Teaching Plan for: E G

Assessment
-female, 65-year-old

Current state of health

-admitted with hyperglycemia
-complained of frontal headache
-complained of occasional swelling in feet
-does not follow her diabetic diet or her exercise programs
-does not take medications regularly

Past Medical History

-diagnosed with DM type 2 x 4 years
-3 hospitalizations in the past
-last hospital admission was 2 years ago
-history of hypertension

Family Background
-main support from daughter, other family only visits when able
-enjoys looking after her grandchildren
-family is not actively involved in managing her health condition

Psychosocial Background
-widowed x 5 years with 5 children

Current Medications
-Altace 10 mg po BID
-Metformin 10 mg po BID
-Tylenol prn for pain

Review of systems
1.Integumentary- dry skin
2. EENT- normal, no concern
3. Respiratory- normal chest sound
4. Cardiovascular- BP on the higher side between 148/94-168/98, history of hypertension
5. GI- no concern
6. GUR- frequent urination
7. Musculoskeletal- occasional swelling in feet
8. Neurological- alert and oriented, no cognitive deficits
- complained of frontal headache, did not sleep well last night, anxious
about going home
9. Endocrine- excessive hunger, high sugar levels, history of DM
10. Immunological- exposed to TB and tested negative 5 years ago
 -vaccination not up to date, last immunization was influenza a year ago
-no known allergies

Needs

1. "I'm here to get my blood sugars sorted out".

-Deficient knowledge regarding disease process, treatment and individual care needs related to
unfamiliarity with information.

2. Blood sugars ranging from 2.0-18

-Risk for unstable blood glucose related to lack of adherence to diabetes management
evidenced by below or above normal levels.

3. "I don't pay attention to my diabetes, I'm too busy".

-Deficient knowledge related to lack of interest in learning regarding plan and management of
diabetes.

4. No financial access to purchase necessary materials for her diabetes control and
management, hence non-compliance.
-Ineffective health maintenance related to support deficits.

Outcomes

1. EG and her family will be able to participate in the learning process and work together to
meet her needs.
2. EG will be able to verbalize understanding of her diabetes and its management.
3. EG will be able to name the barriers to her non-compliance of her diabetic regimen.
4. EG will demonstrate how to take her blood sugar from a device and interpret the result.
5. EG will be able to identify signs and symptoms of hypo and hyperglycemia and the
necessary actions to be taken when these happens.
6. EG will initiate necessary lifestyle changes by modifying her diet, taking her medications
regularly and going to exercise programs and the need to comply them at home.
7. EG will be able to develop a daily menu that meet his diabetic needs.
8. EG will be able to find diabetes support group in her community to get tips for living with
diabetes.
9. EG will be able to manage her condition at home.

Implementation

Content
1. Assess client's readiness to learn by allowing her to express feelings and concerns about the
learning process.
2. Identify support system requiring education about the disease process and its management
to facilitate understanding on the family's part about the client's condition.
3. Determine client's learning preference and objectives in his own term.
4. Identify factors that interfered with client's non-compliance to her diabetes treatment in the
past.
5. Teach EG on how to use the glucometer in checking her blood sugar and interpret the
results. 6. Encourage Edna and family to demonstrate the proper use of glucometer.
7. Educate EG on how often she should be monitoring her sugar levels as well as telling her
what is low, normal and high.
8. Consult with dietician to educate EG and family on her diet.
9. Inquire resources in EG’s community that aids low income families which could help the
cost of her diabetic needs (food, medication, glucometer).
10. Schedule visit by a home care nurse to ensure adequate follow through of instructions
particularly her diet.

Materials and Resources

1. dietician for meal planning
2 support system (family)
3. charitable institutions for chronic disease management (financial aid)
4. home care nurse for follow up visit at home following discharge
5. pamphlets and journals about diabetes
6. diabetes counsellor for follow up counselling with client and family
7. community groups advocating for clients with diabetes

Teaching Strategies
1. audio-visual presentation
2. one-to-one (question and answer)
3. demonstration (teach how to use a glucometer)
4. return demonstration (client will demonstrate)
5. group discussions (with the involvement of family)
6. reading (pamphlets, article, journals about diabetes)

Evaluation

When EG was admitted, she was adamant about not managing her diabetes. But after few days
of education, counselling, gentle persuasion, she agreed to participate and follow her treatment
plan. She was able to meet learning outcomes 1-9. She expressed regret about her non-
compliance with her diabetes treatment in the past. She said that being a retired homemaker
who depends mainly on government assistance, money was not enough to cover the cost of her
maintenance. Now that she has been provided with all the necessary information regarding
diabetes and its complications when left unmanaged, she hopes to comply with the regimen
most especially her diet. And now that her family knows about her condition, they are
supportive of her. They are working together to assist her in meeting her diabetic needs. In
addition, there is a community group close to the reserve where she can meet up with clients
who have diabetes. They hold a gathering every weekend and EG already expressed
excitement in meeting them. EG is going home today and learning outcome 10 is yet to be
evaluated at home. A home care nurse is scheduled to visit her at home to ensure that she's
adequately following through all instructions.