teaching project

Health Medical

Waldorf University

Question Description

write minimum 700 words based on the instructions

No plagiarism!

I have teaching paper with brochure about about (16 year old female with colostomy due to motor vehicle accident) should be done both and it has follow the instructions and the rubric

just follow the instruction and answer to each question there and follow the rubric... also you have to make brochure. in addition you have to follow NANDA for nursing diagnose which is you have to say knowledge deficit related to ..... therefore they need teaching. also you have to include the patient understanding. you can find everything in the attached files.

in the beginning write or talk about the patient if u want I can send u tomorrow an example of teaching paper from my previous classes

attached there is also an example paper but sure it is different topic, the patient wasn't given in the assigment so you have to do

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Running Head: NUTRITIONAL EDUCATION 1 Educating a mother with an infant with jaundice Educating a mother with an infant with jaundice A four-day-old female baby, who weighed 3kg at birth, born at an appropriate gestational age by twenty-six-year-old Maryanne (pseudonym), is having jaundice, leading to her admission to the pediatric ward. Maryanne is A+ primiparous with gestational diabetes. The pregnancy was uneventful, and she gave birth vaginally after augmentation of labor with Pitocin. The baby was NUTRITIONAL EDUCATION 2 discharged on her day two when her weight had reduced by four percent from her birth weight and appeared to have mild facial jaundice. Maryanne breastfed the baby well (every three hours) and had two wet diapers and one diaper with had meconium stain for the 24 hours. While at home on day three, the mother gave her water after realizing that she was hardly satisfied with the regular and frequent breastfeeding. Besides, Maryanne noticed that jaundice was increasing in degree but did not seek medical care after she was assured by a relative that jaundice is common among babies and that it subsides on its own. She realized that jaundice was exacerbating, and the baby was slowly turning yellow not only on the face but also on the skin, which pushed her to make an appointment with a pediatrician. On the day of the appointment with the physician (day four), she narrated the baby’s condition. She reported breastfeeding as frequently as possible (every three hours) and that she had been using two diapers every day. The baby’s urine is dark yellow, and the stool is dark green. Vitals include T 37.9, pulse 154, RR 57, BP 64/46. Baby’s weight 2.7kg (25 percentile), length 55cm (25 percentile), and head circumference 36cm (75 percentile) and very jaundiced and irritable. Her anterior fontanel is sunken, tacky oral mucosa, and jaundice appears to spread to the lower extremities. There is neither cephalohematoma nor bruising, and both sclera are icteric. Baby’s muscle tone and activity are normal, and other physical exam parameters are normal. Lab results were as follows: her total bilirubin was 20mg percent and a direct fraction of 0.8 mg percent. This led to her admission to the pediatric unit for chemotherapy, supplementary formula food, nutrition education, lactation teaching, and consultation. Care is initiated immediately to lower the baby’s bilirubin to at least 12%, after which she will be discharged home on breast milk feeding and follow up with the pediatrician as well as the lactation consult. NUTRITIONAL EDUCATION 3 According to both the subjective and objective data, it is apparent that Maryanne has deficit knowledge not only regarding jaundice, it causes, pathophysiology, management at home but also breastfeeding and its relationship to jaundice and jaundice management which impacts the baby’s care and health (Kaplan et al., 2019). A relative told her that jaundice is common among infants and often subsidies on its own, and she bought the idea leading to the worsening of the degree of jaundice. Similarly, Maryanne opted to give her baby water when she did was not satisfied with three hourly breastfeeding instead of increasing the frequency to even two-hour breastfeeding or considering a supplement to avoid symptoms of jaundice. However, I appreciate Maryanne’s effort in ensuring that she breastfeeds every three hours and seeking care even after being told that jaundice is a common condition and goes away on its own. It is necessary to teach the mother on jaundice comprehensively to ensure that she is well conversant with jaundice, the relationship between breastfeeding and jaundice management and how to go about it when the baby is jaundiced at home or does not seem to be satisfied with breast milk which may interrupt bilirubin levels. In this case, one greater nursing diagnosis is a knowledge deficit related to jaundice, breastfeeding and its relationship to jaundice, and lack of prior exposure, as evidenced by the statement of the problem and misconception about jaundice. The desired outcome is to have the mother verbalize an understanding of jaundice, its cause, treatment, and likely outcome. Also, the mother will recognize