Discharge Teaching Plan Case Study
Week 2: Sherman “Red” Yoder
This case study provides information you will need to know to complete the Discharge Teaching Plan Assignment. Please see the guidelines in Doc Sharing for more details and grading rubrics for this assignment. After you read the case study, obtain the Discharge Teaching Plan form from Doc Sharing and document your teaching plan for Mr. Yoder.
Continuing our story of Mr. Red Yoder, our elderly diabetic patient:
Two weeks later, Red misses his Monday morning coffee at the local VFW. He has also missed church for the past four Sundays. He usually has a few whiskey sours a day and needs to take something for sleep (Benadryl). Jon (Red’s son) gets “irritated with me over my beer and whiskey habits and yells pretty loud” at times. His friends “worry about him.” “I know it’s only 20 miles to the VFW, but I just haven’t felt like eating the last couple of days; maybe I’ve got the flu that’s going around.”
Red does not like to cook and usually picks up whatever is convenient, such as cake and donuts and some fast food. He also loves bacon! The home health nurse wanted to make sure he didn’t get an infection in that toe and now she is back to change the bandage. Red relates to the home health nurse “I’m not sure if I should take my insulin because I’m not eating, but my blood sugar was 203 when I poked my finger this morning. How can my sugar be that high when I’m not eating much? I just took off my sock to check on my sore and my whole foot is red and big. I haven’t looked at it for a few days; it was just a little pink the last time I checked it. I should have paid closer attention to those pills I was supposed to take, that antibiotic. “
Red requires admission to the hospital for sepsis of the wound.
Today’s Date: [assume it is today]
Brief Description of Client:
Name: Sherman “Red” Yoder
Gender: Male Age: 80 Race: Caucasian
Weight: 109 kg (240 pounds)
Height: 183cm (72 inches)
Major Support: Jon (son) Phone: 869-555-3452
Allergies: no known allergies
Immunizations: Influenza last fall; tetanus 4 years ago
Attending Physician/Team: Dr. Frank Baker
Past Medical History: Diabetes Type 2 diagnosed June 2 (last year).
History of Present illness:
Patient developed an ulcer on his big toe that was treated at home for 2 weeks. Son brought patient to ER 6 days ago and patient was treated for sepsis with IV antibiotics.
Widower; son (Jon) lives nearby
Primary Medical Diagnosis:
Surgeries/Procedures & Dates:
L4-5 laminectomy – 25 years ago;
Transurethral resection of the prostate – 6 years ago
· Impaired Walking;
· Impaired Skin Integrity;
· Ineffective Health Maintenance;
· Ineffective Self Health Management
One week later, Red is being discharged home with home health for wound care. Please prepare a discharge teaching plan for Mr. Yoder and his care takers.
Purpose: The focus of this assignment is identifying patient’s needs and analysis and synthesis of details within the written client record and planning an appropriate discharge plan with necessary patient teaching of the disease process.
Points: This assignment is worth a total of 100 points.
Directions: Please refer to the Discharge Teaching Plan Guidelines found in Doc Sharing for details about how to complete this form. Remember there is a 6 page maximum limit on this assignment.
Type your answers on this form. Click “Save as” and save the file with the assignment name and your last name, e.g., “NR305_Discharge_Teaching_ Plan_Form_Smith” When you are finished, submit the form to the Teaching Plan Dropbox by the deadline indicated in your guidelines. Post questions in the Q & A Forum or contact your instructor if you have questions about this assignment.
Look at the EXAMPLE in the first assessment area. This is NOT an all-inclusive response and you will need to add your responses as well. Please be sure to review your guidelines.
|Assessment area||Need(s) identified.||Teaching technique or approach to problem identified.
|Rationale for choosing this technique/approach.|
Special/ age related needs
|These are some ideas, there may be others that you identify.
· Age, lives alone, is non-compliant with diet.
· Expected aging changes such as decreased hearing, visual difficulties.
· Red appears to not understand his glucose numbers and how that relates to his diet and insulin administration.
· Home health nurse to assist Red and family in proper insulin management and administration
|Ideas for teaching methods/approach based on the scenario and problems noted. You may have identified others.
· Teach importance of diet and insulin management to Red and family and how to better manage his diabetes.
· Use videos, audio and teach back methods. It may even be helpful to assure proper reading of the glucometer and administration of the insulin by Red or his family.
|Provide a brief rationale on why you chose these particular technique/approaches.
For example, Red may have poor eyesight due to the diabetes and needs audio and demonstration with return demonstration. He may not be able to see the lines on the insulin syringe.
|Roles and Relationships|
|Resources/ referrals needed|