Nursing Chapter 27 Homework Individuals With The Lowest Health Literacy Skills

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Concepts for Lecture

1. Teaching the client is a major aspect of nursing practice and an

important independent nursing function.

The American Hospital Association’s Patient’s Bill of Rights

mandates client education as a right of all clients.

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Compare and contrast andragogy, pedagogy, and geragogy.

Concepts for Lecture

1. Andragogy is the art and science of teaching adults. The following

concepts relate to teaching adults: As people mature, they move

2. Pedagogy is the discipline concerned with helping children learn.

Parents can be taught the teaching loop: (a) alerting—get the child’s

3.

Geragogy is the term used to describe the process involved in stimulating

and helping older adults to learn. The following concepts relate to teach-

ing older adults: The material must be practical and have meaning for

them individually, especially if the information is new to them. Health

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TEACHING

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Standards of Practice to determine the im-

portance of the teaching role of the nurse as

represented in these documents.

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Give the students a teaching topic—for exam-

ple, teaching the food pyramid. Divide the

students into groups and assign them an age

group. Have the students discuss how to

present this topic to this age group. Have the

groups share with the class and compare and

contrast strategies.

in the clinical agency.

154 CHAPTER 27 / Teaching

promotion is a priority. Set achievable goals with the client and family.

If developing new written materials, use large print and buff-colored pa-

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Describe the three learning domains.

Concepts for Lecture

2. The cognitive domain, the “thinking” domain, includes six intellec-

3. The affective domain, known as the “feeling” domain, is divided into

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Discuss the learning theories of behaviorism, cognitivism, and humanism and

how nurses can use each of these theories.

Concepts for Learning

1. Thorndike, Pavlov, Skinner, and Bandura are major behaviorism

theorists. Thorndike’s contribution is that learning should be based

on the learner’s behavior. An act is called a response when it can be

traced to the effects of a stimulus. Behaviorists closely observe

responses and then manipulate the environment to bring about the

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Provide the students with a list of learning

topics. Have them classify these topics accord-

ing to the domains of learning.

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Discuss the importance of knowing the ra-

tionale for performing psychomotor skills in

• Have the students provide examples of teach-

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Have the students provide additional examples

of when each of these theories can be

appropriately used in teaching clients or other

health care providers.

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• Discuss use of the various theories of learning as

applied in the clinical setting.

2. Cognitivism depicts learning as a complex cognitive activity in

which learning is largely a mental or intellectual or thinking process.

The learner structures and processes information. Perceptions are

selectively chosen by the individual, and personal characteristics

have an impact on how a cue is perceived.

3. Humanistic learning theory focuses on both cognitive and affective

qualities of the learner. Learning is believed to be self–motivated,

self-initiated, and self–evaluated. Each individual is viewed as a

unique composite of biologic, psychological, social, cultural, and

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Identify factors that affect learning.

Concepts for Lecture

1. Factors that can facilitate or hinder learning include motivation,

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Discuss the implications of using the Internet as a source of health infor-

mation.

Concepts for Lecture

2. Certain groups of users are more likely to search the Internet for

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• Have the students provide examples of how

the nurse can manipulate the factors that affect

learning in order to assist the client to learn.

promote learning, if possible.

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• Present the students with a framework for

evaluating a health-related Internet site. Have

them use this framework to evaluate a health–

related Internet site of their choice.

ical conference.

3. Twenty-two percent of American adults have never used the

Internet. This group’s members are those with a high school educa-

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Assess learning needs of learners and the learning environment.

Concepts for Lecture

1. A comprehensive assessment of learning needs incorporates data

from the nursing history and physical assessment and addresses the

2. Several elements in the nursing history provide clues to learning

needs, including age, the client’s understanding and perceptions of

3.

The general survey part of the physical examination provides useful

clues to the client’s learning needs, such as mental status, energy level,

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Discuss the implications of low health literacy skills.

Concepts for Lecture

1. Individuals with the lowest health literacy skills often have the fol-

lowing characteristics: 65 years or older; male; black or Hispanic;

2.

