In the case of Mr. P., the situation is complexified by his age and the fact that his spouse is unable to leave the house. Also, he seems to be in a frustrated state of mind. The approach that is to be taken should, firstly, stabilize the client so that he is capable of further recovery. In Mr. P.’s case, cardiomyopathy has resulted in congestive heart failure. Consequently, medications including ACE inhibitors and beta-blockers have to be used.
His edema can be addressed by antihistamine and anti-steroid medications (McCance & Huether, 2014). Furthermore, Mr. P.’s diet should be improved. As the client undergoes treatment, he should switch to a diet that contains less sodium to reduce fluid retention and take moderate exercise that would simultaneously improve his physical and mental condition.
The teach-back method can be deemed effective in elderly patients with cardiovascular issues. Firstly, it has been proved to prevent early readmission due to improper self-maintenance (White, Garbez, Carroll, Brinker, & Howie-Esquivel, 2013). Secondly, as illustrated by still more recent research, this method improves the patients’ self-reported satisfaction rates with the self-maintenance outcomes and follow-up (Kelly & Putney, 2015).
The education plan can be presented as follows:
- Overview: the client is asked what he thinks he needs to know by the end of the education; also, the client is asked how he learns best;
- Objectives: the client’s dietary needs (low-sodium diet) and medication intake are discussed;
- Content: the diet plan, medication intake, and exercise are discussed, considering the client’s learning method of choice; particularly, the teach-back should include the following:
- Why the client thinks he should cut back on salt (the term “low-sodium” can be confusing);
- How much salt does he think he eats daily;
- How he thinks he can cut back on salt;
- How often and what particular medication he should take (the educator demonstrates, the client reproduces);
- What exercise options does the client consider appropriate (if yoga is not an option due to his financial situation or religious stance, other options should be provided: walking, jogging, etc.);
- Procedures: the abovementioned can be achieved depending on the client’s learning preferences; i.e., the educator and the client can make diet plans in charts or in play form, etc.
- Evaluation: the client should demonstrate what he learned: through a post-test, demonstration, and so forth.
The educator should give the client time to think on his own and suggest the answers in a polite form if there are any difficulties.
Kelly, A. M. & Putney, L. (2015). Teach back technique improves patient satisfaction in heart failure patients. Heart and Lung: The Journal of Acute and Critical Care, 44(6), 556-557.
McCance, K. L. & Huether, S. E. (2014). Pathophysiology: The Biologic Basis for Disease in Adults and Children (7th ed.). Maryland Heights, MO: Mosby.
White, M., Garbez, R., Carroll, M., Brinker, E., & Howie-Esquivel, J. (2013). Is “Teach-Back” Associated with Knowledge Retention and Hospital Readmission in Hospitalized Heart Failure Patients? Journal of Cardiovascular Nursing, 28(2), 137-146.