HEALTH TEACHING

TOPIC #1: PREOPERATIVE TEACHING ON PREPARING FOR SURGERY

General Objective: After 45 minutes of nurse-patient interaction, the patient will be able to recall and have a brief information about preparing on a breast cancer surgery.
Specific Objectives:
- To recall the tests performed and to check if you are fit for the surgery
- To recall the Pre Assessment
- To Know who she might meet before the operation

LEARNING OBJECTIVES LEARNING CONTENT LEARING ACTIVITY TIME ALLOTED TEACHING STYLE EVALUATION

After 45 minutes of nurse- I. Attention 5 minutes Sharing and Discussion After 45 minutes nurse-
patient interaction, the Catching patient interaction, the
client will be able to : Activity patient will be able to
recall and have a brief
 Have you
information about
remember or can
preparing on a breast
you recall the
cancer surgery.
information’s on
preparing before
surgery?

Tests to check you are fit 15 minutes Sharing and Discussion

1. Recall the II. Lecture Proper
tests for surgery
performed You have tests before your
and to check if operation to check:
you are fit for
the surgery  your fitness for a
general anesthetic

 that you'll make a

 good recovery
from surgery

Tests might include:

 blood tests to
check your general
health and how
well your kidneys
and liver are
working

 an ECG to check
that your heart is
healthy

 breathing tests
(called lung
function tests)

 an
echocardiogram (a
painless test of
your heart using
sound waves)

 a chest x-ray to
check that your
lungs are healthy

 a test to check
your heart and
lung function
when you're
resting and
exercising (called a
 cardio pulmonary
exercise test)

10 minutes Sharing and Discussion

Pre assessment clinic
2. Recall the Pre III. Lecture Proper
assessment Your pre assessment clinic
appointment prepares you
for your operation. You
have it about a week or so
before surgery.

You meet members of

your treatment team and
you can sign the consent
form to agree to the
operation.

15 minutes Sharing and Discussion

Who you might meet
before your operation IV. Lecture Proper
3. Know who she
might meet Nurse or healthcare
before the assistant
operation
At the pre assessment
clinic a nurse or health
care assistant checks your:

•    general health

•    weight
•    blood pressure
•    pulse
•    temperature

The nurse asks you

questions to check your
fitness for the operation.
They can organize any
further tests you might
need.

They ask about any

medicines you are taking
and give you information
about what to expect
when you come into
hospital for the operation.

They will let you know if

you need to stop taking
certain medicines before
your operation. Tell them
if you usually take
medicines to thin your
blood or have other
medical conditions, such
as diabetes.

They may give you a

leaflet to teach your leg
and breathing exercises to
do after your operation to
help with recovery.

Specialist breast cancer

nurse
You may also see your
specialist breast nurse.
They can check what help
and support you have to
see what you will need
when you go home. They
are usually your main
point of contact and care
for you throughout your
treatment.

Your breast care nurse or a

physiotherapist will talk to
you about arm exercises
that you need to do after
your operation. This helps
with your recovery.

The breast surgeon

Your breast surgeon or a

member of their team will
tell you about:

•    the operation you are

going to have, and where
the scars will be 
•    the benefits of having
surgery
•    the possible risks
•    what to expect
afterwards

The anesthetist

The anesthetist gives you

 the anesthetic and they
look after you during the
operation. The anesthetic
is the medicine that keeps
you asleep during your
operation. They make sure
you’re fit enough for the
surgery.

Reference: Preparing for surgery | Breast cancer. (2020, April 16). Cancer Research UK. Retrieved October 21, 2022, from
https://www.cancerresearchuk.org/about-cancer/breast-cancer/treatment/surgery/preparing-for-surgery
TOPIC #2: EDUCATING PATIENT ABOUT GENERAL PREOPERATIVE NURSING INTERVENTIONS

General Objective: After 45 minutes of nurse-patient interaction, the patient will be able to gain and apply knowledge on the general preoperative nursing interventions and be
able to prepare self for surgery.
Specific Objectives:
- To understand the importance of patient safety
- To perceive managing nutrition and fluids
- To understand the need of preparing the bowel
- To understand the need of preparing the skin

LEARNING OBJECTIVES LEARNING CONTENT LEARING ACTIVITY TIME ALLOTED TEACHING STYLE EVALUATION

Within 45 minutes of I. Attention 5 minutes Sharing and Discussion After 45 minutes of

nurse-patient interaction, Catching nurse-patient interaction,
the patient will be able Activity the patient was able to
to :  Do you have any idea gain and apply
of what to do before knowledge on the
surgery? general preoperative
nursing interventions and
was able to prepare self
for surgery.
1. Understand the Protecting patient from II. Lecture 10 minutes Interactive Lecture using
importance of injury one of the major Proper visual materials
patient safety roles of a preoperative
nurse. There are Seven
primary National Patient
Safety Goals. The
following are:

