Question

For each scenario below, outline the appropriate patient teaching you would perform.

1. Osteoarthritis

An established patient with a history of osteoarthritis is undergoing ongoing therapy, which includes drug therapy and gentle exercise regimen. The patient is discouraged because of increased pain and loss of mobility. The physician instructs you to provide printed information regarding therapeutic diets and exercise for the patient. In addition, you are to review intended effects of the prescribed drug therapy. How do you handle this patient-teaching opportunity?

2. Lyme Disease

A male patient has been diagnosed with Lyme disease. Antibiotic therapy has been prescribed. The patient has been told to return for a checkup in 1 week. The physician asks you to provide the patient with printed information concerning therapy that is advised in the treatment of this condition. How would you handle this patient-teaching opportunity?

3. Gout

An individual has been diagnosed with gout. The physician has instructed you to provide the patient with printed information regarding therapy for treatment of gout. How do you approach this patient-teaching opportunity?

4. Osteoporosis

An older woman has been diagnosed with osteoporosis. The physician asks you to provide the patient with printed information concerning therapy that is advised in the treatment of this condition. How do you handle this patient-teaching opportunity?

5. Fractures

An individual has a fracture of the ulna and radius at the wrist. A cast was placed on the area a few weeks earlier, and the patient is now requesting additional information about therapy for the hand, wrist, and arm. The physician has explained the anticipated therapy to the patient and asks you to review this information with him or her. How do you handle this patient-teaching opportunity?

Answer 1

1) Osteoarthritis :

Patient Teaching-General

disorder, underlying causes, diagnosis, and treatment, including the use of medications and heat therapy

need for adequate rest during the day, after exertion, and at night and the need to allow time in the morning for stiffness to resolve

energy conservation methods

prescribed medications, including drug name, dosage, route of administration, frequency of administration, and duration

how to apply topical NSAIDs and that topical capsaicin may cause local burning

possible adverse effects of medication, including GI distress and a possible increased risk of bleeding

need to take NSAIDs with food and to notify the practitioner if any bruising or bleeding (frank or occult) is noted

exercise plan, such as ROM exercises, performing them as gently as possible

proper use of heat or cold therapy to the joints including the need to protect the skin from burning

proper application of TENS

need for proper footwear

home safety precautions including the installation of safety devices at home

importance of maintaining proper body weight to avoid overstressing the joints

use of crutches or other orthopedic or assistive devices.

Patient Teaching-Discharge Planning

Refer the patient to occupational or physical therapist as indicated.

2) Lyme disease :

Patient Teaching-General

disorder, diagnosis, cause, and treatment, including the fact that early treatment with antibiotics can shorten the duration of symptoms and prevent later disease

prescribed medications, including drug names, dosages, routes, schedule of administration, and duration of therapy

need to take oral doxycycline with a full glass of water on an empty stomach 1 hour before or 2 hours after meals

possible adverse effects of therapy, such as GI upset and hypersensitivity reaction

importance of follow-up care and reporting recurrent or new symptoms to a practitioner

methods for preventing Lyme disease, such as avoiding tick-infested areas, covering the skin with clothing, using insect repellants, inspecting exposed skin for attached ticks at least every 4 hours, and removing ticks

importance of follow-up care to evaluate the effectiveness of therapy.

Patient Teaching-Discharge Planning

If the patient is in the late stages of the disease, refer him to a dermatologist, neurologist, cardiologist, or infectious disease specialist, as indicated.

3) Gout :

Patient Teaching-General

disorder, diagnosis, and treatment, including the need to adhere to treatment and medication therapy to ensure control of the disorder

need to drink plenty of fluids (up to 2 qt [2 L] per day)

signs and symptoms of an acute attack and measures to address an acute attack, including using colchicine within 24 hours of symptom onset

adverse effects of drug therapy, such as diarrhea with colchicine therapy

relaxation/pain management techniques

dietary adjustments and risk factor modification; foods to avoid

importance of controlling underlying hypertension.

Importance of adhering to medication therapy and follow up for evaluation of effectiveness of therapy.

Patient Teaching-Discharge Planning

Refer the patient to a weight-reduction program if appropriate

4) Osteoporosis :

disorder, diagnosis, and treatment, including the need to adhere to treatment and medication therapy to ensure control of the disorder.

need proper calcium and vitamin D intake. lifestyle prevention: weight-bearing exercise, avoid alcohol, caffeine, soda, high fat foods, and smoking.

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