Question 1
When it comes to communicating to children about achieving and maintaining good health, nurses should keep in mind that the understanding of children is different from that of adults. In the current case, the nurse should make use various approaches ranging from engagement, empathy, education, and enlistment to develop Brian’s trust in her. The nurse-child communication must entail both verbal and non-verbal communication.
The nurse must ensure that her approach does not make Brian nervous and should encourage Brian to talk freely. With regard to non-verbal communication, the nurse should smile a lot as this would ease any tension that may arise at the very beginning. It is also important to note that stories are usually easier to remember hence the nurse should consider using stories to pass health messages. The nurse should further engage Brian in health informative activities such as hygiene related games. Children are also highly attracted to audiovisual materials and the nurse should also use the same to demonstrate important hand-washing methods. The use of a Glow Germ Lotion can also be a helpful especially regarding cleanliness of the hands. Every lesson should relate to the everyday activities that Brian is able to recognize.
In the end, the nurse should request the child to demonstrate what he has learnt. This will enable the information to come from Brian. Such an approach enables the nurse to review how much Brian has learnt and whether the training techniques are effective. If the techniques are not effective then the nurse should consider using a different approach.
Question 2
Industry versus inferiority is a psychosocial development stage that occurs between the ages of six and eleven years. This psychological stage was proposed by Erick-Erickson. The stage is marked by creativity of the child in performance of various activities that are satisfying to a child. Failure to achieve industry will create an aspect of inferiority in the child. If Brian feels inferior his ability to learn will be reduced but if he displays a sense of pride and accomplishment then he will be motivated to become more diligent in performing hand hygiene.
Question 3
In assessing learning needs, the nurse would begin by ascertaining Brian's capabilities regarding hand washing Brian. Here, the nurse should aim to determine whether Brian is he old enough to perform the hygiene procedures independently and whether he is capable of understanding what “germs” are. This approach would entail determining Brian’s strengths and weaknesses. The strengths should be complemented while weaknesses should be carefully corrected.
The ability to learn will be assessed from the client’s prevailing condition including self-esteem. Attempts should be made to motivate the patient. Consequently, the motivation to learn is assessed from the patient's ability to interact freely with the surroundings. The attitude of the client towards life and learning opportunities is also important in enhancing learning. For example, when the child is asking questions and answering questions posed to him by the nurse, it is a good sign that the child is eager to learn. The assessment of the teaching environment entails ascertaining privacy and appropriateness in ensuring the learning objectives are achieved. The learning resources that are required may include charts for proper demonstration, a film that the burse may watch with the patient as well as the hand washing equipment that would enable the nurse to demonstrate the proper hand-washing practices.
Question 4
- Knowledge deficit related to proper hand washing techniques as evidenced by the patient's inability to adhere to the principles of hand hygiene.
- Risk of infection related to improper hand washing techniques.
- Low self-esteem related to lack of interaction with the environment as evidenced by the shyness of the patient.
Question 5:
- The patient will demonstrate proper hand washing techniques and will incorporate them in his daily routine by the end of the shift.
- Brian will verbalize once a day to the times when he should wash his hands in order to remain infection free.
- The patient will interact freely with people in the environment. This involves intermingling with peers as well as proper interaction with strangers.
Question 6:
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 could have Brian teach someone else achieve and maintain hand hygiene to ensure that Brian understands the procedures better. The nurse and Brian's mother should also consider positive reinforcement of learning in order to enhance mastery of such skills through appreciation of the performance of the procedures.