 Improve the
accuracy of
patient
 identification
 Improve
effectiveness of
communication
among caregivers
 Improve safety of
using medication
 Improve safety of
using infusion
pumps.
 Reduce the risk of
health-care
associated
infections
 Accurately and
completely
reconcile
medications
across continuum
of care
 Reduce the risks
of surgical fires

The major purpose of

2. Perceive withholding food and fluid
managing before surgery is to III. Lecture 10 minutes Sharing and Discussion
Nutrition and prevent aspiration. Until Proper
Fluids recently, fluid and food
were restricted
preoperatively overnight
and longer. Specific
recommendations depend
on the age of the patient
and the type of food
 eaten. For example, adults
may be advised to fast 8
hours after eating fatty
food, 4 hours after
ingesting milk products.
Most patients are
currently allowed clear
liquids up to 2 hours
before an elective
procedure.

Enemas are not commonly

3. Understand prescribed preoperatively
Sharing and Discussion
Preparing the unless the patient is IV. Lecture 10 minutes
bowel undergoing abdominal or Proper
pelvic surgery. In this case,
a cleansing enema or
laxative may be prescribed
the evening before
surgery and may be
repeated the morning of
surgery. The goals of this
preparation are to allow
satisfactory visualization
of the surgical site and to
prevent trauma to the
intestine or contamination
of the peritoneum by
feces. Unless the condition
of the patient presents
some trauma to the
intestine or contamination
of the peritoneum the
 bedpan, is used for
evacuating the enema if
the patient is
contraindication, the toilet
or bedside commode,
rather than hospitalized
during this time. In
addition, antibiotics may
be prescribed to reduce
intestinal flora.

The goal of preoperative

4. Understand skin preparation is to
Preparing the skin decrease bacteria without V. Lecture 10 minutes Sharing and Discussion
injuring the skin. If the Proper
surgery is not performed
as an emergency, the
patient may be instructed
to use a soap containing a
detergent-germicide to
cleanse the skin area for
several days before
surgery to reduce the
number of skin organisms;
this preparation may be
carried out at home.
Generally, hair is not
removed preoperatively
unless the hair at or
around the incision site is
likely to interfere with the
operation. If hair must be
removed, electric clippers
are used for safe hair
removal immediately
 before the operation.

Reference: Melter, S. C., Bare, B. G., & HInkle, J. L. (n.d.). Brunner & Suddarth's Textbook of Medical-Surgical Nursing (11th ed., Vol. 1). Wolters Kluwer.

TOPIC #3: EDUCATING PATIENT ABOUT IMMEDIATE PEOPERATIVE NURSING INTERVENTIONS

General Objective: After 45 minutes of nurse-patient interaction, the patient will be able to gain and apply knowledge on the immediate preoperative nursing interventions and
be able to prepare self for surgery.

Specific Objectives:
- To prepare self before surgery
- To understand on administering preanesthetic medication
- To understand about preoperative record
- To Recognized about transporting patient to the Presurgical Area
- To know the needs of Family and S.O

LEARNING OBJECTIVES LEARNING CONTENT LEARING ACTIVITY TIME ALLOTED TEACHING STYLE EVALUATION

Within 45 minutes of I. Attention 5 minutes Sharing and Discussion After 45 minutes of nurse-
nurse-patient interaction, Catching patient interaction, the
the patient will be able to : Activity patient was able to gain
and apply knowledge on
 Do you have any
the immediate
idea of what to do
preoperative nursing
before surgery?
interventions and was
able to prepare self for
surgery
The patient changes into a II. Lecture Proper 10 minutes Sharing and Discussion
1. Prepare self
hospital gown that is left
before surgery
untied and open in the
back. The patient with
long hair may be braid it,
remove hairpins, and
cover the head completely
with a disposable paper
cap.

The mouth is inspected,

and dentures or plates are
removed. If left in the
mouth, these items could
easily fall to the back of
the throat during
induction of anesthesia
and cause respiratory
obstruction.

Jewelry is not worn to the

OR; wedding rings and
jewelry body piercings
should be removed to
prevent injury. All articles
of value, including
assistive devices, dentures,
glasses, and prosthetic
devices, are given to
family members or are
labeled clearly with the
patient’s name and stored
in a safe and secure place
according to the
institution’s policy.

All patients should void

immediately before going
to the O.R to promote
continence during low
abdominal surgery and to
make abdominal organs
more accessible.
 If a prenanesthetic
medication is
2. Understand on 5 minutes Sharing and Discussion
administered, the patient III. Lecture Proper
administering
is kept in in bed with side
preanesthetic
medication rails raised, because the
medication can cause
lightheadedness. During
this time, the nurse
observes the patient for
any untoward reaction to
the medications. The
immediate surroundings
are kept quiet to promote
relaxation. It usually takes
15 to 20 minutes to
prepare the patient for the
OR.