Low health literacy skills are associated with poor health outcomes and

higher health care costs. This places the client at a greater risk of

preventable adverse events. Clients with low literacy skills have less

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• Discuss methods to use to assess an individual’s

health literacy skills.

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Have the students identify methods to assess

an individual’s learning style.

CHAPTER 27 / Teaching 157

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Identify nursing diagnoses, outcomes, and interventions that reflect the

learning needs of clients.

Concepts for Lecture

1. Nursing diagnoses for clients with learning needs can be designated

in two ways: as the client’s primary concern or problem, or as the

etiology of a nursing diagnosis.

Another nursing diagnostic label where a learning need may be

the primary concern is Health–Seeking Behavior: active seeking by

an individual in stable health of ways to alter personal health habits

and/or the environment in order to move toward a higher level of

health. The client may or may not have an altered response of dys-

2. One example of deficient knowledge as the etiology is Risk for

Infection related to deficient knowledge (sexually transmitted

3. Learning outcomes can be considered the same as desired outcomes

for other nursing diagnoses. State the client’s behavior or perfor-

mance, not the nurse’s behavior. Reflect an observable, measurable

4.

Interventions include choosing the content, which is determined by the

learning outcome; selecting teaching strategies, which should be suited

to the individual and to the material to be learned (see Table 27–3); and

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Present the students with a case study in

which the defining characteristics of one or

several of the nursing diagnoses related to

knowledge are present. Have the students di-

agnose the problem and provide rationales for

their diagnoses.

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158 CHAPTER 27 / Teaching

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Describe the essential aspects of a teaching plan.

Concepts for Lecture

come 9), content outline, and teaching and evaluation methods.

2. Content is determined by learning outcomes. Nurses can select

3. Teaching strategies should be suited to the individual and to the ma-

terial to be learned. Teaching strategies and methods include expla-

nation or description (lecture), one–to-one discussion, answering

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Discuss guidelines for effective teaching.

Concepts for Lecture

1. When a client is ready to change a health behavior and when imple-

menting a teaching plan, the nurse may find the following guidelines

helpful:

• Rapport between teacher and learner is essential.

• Using a layperson’s vocabulary enhances communication.

• The pace of each teaching session also affects learning.

• An environment can detract from or assist in learning.

• Teaching aids can foster learning and help focus a learner’s atten-

tion.

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• Have each student develop a teaching plan for

a health promotion topic for freshmen college

students using the components listed in the

textbook.

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Have the students develop and implement a

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• Invite a panel of nurses from various types of

clinical agencies to discuss how they incorpo-

rate the guidelines for effective teaching with

the clients in their agencies.

• Discuss the importance of providing effective

teaching within the context of early discharge

from the acute care setting.

ing and ineffective teaching in this situation.

Ask them to suggest ways to improve the

teaching, if appropriate.

CHAPTER 27 / Teaching 159

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Discuss strategies to use when teaching clients of different cultures.

Concepts for Lecture

1. Nurses should consider the following guidelines when teaching

clients from various ethnic backgrounds:

• Obtain teaching materials, pamphlets, and instructions in the lan-

guage used by the client.

• If understanding another’s pronunciation is a problem, validate

brief information in writing.

• Use humor very cautiously, and do not use slang words or collo-

quialisms.

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Identify methods to evaluate learning.

Concepts for Lecture

1. The evaluation method is determined by measuring against the

predetermined learning outcomes. The best method for evaluating

depends on the type of learning. In cognitive learning, the client

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• Invite nurses with various cultural

backgrounds to discuss the implications of

their cultures for client teaching.

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• Provide the students with several examples of

learning goals/outcomes and related interven-

tions. Ask them to identify appropriate

methods of evaluation.

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ed in the clinical agency. Compare to the

160 CHAPTER 27 / Teaching

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Demonstrate effective documentation of teaching–learning activities.

Concepts for Lecture

1. Documentation of the teaching process is essential because it

provides a legal record that the teaching took place and communi-

cates the teaching to other health professionals. If teaching is not

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• Obtain examples from various institutions of

chart forms used to document teaching, and

share these with the class.

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