can assist Mr. Grey to
gradually adapt to the facilitation of treatments that must be done unto him.

Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403

 University of San Agustin
General Luna St., 5000 Iloilo City, Philippines
www.usa.edu.ph

COLLEGE OF HEALTH AND ALLIED MEDICAL PROFESSIONS - DEPARTMENT OF NURSING

 

3. Choose 1 among the areas (focus of health teaching) that you have cited in #2 and
enumerate the health teachings you will give to him. State your specific objectives then
followed by your health teachings or instructions. Cite your references. Follow the
sample template given below:

I. Rehabilitation
Domain Specific Objectives Plan/Intervention Health Rationale
Teachings

Cognitive Develop his physical, Restoration of Health: In order to To assess what

social, and restore its health, it is a crucial specific actions to
psychological action to nurses that they must develop its
potential to a point recognize what self-care skills that physical health,
that he can operate the patient knows and is able to do social health and
freely and live a self- to re-establish its health psychological
sufficient existence. development. Also the nurse can health.
educate the patient’s family what
are the exercises and stretches
after the surgical procedure of his
below knee amputation.

Psychomotor Improve efficiency Promotion of Health: In order for To recognize if a

towards Mr. Grey’s
optimal health to
perform
independently of its
self care needs.
Mr. Grey's to perform her self care patient can
needs independently. It is function to his self
important for me as a nurse to care requisites
educate him how to exercise effectively.
moderately, what are the
treatments to improve the healing.
And also nurses can assist Mr.
Grey to attend health promotion
programs about the dangers of
smoking and alcohol consumption,
so that Mr. Grey is able to change
his habits and can perform its own
restoration or rehabilitation
successfully.

Affective Advocate support to Adapting to altered health and To identify what

Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403

 University of San Agustin
General Luna St., 5000 Iloilo City, Philippines
www.usa.edu.ph

COLLEGE OF HEALTH AND ALLIED MEDICAL PROFESSIONS - DEPARTMENT OF NURSING

Mr. Grey through function: As a nurse, when your habits and

helping him adjust patient Is having rehabilitation. You problems to be
with his disability and must construct a structured and altered.
how he is able to specialized plan to its goals and
change his ways and eventually be able to attain
improve its own successfully the  goal outcomes.  It
health condition. is important to patient’s to have
insights about the treatment that is
to be performed. As a nurse you
must be able to assist him make
decisions that can benefit better
health outcomes.

II. Strict drug compliance

Domain Specific Plan/Intervention Health Rationale
Objectives Teachings

Cognitive Explain the Prevention of Illness/Injury: As a It is a guide for the

significance of nurse, you are one of the sources of client to know how
medication knowledge of the patients about these medications
adherence on a their medication. You should are important to
daily basis. cooperate with the physician to healing or
properly adhere to the medications. recovery.

Psychomotor Manage Prevention of Illness/Injury: In this To apply the

thoroughly the intervention it is essential to follow correct and best
adherence of the prescribed medication of the adherence of
medications. physician. medication to avoid
any uncertain
problems.

Affective Be aware of the Prevention of Illness/Injury: As a To apply the rights

prescribed nurse, your responsibility is to of medication
medications. educate the patient to take medicine adherence.
in the right amount, at the right time,
in the right way and for the right
duration. And also to administer
drugs safely.

Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403

 University of San Agustin
General Luna St., 5000 Iloilo City, Philippines
www.usa.edu.ph

COLLEGE OF HEALTH AND ALLIED MEDICAL PROFESSIONS - DEPARTMENT OF NURSING

 

III. Lifestyle changes

Domain Specific Plan/Intervention Health Rationale
Objectives Teachings

Cognitive Compare the Promotion of Health: Discuss the To facilitate the

previous life habit to risk factors of smoking and alcohol patient’s
the current or consumptions that could affect the cardiovascular
following lifestyle. health of an individual. Plan out system to avoid
necessary care plans that a patient any diseases may
must accomplish after its discharge. arise.
For example, to balance a healthy
diet and eat nutritious foods. What
exercises are necessary to improve
the cardiovascular system. Through
this the nurse can evaluate what
are the proper health promotion
activities that the patient must
perform to his current lifestyle.

Pyschomotor Design an effective Prevention of Illness/Injury: In this To apply the

outline of activities intervention it is essential to follow correct and best
to maintain the the prescribed medication of the adherence of
continuum of health. physician. medication to
avoid any
uncertain
problems.

Affective Conceptualize a Adapting to altered health and To differentiate

hierarchy listing to function:  The nurse can modify the what are good and
provide a patient a behavior of patients through giving bad factors that
framework on what the patients knowledge about other can affect the
the patient must health problems that can probably body.
change, improve occur. List all the behavioral,
and adapt. material and psychological health
problems.

 
IV. Care of the wound
Domain Specific Plan/Intervention Health Teachings Rationale

Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403

 University of San Agustin
General Luna St., 5000 Iloilo City, Philippines
www.usa.edu.ph

COLLEGE OF HEALTH AND ALLIED MEDICAL PROFESSIONS - DEPARTMENT OF NURSING

Objectives

Cognitive Discuss the 5 Restoration of Health: The nurse must To have proper
basic post- clearly explain the post-operative care briefing on what to
operative care. which are the casting methods, rigid do with the below
dressing, semi-rigid dressing and soft knee amputation.
dressing. It is also the responsibility of
the nurse to explain the self care skills
that the patient's family will have.

Psychomotor Demonstrate Restoration of Health: The nurse will To have

post-operative execute the proper care such as knowledge about
care with the washing the surface of the wounds, the do’s and
patients and the changing its dressing and safely don'ts in the
patient’s family. applying the bandage. proper care of
wounds.

Affective Accept and don’t Prevention of Illness/ Injury: To evaluate the

invalidate the Acknowledge the patient by giving patient’s
patient's behavior them attention and advice to lessen satisfaction
and emotions. their suffering. Cooperate with the towards the health
patient's family to ensure that they system.
can apply the proper care and
medication.

Email: cn@usa.edu.ph | Tel. No.: 0999-997-1485 | Fax No.: (033) 337-4403