MSll Teaching Plan Lovenox PDF

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Summary

Patient Teaching Plan: Knowledge Deficit Related to Lovenox Self-Administration...

Description

Terra Community College Associate Degree Nursing Program TEACHING PLAN Student Name: Melissa Hope

NANDA (Problem) Related/To (Etiology) AEB (Signs/Symptoms; subjective/objective data) Patient Learning Outcomes/ Domain(s) of Learning 4. Cognitive:

Patient’s Initials: E.F.

b. Step-y-step procedure of injection

c. Side effects & possible adverse reactions

Date: 01/17/2021

NURSING DIAGNOSIS Deficit Knowledge Self- Administration of Anticoagulant (Lovenox)  Increased Risk of DVT; Thrombocytopenia  Impaired/Limited Mobility  Postoperative Status Teaching Strategies & Resources Discussion & Handout:

(K n o w l e d g e )

a. Reason for Lovenox injections & Order

Client’s Age: 89yrs.

a. What is Lovenox? What is it used to treat? How does it treat said condition?

b. Supplies, injection preparations, & steps of administration

c. Difference between common/normal expected side effects & adverse reactions that require medical attention

Criteria & Means for Evaluating a. Patient will verbalize what Lovenox is, why it was ordered, what it is used to treat, mode of action. b. Patient will state the supplies needed, how to prepare for injection, & how to correctly administer injection. c. Patient will list side effects and differentiate between normal side effects and adverse effects that require immediate medical attention.

Documentation & Evaluation -Patient was able to correctly name medication specifics, steps of administration, side effects and possible adverse reactions to monitor forFully Met

Partially Met

Barriers to Learning: Apprehension of drug therapy, irritability & agitation, mild cognitive deficits (confusion); mild inability to focus.

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2. Affective: (A t t i t u d e ) a. Allows discussion of personal, sensitive, & topics of interest or concern b. Acceptance & compliance

Discussion: One-on-One: a. Fear or anger regarding order for Lovenox, long-term effects, feelings of inability vs. competency surrounding self-administration, eagerness to learn, & proper of and handling of equipment/supplies. b. Discuss danger of noncompliance with prescribed anticoagulant therapy.

3. Psychomotor: (S k i l l s ) a. Nurse lead instruction b. Patient lead demonstration with nurse supervision c. Feedback &

a. Patient remains engaged with minimal distractions during discussion & expresses any fears or concerns, allows for reassurance from nurse by acknowledgement of comfortability in learned administration and disease process.

-Patient acknowledged and accepted need for compliance with anticoagulant therapy and stated that he felt good about his ability to effectively carry out prescribed orders and correct administration procedure.

b. Patient verbally acknowledges dangers of not complying with prescribed drug therapy and accepts responsibility for carrying out drug therapy as prescribed.

Barriers to Learning: Apprehension of drug therapy, initial emotional response of disease process, irritability & agitation, mild cognitive deficits (confusion); mild inability to focus with distractions of nurse coming into room.

Instruction & Return Demonstration: a. Patient verbalizes each step along with nurse a. Patient has better idea of procedure throughout the step-by-step after step-by-step explanation. explanation. b. Patient correctly performs return demonstration with verbalization of each step during procedure. c. Nurse provides positive feedback of

b. Patient correctly administers injections while verbalizing each step throughout return

Fully Met

Partially Met

-Patient correctly listed and carried out subcutaneous injection according to step-bystep instructions provided by nurse, and effectively adjusted technique when indicated by nurse-

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demonstrated strengths during patient self-administration & provided additional information and teaching, as needed, prior to DC.

demonstration.

Fully Met

c. Patient understands and acknowledges strengths and weaknesses pointed out by nurse and discusses any concerns.

Barriers to Learning: Vision impairment, physical limitations, ability to retain the large amount of information given in one setting, understanding of language & medical terminology.

Partially Met

4. ____________ (Optional)

Fully Met

Partially Met

Barriers to Learning:

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Terra Community College Associate Degree Nursing Program

References: https://www.coursehero.com/u/file/32723565/teaching-plan-2-Lovenoxdocx/#question https://www.mghpcs.org/eed_portal/Documents/AMS/MGHAMSSelfinjectionsInstructions_en.pdf https://www.rn.com/nursing-news/teaching-patients-about-enoxaparin-lovenox/ https://www.drugs.com/sfx/lovenox-side-effects.html.

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Terra Community College Associate Degree Nursing Program Content for Teaching Plan Client Learning Objectives

1. Cognitive Domain: a. Explains in own words reason for Lovenox injections. b. Comprehends step-by-step procedure of safely administering injection. c. Acknowledges and states differences between common side effects and adverse reactions that require immediate medical attention.

Outline of Teaching Plan Discussion: One-on-One & Informational Handouts: a. What is Lovenox?

