Implementations of Nursing Interventions

Client Name: DW

Age: 43 years

Client Perception of Health Needs: The client experiences headaches, vision changes, anxiety, fatigue, and irregular heart rhythms and perceives herself unable to manage these symptoms, requiring professional help. The client needs more help with disease management to function properly at work and in other activities.  

Client Goals for Health: Maintain a healthy weight, adopt a healthy diet, increase physical activity, and maintain optimal blood pressure.(Implementations of Nursing Interventions Teaching Plan Essay)

Assessment of metaparadigm concepts.

Summarize general assessment findings in four boxes below.

Client

The client, D.W., is a 43-year-old female in middle adulthood. The patient is Caucasian and speaks English.

Health

The client is experiencing headaches, vision changes, anxiety, fatigue, and irregular heart rhythms. She is constantly worried about when the symptoms will appear next, which increases her anxiety. In addition, the patient feels like she cannot function correctly because her blood pressure can rise at any time, and she might not be able to manage her condition in the long term.(Implementations of Nursing Interventions Teaching Plan Essay)

The patient has a medical history of obesity and generalized anxiety disorder, which she has been treated with. However, her blood pressure has been irregular lately, constantly rising at unpredictable times and situations, including during normal home and work activities, causing her anxiety to rise.(Implementations of Nursing Interventions Teaching Plan Essay)

She is under enalapril, ramipril, Diovan, and Benicar, which have helped her manage symptoms but seem ineffective of late.

Environment

The client lives with her family in Washington, D.C. She is a mother of two and married.

The husband is the family’s primary provider, but the client also contributes financially, although her job is not well-paying as her husband’s. The family is a middle-income family living in a gated community.

The family is the primary support system for the client.

Nursing

The client has been diagnosed with obesity and generalized anxiety disorder before; therefore, therapy and nursing knowledge, communication, interventions, and interactions aid recovery and promote quality of life.(Implementations of Nursing Interventions Teaching Plan Essay)

The client is seeking nursing intervention to help manage her blood pressure, which has constantly fluctuated in the last month.(Implementations of Nursing Interventions Teaching Plan Essay)

The client is willing to learn how to improve disease management and live a quality life.

Learning Needs:

The client needs to learn to manage her condition without depending primarily on medications. Despite job and family responsibilities, the client should put extra effort into adopting healthier lifestyle behaviors, including a healthy diet, exercising regularly, reducing stress levels, monitoring blood pressure at home, and maintaining a healthy weight.   

Factors affecting the learning process/Barriers to learning:

·         The client is busy with work and family duties, leaving her with almost no time to engage in patient education.

·         Hypertension is a complex condition that might seem difficult for the client to understand and enhance her knowledge of disease management.(Implementations of Nursing Interventions Teaching Plan Essay)

·         Multiple competing demands and priorities make learning almost an inconvenience.

·         Schedule mismatch, where the client is free mostly in the evenings, but the healthcare provider is unavailable at the time.

·         Her constant stress, worry, and anxiety can make learning difficult.

These factors will affect the learning process because getting the client to engage in a learning activity when needed seems impossible. The provider has to adapt to the client’s schedule, which might be difficult.(Implementations of Nursing Interventions Teaching Plan Essay)

The family members, especially the husband and the first-born daughter, will be involved in the learning process.  

Nursing Diagnosis: (Identify the learning need)

The client has decreased activity tolerance related to generalized weakness, an imbalance between oxygen supply and demand, and a sedentary lifestyle, as evidenced by a verbal statement or report of fatigue, irregular heart rate, blood pressure response to activity, and exertional discomfort or headaches.(Implementations of Nursing Interventions Teaching Plan Essay)

Planning 

Client Learning Goals and Objectives: The client stated she wants to manage her blood pressure effectively, reduce her anxiety, and be able to complete needed activities and duties at work and home without too much worry, contributing to the following clinical goals:

BROAD GOAL: The client will engage in desired and necessary activities and adopt techniques to improve activity tolerance.