the possible signs and symptoms of jaundice, inappropriate or unsatisfactory breastfeeding that may lead to complications such as jaundice or show signs of the same that necessitate seeking medical assistance. Lastly, the mother will demonstrate the proper care of the baby throughout and demonstrate an understanding of how to manage mild to moderate jaundice at home. NUTRITIONAL EDUCATION 4 The interventions and rationales will include the following. Firstly, I provide the mother with detailed information related to neonatal jaundice, including its pathophysiology, signs and symptoms, implications. I will often encourage Maryanne to ask questions and seek clarification when she does not understand any points, and I will reinforce my points as appropriate. This helps to promote understanding of jaundice, correct misconceptions and reduces the fear that may impact care for the child while at home (Kaplan et al., 2019). Secondly, I will discuss home management of jaundice (mild to moderate) before seeking medical care such as signs of increased breastfeeding, exposure to sunlight, and observing the baby more frequently and following up on serum testing programs. I believe that when parents understand the home remedy of mild jaundice, they can adequately and appropriately care for the baby at home. Similarly, the mother’s understanding of jaundice will foster care and cooperation post-discharge and maintain great collaboration with the follow-up team to promote care. Thirdly, I will help Maryanne to understand the relationship between breastfeeding and neonatal jaundice and how adequate breastfeeding can be a remedy to jaundice. I will provide the mother with information about excellent breastfeeding and maintaining adequate milk supply via milk pump, and possibly reinstating breastfeeding as a way to lower bilirubin level in case jaundice interrupts breastfeeding. This will promote the mother’s understanding of adequate breastfeeding, maintaining an adequate milk supply that meets her baby’s demand, and understanding that breastfeeding can be interrupted by jaundice can how it can help lower bilirubin. Lastly, I will teach the mother the means of assessing a baby for increased bilirubin, such as blanching the skin to show its color and weight monitoring. This will make the mother quickly recognize the signs and symptoms of jaundice and seek medical assistance as soon as possible for relevant action (Ullah, Rahman & Hedayati, 2016). I will need a formula milk NUTRITIONAL EDUCATION 5 product for demonstration, short video clip on latching, and some images showing the signs and symptoms of jaundice. I will also provide the mother with a leaflet showing the information on jaundice and breastfeeding for future reference. I will begin the session by greeting Maryanne and introducing myself. After that, I will explain to her about the baby’s progress and update her on every treatment and discharge plan then finally tell her why I had asked to meet her and the goals of the teaching. I will tell her that I have come to teach her on jaundice, breastfeeding as a remedy to prevent jaundice and warrant good health for the baby, maintenance of adequate breast milk to ensure the baby is satisfied to warrant maturation of liver to eliminate excess bilirubin to avoid neonatal jaundice, and home management of mild to moderate jaundice. The aim of the teaching session will include having Maryanne verbalizing a greater understanding of jaundice, including its cause, sign and symptoms, and treatment. Similarly, she will report a greater understanding of how to breastfeed and when to consider breastfeeding adequate to ensure maturation of the liver and prevent neonatal jaundice. Maryanne will always state the relationship between breastfeeding and jaundice and how to prevent neonatal through adequate breastfeeding. Also, she will demonstrate the ability to care for the baby while at home, assessing possible signs and symptoms of increased bilirubin as well as dehydration, which may show unsatisfactory breastfeeding and bottle feeding. Neonatal jaundice is a condition where the baby’s skin or eyes appear yellow, and a mother or a caregiver will quickly notice this by either blanching the skin or keenly looking at the child’s eye in a place called sclera in the eye in a well-lit place. It is common among term babies, and about eighty percent of babies born in American have it at some instances in their lives (Ullah, Rahman & Hedayati, 2016). Why is jaundice common in babies? We all have a NUTRITIONAL EDUCATION 6 substance called bilirubin in our blood. Bilirubin is the substance that is produced by our red blood cells and eliminated by the liver. Their increased level leads to jaundice both in babies and adults; however, it is less common in adults because of their mature and well-developed liver removes its excess. Before a baby is born, his mother’s liver does the work of eliminating excess bilirubin from the baby’s blood. Usually, babies develop jaundice a few days after birth because the mother’s liver no longer removes excess bilirubin, and their liver takes days to develop to the extent of removing excess bilirubin leading to build up that causes jaundice (Ullah, Rahman & Hedayati, 2016). Note that often adequate breastfeeding accelerates the speed of liver development as well as adds to baby’s immunity, thus preventing jaundice and other conditions. This is why exclusive and adequate breastfeeding is encouraged. Neonatal jaundice will occur when the infant’s liver is not well developed thus may be unable to eliminate certain elements found in albumin in the body produced by the body’s red blood cells known as unconjugated bilirubin. This is what makes the skin or sclera to appear yellow. Neonatal jaundice can either be physiologic or pathological; however, the former is common after four days of childbirth, and the latter comes early before the baby gets to four days. Often, when a baby does not make enough breast milk or feed appropriate, she will be dehydrated and have low calories, thus leading to neonatal jaundice, which occurs early. Later onset often attributed to the presence of a substance in the mother’s breast milk that reduces the maturity of the life and ability to eliminate bilirubin (Lori et al., 2020). Laboratory test on total serum bilirubin is the most effective way to diagnosis bilirubin. However, there are symptoms such as drowsiness, inability to breastfeed well, lethargy, yellow skin and sclera, greater and unexplained weight reduction that are signs and symptoms of jaundice. Whenever NUTRITIONAL EDUCATION 7 you notice these symptoms, kindly seek medical assistance. Yellowing of the skin, which you can notice through either blanching the skin or pressing the forehead, is the most common symptom. Note that, though jaundice is common, it can complicate to fatal conditions which may risk life; thus, it is mandatory always to seek medical assistance when you realize anything abnormal with the baby. Moreover, we may produce breast milk and feed the baby as required, but unfortunately, breast milk may not be enough for the baby, and this may put the baby at a higher risk of increased bilirubin (Ullah, Rahman & Hedayati, 2016). Breast milk helps in the baby’s liver development. The liver is the organ in the body that eliminates excess bilirubin manufactured by the baby’s red blood cells. When a baby does not breastfeed well either due to inadequate breast milk or other conditions, her liver will not develop adequately, and he will not adequately remove excess bilirubin from his body leading to excess level driving to neonatal jaundice. You are a great mother because you realized that the baby was not satisfied with whatever breast milk you were producing. Now that you understand how breastfeeding can lead to neonatal jaundice, we can dwell on how you can improve breastfeeding and breast milk to ensure that your baby is adequately breastfed to avoid neonatal jaundice. Sometimes we can improve on breastfeeding as well as milk production by improving latch, but how? You will have to line the baby with her nose just opposite the nipple then support the breast as you gently stroke her lips with the nipple and make sure the nipple aim to roof of her mouth. Then support the baby’s head at the neck and shoulder, leaving it to freely tip back a little as you hold the baby onto the breast. This may also improve the baby’s breastfeeding and promote milk production as the baby breastfeeds. I want to congratulate you on maintaining the three hourly breastfeeding as this is a great attempt to ensure your baby gets enough breast milk to enable the development of her liver to NUTRITIONAL EDUCATION 8 eliminate excess bilirubin and prevent neonatal jaundice. However, when you realize that the baby needs more milk, you should breastfeed as frequently as every two hours as long as you have breast milk to warrant that the baby gets almost adequate breast milk for liver development (Ullah, Rahman & Hedayati, 2016). When the milk is not enough, do not go for water but supplement it with appropriate formula after medical advice. However, this should only apply when you have breastfed the baby, and you are convinced that she is not satisfied because breast milk has numerous natural nutrients that promote liver development and increases its functioning to remove excess bilirubin (Lori et al., 2020). Besides, breast milk passes a certain degree of immunity to the baby will strengthen its ability to fight conditions such as neonatal jaundice, thus increasing wellbeing (Ullah, Rahman & Hedayati, 2016). I hope you understand how adequate breastfeeding is good at preventing a baby from having jaundice and please anytime you have any question or need clarification, feel free since today is your time that I dedicated wholly for this an would want all of us to learn and come out victors in fighting neonatal jaundice. Do not substitute breast milk with formula unnecessarily, please; there may be risks to your breast and general health as well as the baby’s health. Though most formula-fed babies rarely develop jaundice, breast milk is the ideal food for babies because of its natural nature and other benefits such as increasing bonding, improving immunity, among others. Hence ensure you breastfeed your baby at least 8-12 times a day to ensure that he is satisfied with breast milk to develop his liver that effectively