The nurse is going to be working with a client who has a ...

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The nurse is going to be working with a client who has a permanent colostomy and is ready to go home within the next several days. When organizing the teaching/learning experience, the nurse should
 
  1. start from the beginning and proceed through all material.
  2. break up sessions into shortened time periods.
  3. discover what the learner knows before proceeding with further teaching.
  4. make sure the client's spouse is present before the teaching session begins.

Question 2

A client needs discharge teaching regarding the use of a walker before going home. The client's room is small and adjacent to a soda machine and small lounge area. In planning a teaching session, which is the best thing the nurse can do?
 
  1. Wait until just prior to discharge, then do the teaching in the hospital lobby.
  2. Close the door to the client's room and make sure there is no clutter on the floor before the teaching session begins.
  3. Take the client to a larger area (treatment room, for example) for teaching, then evaluate on the way back to the client's room.
  4. Make sure a physical therapist is available to do the teaching and can see the client before discharge.

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Answer to Question 1

Correct Answer: 3
Rationale 1: Going over information already taught and learned isn't practicing good time management for the nurse or the client.
Rationale 2: Unless the client has attention problems or may be elderly, breaking up the sessions may not be necessary.
Rationale 3: Nurses should save time in constructing their own teaching sessions and should follow basic guidelines when sequencing the learning experience. The nurse should find out what the learner knows, and then proceed to the unknown. This gives the learner confidence. This information can be elicited either by asking questions or by having the client take a pretest or fill out a form.
Rationale 4: Having the spouse present is always a good idea, but may not be possible all the time.

Answer to Question 2

Correct Answer: 3
Rationale 1: Noise or interruptions can interfere with concentration, whereas a comfortable environment can promote learning. The hospital lobby does not provide privacy and can be noisy. There also would be little time to reinforce any teaching needs that might be necessary.
Rationale 2: Noise or interruptions can interfere with concentration, whereas a comfortable environment can promote learning.
Rationale 3: Going to a larger area and then evaluating the learning by watching the client ambulate back to the room would be the best way to implement teaching in this particular situation.
Rationale 4: Not all hospitals have a physical therapist available to help implement teaching for clients.