SPECIFIC OUTCOMES-

Cognitive – The client will be able to learn and apply techniques that improve activity tolerance and display reduced anxiety associated with activity participation.(Implementations of Nursing Interventions Teaching Plan Essay)

Psychomotor – The client will be able to demonstrate desired or necessary activity participation and completion without reporting fatigue or weakness, or BP response to the activity. 

(Implementations of Nursing Interventions Teaching Plan Essay)

Implementation of Teaching Plan

Equipment and Resources required:

To help the client improve disease management, the following are required:

1.      Reminders.

2.      Day planners, agendas, and calendars for physical activity engagement and when to take meals.

3.      Self-measured blood pressure monitoring action guide.

4.      Hypertension clinical practice guidelines for preventing, detecting, evaluating, and managing high blood pressure

5.      Guide to community preventive services to identify community-based interventions that can be suitable or helpful to the client.

6.      Upper-arm monitors for monitoring BP at home.

7.      Self-reported surveys for behavior change.

Timing and Environment Considerations:

The client requires an environment with the following:

1.      Limited distractions

2.      Positive reinforcements

3.      Natural consequences

4.      Enough time to engage in specified activities

Individuals involved/required:

The teaching process will require the involvement of the following:

1.      Family members, including husband and two daughters.

2.      The client’s therapist

3.      Any other trusted family member or friend.

Interventions

Teaching Strategies: Pick at least 2. 

·         Appropriate and desired behavior will be communicated through demonstrations and presentations.

·         The client will engage in role-playing, supported by AV materials.

·         Learning goals, progress, and updates will be communicated and elaborated to the patient and involved parties through in-person meetings and discussions.

Rationale: include a rationale for each strategy selected

·         Demonstrations are a great way to communicate with patients because they are more engaging, focus on the visual elements of processing information, and encourage client participation (Hranchuk et al., 2018).(Implementations of Nursing Interventions Teaching Plan Essay)

·         Role-playing helps the client learn in a real-world situation, motivates, and engages the client. Moreover, it is experiential and requires no special equipment or environments (Dorri et al., 2019).(Implementations of Nursing Interventions Teaching Plan Essay)

·         Discussions with the client and involved parties will be used for brainstorming additional interventions and helping them process information instead of just receiving it (Ying, 2020). It will involve more practical thinking to help the client improve her activity tolerance and manage the disease more effectively.  

Evaluation

Achievement of Learning Objectives:

The primary goal is improved activity tolerance, which will be indicated by the following;

1.      Ability to engage in desired or necessary activities

2.      Ability to use techniques and approaches to improve activity tolerance.

3.      Reporting a measurable activity tolerance increase.

4.      Demonstrating reduced physiological and psychological signs of intolerance, including BP changes and irregularities and increased anxiety.

These achievements will be used to assess whether the learning outcome was met.

Further Nursing Actions:

The nurse will continue to monitor BP changes during weekly follow-ups until the patient achieves optimal blood pressure and learns to manage the disease.

Reflection

The teaching plan is objective and simple to understand. The goals are achievable, measurable, and borrowed from the client’s perspectives and learning needs to ensure a client-centered learning process and strategies tailored to the patient’s needs. The strategies selected are straightforward, and parties involved in the teaching and learning process need no special training or elaboration to understand them or what is required of them. The equipment and resources needed to facilitate the learning process are affordable, readily available, and do not require special maintenance to make it easier for the client and family members to utilize. Learning resources like self-reported measures and community guidelines are available online on the CDC website, hence easily accessible. However, if further assessment indicates increased severity of hypertension symptoms, this teaching plan will be simplistic and require adjustment to ensure effectiveness. This case is a unique learning experience, and I will build on it for future practice. It offers insights into the daily challenges of high blood pressure patients and how managing the disease is challenging and exhausting. It also shows the lack of sufficient knowledge of disease management strategies; many people rely primarily on medication.(Implementations of Nursing Interventions Teaching Plan Essay)