removes the excess bilirubin that causes jaundice. Additionally, sometimes when a patient has jaundice, she may not be willing to breastfeed (Ullah, Rahman & Hedayati, 2016). In this case, do not stop breastfeeding, continue pampering the baby to breastfeed and seek medical assistance immediately. This is because NUTRITIONAL EDUCATION 9 adequate breastfeeding is a remedy on its own against neonatal jaundice; thus would help fighting jaundice. This is why you hear people say jaundice goes away on its own. It is the power of breast milk that treats jaundice in babies that makes is subsidies sometimes without medical intervention. Also, in such cases, always assess the skin by blanching under natural sunlight or fluorescent light to assess the hydration status and yellowing of the baby’s skin. Always remember also to feed well because your body too will need nutrients to manufacture milk and know that your diet determines the quality of milk, so it is good to maintain a balanced diet. While at home, you can manage mild neonatal jaundice through increasing feeding of the baby and ensuring diffused exposure to sunlight through a well-lit window for about ten minutes (Lori et al., 2020). Also, keep track of the baby’s weight and bilirubin levels. Note that you should avoid exposure to the baby’s skin to direct sunlight since studies confirm that it is susceptible to thermal injury. Exposing the baby to sunlight lowers the baby’s body bilirubin level thus will manage mild to moderate jaundice at home. Likewise, you can set the special type of light known as phototherapy at home that helps lowers the baby’s bilirubin; however, you need the help of a doctor to closely monitor the baby, frequency, and duration of phototherapy as often as possible. Any time you assess the baby an realize that his skin and white part in his eye are yellow for more than three weeks or worsening and does not respond to either breastfeeding, formula or and home remedies call a doctor, visit any nearby health facility or call our emergency number, and you will get help as soon as possible. Maryanne showed a greater understanding of jaundice, cause, symptoms, and pathophysiology. She also said that she learned a lot, particularly relating to breastfeeding and how it helps prevent and manage jaundice. Lastly, she showed an understanding of how to manage mild jaundice at home and asked positive NUTRITIONAL EDUCATION 10 questions on jaundice management, symptoms, and home management, which I answered to her satisfaction. Throughout the teaching, I will constantly encourage questions and will be reinforcing my points. Finally, I will end the session by thanking Maryanne for allowing me to teach her and cooperating throughout and will wish her and the baby good health as they are discharged home. I will then provide a hospital emergency landline number, which she can contact any time she has a problem that may need medical assistance. References Kaplan, M., Zimmerman, D., Shoob, H., & Stein‐Zamir, C. (2019). Post‐discharge neonatal hyperbilirubinemia surveillance. Acta Paediatrica. NUTRITIONAL EDUCATION 11 Lori Kenari, R., Aziznejadroshan, P., Haghshenas Mojavaeri, M., & Hajian-Tilaki, K. (2020). Comparing the effect of kangaroo mother care and field massage on serum bilirubin level of term neonates with hyperbilirubinemia under phototherapy in the neonatal ward. Caspian J Intern Med 2020; 11 (1): 34-40. Hyperbilirubinemia commonly occurs during the first week of birth and one of the most common causes of hospitalization among term and preterm neonates (1, 2). According to available evidence, 60% of term infants have clinical symptoms including sclera and yellowish skin caused by an increase in .... Caspian J Intern Med, 11(1), 34-40. Ullah, S., Rahman, K., & Hedayati, M. (2016). Hyperbilirubinemia in neonates: types, causes, clinical examinations, preventive measures and treatments: a narrative review article. Iranian journal of public health, 45(5), 558. Teaching Plan 1. Purpose: To document and evaluate teaching skills necessary to provide teaching to an individual client with a demonstrated need. With the completion of this assignment the student will be able to achieve the following objectives. a. Demonstrate ability to thoroughly assess the learning styles of an individual or family using given developmental or cultural models. b. Demonstrate ability to anticipate learning needs based on developmental or cultural assessments. c. Identify and utilize teaching/learning principles to facilitate achievement of learning goals and outcomes. d. Select and prioritize learning strategies based on the developmental or cultural assessment to achieve learning goals and outcomes. e. Support rationales for teaching plan using teaching and learning theories from required readings with references. 2. Nursing Competencies: a. Assessing and identifying developmental, cultural, and socioeconomic factors affecting a client. b. Providing evidence-based health information and teaching based on developmental, cultural, and socioeconomic factors affecting a client or family c. Integrating teaching/learning activities into client interactions bas ...
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