Patient education is a very important role for the registered nurse in the health care setting. It is even more significant because ill patients are leaving the hospital early due to shorter hospital stays. Patients need adequate information in order to care for themselves when they get home. In renal failure, there is a sudden loss in kidney function, leading to muscle weakness, seizures, and accumulation of nitrogenous waste in the body, among other things. The goal of teaching patients about renal failure is to help them achieve an optimal level of health.
Interview your patient. Ask him what he knows about renal failure. During your interview, assess his learning needs. Know what barriers he has to learning, such as language barriers, and what would facilitate his learning process. Ask him if he has any cultural or spiritual beliefs about health. Ask your patient if he wants his family to be involved in his care. Determine if he is interested in learning by observing his body language, attention span and responses. Is he asking questions and concentrating on what you are saying? It's important for your client to be interested in learning about renal failure; if he is not, any information you give him won't matter because he won't retain it. Honor his wishes about including or not including his family in his care.
Organize and analyze the information you gathered from the interview. Formulate a nursing diagnosis related to teaching your patient about renal failure. The nursing diagnosis would be: "knowledge deficit of disease process related to lack of information." Next, identify what the objectives of your teaching plan will be. For your nursing diagnosis, the appropriate objectives would be: 1) Your patient will be able to explain what renal failure is; 2) Your patient will be able to explain possible causes of renal failure; 3) Your patient will be able to explain diet and fluid restrictions for renal failure; 4) Your patient will be able to state the names of some drugs that are toxic to the kidneys and that he needs to avoid them; 5) Your patient will be able to monitor his pulse, blood pressure, weight and urine output; 6) Your patient will explain what symptoms he must report to his health care provider; 7) Your patient will state lifestyle changes he needs to make; 8) Your patient will state the importance of keeping his health care appointments.
Develop content for your teaching session based on the objectives you want to achieve. Content for your teaching session should include the definition of renal failure, diet changes that need to be made, information about what medications to avoid and how to take all prescribed medications, self-monitoring techniques and how to recognize changes that are not normal, necessary lifestyle changes, the importance of keeping doctor's appointments, and signs of renal failure complications.
Include content that addresses symptoms your client must report to his health care provider immediately. The final part of your content should be evaluating how much your client has learned from you. Evaluation methods include asking him to demonstrate techniques you showed him and asking questions about the content you taught him.
Teaching and Time Allotment
Decide on how much time you need to teach your patient, your teaching methods, and what teaching materials you will need for your session, such as videos, pamphlets, audio tapes, a list of foods to avoid, a list of medications to avoid, a list of foods that he can eat, pictures, and booklets.
Gather all of your materials and meet with your patient in a quiet area that is conducive to learning. Discuss the content of your teaching plan with him, and teach him with his consent. Demonstrate pulse taking, blood pressure, weight measurement, and urine output measurement. Then have him choose literature from your teaching materials, but make sure that this is material that will be helpful to him.
Evaluate the outcome of the teaching and learning process to see if your patient met the objectives you planned. Use the evaluation methods you included in your teaching content. Ask him to demonstrate the techniques you showed him. Ask him questions about the content that you taught him and ask him to state some specific things you taught him, like diet restrictions, medications to avoid, and symptoms that he needs to report to his health care provider. Ask him why he needs to keep his follow up appointments and if he will. If he still does not understand the material you taught him after evaluation, consider how you can change your teaching plan to promote better understanding.
Write down what transpired during your teaching session and your patient's response to the teaching session in his medical records. Include teaching methods that helped your client learn best and techniques that helped you keep his attention. Your documentation gives other health care providers who are involved in your patient's care an idea of what he knows about renal failure, the best methods for teaching him, and what he still needs to be taught.
- Fundamentals of Nursing; Patricia A. Potter, Ph.D. and Anne Griffin Perry, Ed.D. ; 2009
- Lippincott Manual of Nursing Practice; Sandra M. Nettina ANP-BC; 2009