- Lovenox is a blood thinner used to prevent or treat blood clots; is also referred to as an anticoagulant (“anti”  against & “coagulant”  blood clotting) and helps reduce clot formation in the blood. b. Administration of Lovenox - Lovenox is administered only by injection (subcutaneous) and is best absorbed in the abdominal region. If prescribed daily, it is important to administer injection at the same time each day. Lovenox should never be injected into the muscle, as bleeding in the muscle tissue may occur. - Anticoagulant Therapy: Patient & Family Instructions: 1. Supplies:  Pre-filled syringes of prescribed medication  Alcohol pads  Biohazard sharps container 2.Preparing to Give the Shot:  Wash hands  hand hygiene  Sit/lie in comfortable position so that you have easy access to site of injection.  Select site of injection  subcutaneous (under the skin) in fatty tissue of abdominal region.  Do not inject dose into the same site each time  alternate between 4 quadrants of abdomen and keep injection at least 2 inches away from navel. 3.Administering the Injection:  Wipe injection site with alcohol pad and allow to dry.  While injection site is drying, remove needle shield from syringe.  Syringe is pre-filled and ready to go  do not remove air bubble inside the syringe.  Do not press plunger before injecting.  Gently pull up a “fold of skin” at injection site to hold fat tissue away from abdominal

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Terra Community College Associate Degree Nursing Program           

muscle. Hold syringe like a pencil. Insert needle at an angle of 45-90 degrees. Be sure to hold “skin fold” away from abdominal muscle throughout injection. Quickly push the needle into the prepped injection site of choice Be sure needle is all the way inserted. Push in plunger at a steady rate  all the way down to ensure injecting full amount. Pull needle straight out quickly. Hold clean alcohol pad over injection site  do not rub area. Turn needle away from you & others  activate safety mechanism by firmly pushing plunger rod down. Safely dispose of syringe  sharps container provided. Record dose, site, and time of injection on sheet provided.

c. Side Effects & Adverse Reactions: 1. Side Effects:  Bruising, itching, bleeding around injection site, swelling in hands & feet, nausea, diarrhea  If bleeding occurs, it may take a little longer than normal to stop  minor pain & bruising is common.  Take special care when brushing teeth, flossing, and shaving. 2.Adverse Reactions:  Notify HCP: Unusual bleeding in nose, vagina, rectum  bleeding that will not stop; bruising that occurs easier than normal, red, or purple pinpoint spots under the skin, pale skin, feeling of lightheadedness or shortness of breath, tachycardia, trouble concentrating, black or bloody stools, coughing up blood or vomit that looks coffee grounds, sudden weakness, severe headache, confusion, slurred speech, blurred vision, or impairment in balance.  Seek Immediate Medical Attention: Symptoms of spinal blood clot (back pain, numbness, muscle weakness in lower extremities, loss of bladder/bowel control).

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Terra Community College Associate Degree Nursing Program 2. Affective Domain: a. Allows discussion of personal, sensitive, & topics of interest or concern pertaining to disease process and treatment thereof b. Patient listens to nurse with respect. c. Patient accepts responsibility for drug therapy compliance

Discussion: One-on-One: a. Allows Expression of Values, Feelings, & Attitudes:  Fear/anger: Regarding injury or disease process, anticoagulant therapy orders, & longterm effects  Feelings of inability vs. competency: regarding self-administration of Lovenox injections  Eagerness/willingness to learn, proper use & handling. b. Patient Listens to Nurse with Respect:  Patient remains engaged throughout teaching session with few distractions.  Patient saves questions and/or concerns for end of instruction and/or demonstration. c. Patient Accepts Responsibility for Therapy Compliance:  Patient understands danger of not complying with prescribed orders regarding administration of Lovenox (dosage, route, time of day, & proper injection techniques)  potential for thrombus increases  life threatening.

Client Learning Objectives

Outline of Teaching Plan

3. Psychomotor Domain:

Instructions & Return Demonstration:

a. Nurse provides presentation and/or demonstration of skill.

a. Instruction/Demonstration of Skill by Nurse:  Follow step-by-step instructions provided.

b. Nurse able to control questions during teaching session.

b. Nurse Able to Control Questions Throughout Teaching Session:  Patient saves questions and/or concerns for post instruction Q&A time  Patient does not interfere with instruction and/or demonstration.

c. Patient permitted to perform skill as nurse observes.

c. Patient Permitted to Perform Skill as Nurse Observes:  Patient will verbalize each step while demonstrating the correct step-by-step procedure

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Terra Community College Associate Degree Nursing Program d. Nurse assists patient in knowledge application. e. Nurse provides feedback & reinforcement.

(patient teach-back). d. Assist Patient in Applying Knowledge:  Nurse will stand by and observe allowing patient to apply knowledge gained during teaching session only interfering when necessary. e. Feedback & Reinforcement:  Nurse will acknowledge patient’s strengths demonstrating procedure.  Nurse will provide additional information and teaching to patient as needed.

4.

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Terra Community College Associate Degree Nursing Program

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