Nursing Teaching Plan: A Detailed Report

Question

Task: Provide a detailed nursing teaching plan on the theme of colostomy care and education.

Answer

The nursing teaching plan is based on the case scenario of a 16-year-old female patient who is suffering from abdominal injuries because of an accident. She underwent an emergency surgery which led to the condition of temporary colostomy. It was notified to her by the medical team that this condition may even end up in a permanent colostomy condition. The patient is suffering from a high medical condition level because of other injuries that happened through the accident. The patient is not giving much heed to colostomy's biological condition since she wants to divert her focus entirely on her studies (Hayes et al., 1994). However, herfamily is stressing on taking appropriate medical interventionsregarding colostomy for a certain period to avoid reversal. The nursing teaching plan would focus on making the patient (Sandra) and her family aware of the effective measures to be undertaken for the colostomy.

Diagnosis process in the nursing teaching plan
The colostomy of Sandra needs to be urgently addressed by the medical team as per the information provided in the medical report. Such patients should be provided with the appropriate phycologicaland emotional support, along with the required diet. The diagnosis measures to be taken in such conditions are: -

• Lessons regarding the self-care technique should be given in order to handle the situation
• Preparing the patients for handling the situation of colostomy.
• Mitigating the impact of the complications, if there exists any.
• Providing more awareness regarding the change in appliances to the family members by stressing more on the significance of emotional support (Dellasega et al., 1994).

Implementation
By making an opening in the intestine through the abdominal walls, the surgical procedure of colostomy is conducted on a patient.Though the task seems to be a very easy one, at first sight, there is a high risk of skin irritation, the formation of hernia, wound breaking, unexpected bleeding, lung infection, etc. Thus, Sandra's family members should be made aware of all the negative aspects of conducting the medical procedure. In the below section of this nursing teaching plan, we have discussed the basic self-care guidelines to be followed in the case of colostomy.
Basic teaching principle in the care of colostomy:

• It is the duty of the medical team to provide the patient with the appropriate information and awareness about the health services and risks involved in the colostomy so that the patient would not face many difficulties after the initial phase of the surgical recovery.
• A high focus should be given on hygiene, and the related appliances should be changed on a regular basis.There should be a regular inspection of the surgical opening, and the skin on its proximity should be kept clean. By making this precaution, the integrity of the skin in the stoma could be sustained (Wingard, 2005).
• There is a high chance that the stoma would make an odor, and hence the appropriate use of deodorants should be done to mitigate the foul smell.
• The accessory bags should not be used to its maximum and hence should be removed even when it becomes full about one-third.
• The bowel movement would get disrupted by the presence of a stoma. The balance of the whole body would get disrupted by the discrepancy in the level of biophysical elements. The body structure would get disrupted by the imbalance in the psychosocial elements. The medical team should encourage the patient affected with the colostomy by the appropriate emotional and verbal support.The approach would increase the efficiency of the treatment (Cui, 2018).
• The nurses working in the enterostomy should be contacted on an urgent basis if there occurs any sort of medical complications. The technical support of the enterostomy nurses is required both before and after the surgery. The stoma should be placed before the treatment of the patient. Further assistance is given by the authorities so that the clothing style would not disturb the output of stoma. The process could only be performed in a perfect manner by going through a prolonged experience. It is only by regular exposure to the situation that the related employees would better hold the situation (Tanneret al., 1986).

Guidelines on the fluid intake and the related teaching dietary:

• The occurrence of dehydration should be avoided by giving proper fluid to the patient.
• The occurrence of malnutrition inpatients should be avoided by providing them with vitamin supplements in a well-balanced manner (Villela et al., 2013).
• The food products that would lead to the occurrence of constipation and gas should be avoided strictly from the diet of the patient.

The best approaches to provide the patient with the required emotional and psychological support:

• The actual reason behind conducting the surgery or particular treatment should be explained to the patients. This approach would prepare the patient todeal with a chronic or temporary colostomy after the surgery(Kick, 1989).
• The medical team should approach the patient's closerelatives and encourage them to motivate and provide emotional support during the recovery phase.
• Proper coordination and communication should be established between the patients affected with the colostomy.It should be ensured that the patients remain mentally positive.
• The associated groups should be introduced to the patients so they could rely on peer support to get more information about the colostomy (Brandt, 2013).
• If the patient goes through extreme depression, he or she should be referred to counselling sessions.

Evaluation
From this nursing teaching plan, the family members and the patients themselves can assess the seriousness of the condition. The proposed nursing teaching plan could only be considered a successful one if the patients and their family members have changed their opinion regarding the treatment of colostomy. The medical team should analyze the parameter of self-care by taking into account patients' ability to operate the stoma appliances themselves. The medical team should study the patients' valuable feedback regarding the treatment todeterminewhether they are satisfied with the medical treatment. In this nursing teaching plan, a final report should bepresentedbefore the patients thatclearlyexplain the positive and negative aspects of the treatment.

References
Brandt, C. L. (2013). Study of Older Adults' Use of Self?Regulation for COPD Self?Management Informs An Evidence?Based Patient Teaching Plan.Nursing Teaching Plan, Rehabilitation Nursing, 38(1), 11-23.

Cui, C., Li, Y., Geng, D., Zhang, H., & Jin, C. (2018). The effectiveness of evidence-based nursing on the development of nursing students' critical thinking: A meta-analysis. Nurse education today, Nursing Teaching Plan, 65, 46-53.

Dellasega, C., Clark, D., McCreary, D., Helmuth, A., & Schan, P. (1994). Nursing Teaching Plan: teaching elderly clients. Journal of gerontological nursing, 20(1), 31-39.

Hayes, P. A., Wolf, Z. R., & McHugh, M. K. (1994). Effect of a teaching plan on a nursing staff's knowledge of pressure ulcer risk, assessment, and treatment. Nursing Teaching Plan, Journal of nursing staff development: JNSD, 10(4), 207-213.

Kick, E. (1989). Patient teaching for elders. The Nursing clinics of North America, Nursing Teaching Plan, 24(3), 681-686.

Tanner, C. A. (1986). The nursing care plan as a teaching method: reason or ritual?. Nursing Teaching Plan, Nurse educator, 11(4), 8-10.

Villela, J. C., Maftum, M. A., & Paes, M. R. (2013). The teaching of mental health in an undergraduate nursing course: a case study. Nursing Teaching Plan, Texto Contexto Enferm, 22(2), 397-406.

Wingard, R. (2005). Patient education and the nursing process: meeting the patient's needs.Nursing Teaching Plan, Nephrology Nursing Journal, 32(2), 211.