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23 Cards in this Set

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Principles of Teaching - Learning
- process facilitated by helping relationship
- knowledge of communication process to assess verbal and nonverbal feedback
- thorough assessment affecting learning to address needs
- more effective if involved in planning process
- proposed changes should be realistic
subcutaneous injections
- given in subQ layer (adipose tissue)
- special insulin/tuberculin syringes
- only small amounts (less than/equal to 1 mL)
- use 1 mL syringe; 25- or 27g; <1" needle (usu. 3/8 or 5/8)
- pinch skin to inject
- insert at 45 degrees for avg. to thin weight; 90 deg. for obese
- sites: outer aspect of upper arms, abdomen, anterior aspects of thighs, or scapular area of upper back
Z-track
technique for intramuscular injections

DAIWR - Displace - Aspirate - Inject (wait 10 sec) - Withdraw - Release

(Deliver All Injections With Responsibility)
intradermal injections
- given into dermis
- usually TB or allergy testing
- only small amount given (0.01 to 0.1 mL)
- use 1 mL syringe; 25- or 28g; 1/4 to 5/8" needle
- create a wheal or bleb
- insert at 5-15 degree angle, bevel up
- sites: ventral surface of forearm, upper back, or upper chest
intramuscular injections
- given into muscular area
- dose: greater than 3 mL
- use 1 to 3 mL syringe; 21- to 25g; 1 to 1-1/2" needle
- palpate area/landmarks and check muscle mass
- insert at 90 degree
- aspirate before injecting
- sites: deltoid (no more than 1 mL) (arm); ventrogluteal (hip); vastus lateralis (midlateral thigh); rectus femoris (mid third of anterior thigh)
dorsalgluteal
approx. 1 inch above center of imaginary line between head of trochanter and posterior superior iliac spine

**use only when no others are accessible
vastus lateralis
midlateral thigh

one handbreath below the head of trochanter and one handbreath above the knee - site is middle third of this area

**preferred site for infants under 7 mos.
rectus femoris
middle third of anterior thigh

**use only if not others are accessible
deltoid
inverted triangle

2 to 3 fingerbreaths below acromion process, and tip is even with top of axilla
ventrogluteal
triangle formed between your fingers when you place your palm on the head of the trochanter, index finger on anterior superior iliac spine, and middle finger on the iliac crest

**preferred site for adults and children over 7 months
Principles of Learning
Relevance - meaningful, understood to client, relatable to other learned material
Motivation - want to learn, preceive value of info
Readiness - should be willing and able
Maturation - developmentally/cognitive/psychomotor abilities
Reinforcement - positive/immediate feedback
Participation - active involvement
Organization - incoroporate previously learned/present simple to complex
Repetition - retention by repetition, presentation
Components of Primary Prevention
Specific Protection

Health Promotion
Pender's Health Promotion Model
"belief in oneself's ability"
(fear not motivating factor)

- perceived benefits
- perceived barriers
- perceived self efficacy
- activity-related effects
- interpersonal and situational influences
Teaching-Learning Process
1. Assessment
2. Indentification of Needs
3. Planning - goals, objectives, content
4. Implementation
5. Evaluation - learners progress, teaching efficacy
Routes for non-parenteral medications
oral
buccal
sublingual
topical - transdermal (on skin); instillation (rectal, vaginal, ophthal, otic); inhalation (gases)
Johari's window
tool to increase self-awareness

PUBLIC (known to both) SEMI PUBLIC (known to others)
PRIVATE (known to self) INNER (known to no one)
Health Belief Model
Avoidance of negative health behavior
1. susceptibility (vulnerability)
2. adverse effect
3. benefits outweigh barriers (worth it)
4. confident in ability (self efficacy)
Prochaska's Model of Change
Incremental steps, relapses, and sustainability
1. Precontemplation - no problem/no intent to change
2. Contemplation - weighs pros v. cons/change within 6 mos.
3. Preparation - action plan prep
4. Action - active change for min. 6 mos.
5. Maintenance - sustain change > 6 mos.
6. Termination - lifestyle change automatic
Levels of Prevention
Primary - action precedes disease or dysfunction

Secondary - action designed to detect and intervent in early stage or potential of disease

Tertiary - action designed to reduce disability or rehabilitation
Barriers to Learning
External
- Environmental
- Sociocultural

Internal
- Psychological
- Physiological
teaching strategies
lecture
discussion
demonstration
role playing
value clarification
learning domains
cognitive (know) - identify, define, explain, ....

psychomotor (do) - demonstrate, create, ...

affective (feel) - choose to, ...
principles for safe medication administration
six rights
- right patient
- right medication
- right dose
- right route
- right time
- right documentation

three checks
- before prep
- after prep
- at bedside