Question 1
In order to deliver health message about hand washing to Brian, the nurse should establish an enabling environment that would enable Brian to speak openly. The nurse should be friendly to Brian with a brilliant smile. This includes using stories to attract his attention. The nurse should engage Brian in play activities or a game that would enable Brian to freely enjoy as well as develop the trust in the nurse. To pass the message on hand hygiene, the nurse should use audiovisual aids to demonstrate proper hand washing methods. She can show a film of children who visit the toilet and afterwards they wash their hands. This will revolve around the various activities of daily living. The nurse would then ask Brian about the lessons learnt from the film shown. This would enable the information come from Brian directly without being informed by the nurse. The nurse would then easily make emphasis on hand washing.
Question 2
Industry versus inferiority is a psychosocial development stage between the ages of 6and 11 years as proposed by Erick-Erickson. This stage is marked by creativity of the child in performance of various activities. These satisfy the child. Failure to achieve industry will create inferiority in the child. If Brian feels inferior, his ability to learn will be reduced and vice versa.
Question 3
In assessing the learning needs, the nurse would begin by ascertaining Brian's capabilities. This entails both strengths and weaknesses. The strengths should be complemented while weaknesses should be professionally corrected. Ability to learn will be assessed from the prevailing condition of the client including self-esteem. Attempts should be made to motivate the patient. Motivation to learn is assessed from the patient's ability to interact freely with the environment. Attitude of the client towards life and learning is also important in enhancing proper learning. Teaching environment assessment entails ascertaining privacy and appropriateness in ensuring the learning objectives are achieved. The learning resources that are required include charts for demonstration, a good film to watch with the patient as well as the hand washing equipment that would enable the nurse to demonstrate the proper principles of hand washing.
Question 4
Nursing diagnoses
- Knowledge deficit related to proper hand washing techniques as evidenced by the patient's inability to adhere to the principles of hand hygiene.
- Low self-esteem related to lack of interaction with the environment as evidenced by the shyness of the patient.
- Risk of infection related to improper hand washing techniques.
Question 5: Client centered learning goals
- The patient will demonstrate proper hand washing techniques and will incorporate them in his daily routine.
- The patient will interact freely with people in the environment. This involves intermingling with peers as well as proper interaction with strangers.
- The patient will be free from infections and will not contract feco-oral diseases related to improper hand hygiene.
Question 6: Teaching strategy
Affective domain- The nurse should demonstrate proper methods of hand washing. This can best be implemented by showing Brian a video on hand washing methods and culture. This is then followed by the nurse doing a practical demonstration of the hand washing procedure following the required method.
Cognitive domain- Brian should demonstrate the proper hand washing technique repeatedly under the supervision of the nurse. Brian should follow proper procedures in performing the exercise. The nurse should also ask Brian on his perceived importance of hand washing.
Psychomotor domain- Brian should master the hand washing procedure and should incorporate it in his daily routine. The nurse and Brian's mother should also do positive reinforcement of learning in order to enhance mastery of such skill. This includes appreciation on performance of this procedure.