Preoperative checklists
contain critical elements Interactive lecture using
3. Understand about 5 minutes
that must be checked and IV. Lecture Proper visual materials
the Preoperative
verified preoperatively.
Record
The completed chart with
the preoperative checklist
and verification form
accompanies the patient
to the OR with the surgical
consent from attached,
 along with all laborative
reports and nurse’s
records. Any unusual last-
minute observations that
may have a bearing on
anesthesia or surgery are
noted prominently at the
front of the chart.

The patient is transferred 10 minutes

to the holding area or Sharing and Discussion
4. Recognized about V. Lecture Proper
presurgical suite in a bed
Transporting
patient to the or on a stretcher about 0
Presurgical Area. to 60 minutes before the
anesthetic is to be given.
The stretcher should be as
comfortable as possible,
with a sufficient number of
blankets to prevent
chilling in an air-
conditioned room. The
patient is taken to the
preoperative holding area,
greeted by name, and
positioned comfortably on
the stretcher or bed. The
surrounding area should
be kept quiet if the
preoperative medication is
to have maximal effect.
 Sharing and Discussion
10 minutes
5. Know the Family Most hospitals have a VI. Lecture Proper
and S.O needs waiting room where family
members and significant
others can wait while the
patient is undergoing
surgery. This room may be
equipped with
comfortable chairs,
television, telephones, and
facilities for light
refreshment. Volunteers
may remain with family,
offer them coffee, and
keep them informed on
the pt’s progress. After
surgery, the surgeon may
meet the family in the
waiting room and discuss
the outcome.

Reference: Melter, S. C., Bare, B. G., & HInkle, J. L. (n.d.). Brunner & Suddarth's Textbook of Medical-Surgical Nursing (11th ed., Vol. 1). Wolters Kluwer.

TOPIC #4: PREOPERATIVE INSTRUCTIONS TO PREVENT POSTOPERATIVE COMLICATIONS

General Objective: After 45 minutes of student nurse-patient lecture demonstration, the client will be able to acquire knowledge and demonstrate properly preoperative
instructions.
Specific Objectives:
-To define diaphragmatic breathing
-To demonstrate diaphragmatic breathing
-To demonstrate leg exercises
-To demonstrate turning to the side
- To demonstrate getting out of bed
LEARNING OBJECTIVES LEARNING CONTENT LEARING ACTIVITY TIME ALLOTED TEACHING STYLE EVALUATION
Within 45 minutes of I. Attention 5 minutes Sharing and Discussion After 45 minutes of
student nurse-patient Catching student nurse-patient
lecture demonstration, Activity lecture demonstration,
the client will be able to :  Have you tried to the client was able to
perform any acquire knowledge and
preoperative perform properly the
instructions before? preoperative instructions.

1. Define Diaphragmatic breathing II. Lecture 5 minutes Interactive lecture using

Diaphragmatic refers to a flattening of Proper visual materials
breathing. the dome of the
diaphragm during
inspiration, with resultant
enlargement of the upper
abdomen as air rushes in.
During expiration, the
abdominal muscles
contract.

2. Demonstrate 1. Practice in the III. Learning Demonstration- Return

Diaphragmatic same position you Assessment 10 minutes demonstration and
Breathing. would assume in  Proper Demonstration Sharing
bed after surgery: of Diaphragmatic
 a semi-fowler’s Breathing
position, propped  Questioning the client
in bed with the of the things she
back and learned about
shoulders well Diaphragmatic
supported with Breathing
pillows.
2. With your hands
in a loose-fist
position, allow the
hands to rest
lightly on the
front of the lower
ribs, with your
fingertips against
lower chest to feel
the movement.
3. Breathe out
gently and fully as
the ribs sink down
and inward
toward the
midline.
4. Take a deep
breath through
your nose and
mouth, letting the
abdomen rise as
the lungs fill with
air.
5. Hold this breath
for a count of five.
6. Exhale and let out
all air through
your nose and
mouth.
 7. Repeat this
exercise 15 times
with a short rest
after each group
of five.
8. Practice this twice
a day
preoperatively.

3. Demonstrate 1. Lean forward IV. Learning Demonstration- Return

Coughing slightly from a Assessment 5 minutes demonstration and
sitting position in  Proper Demonstration Sharing
bed, interlace of Coughing
your fingers  Questioning the client
together, and of the things she
place your hands learned about
across the Coughing
incisional site to
act as a splintlike
support when
coughing.
2. Breathe with the
diaphragm as
described under
“Diaphragmatic
Breathing”.
3. With your mouth
slightly open,
breathe in fully.
4. “Hack” out
sharply for three
short breathes.
5. Then, keeping
mouth open, take
in a quick deep
 breath and
immediately give
a strong cough
once or twice.
This helps clear
secretions from
your chest. It may
cause some
discomfort but
will not harm your
incision.

1. Lie in a semi-
fowler’s position Demonstration- Return
4. Demonstrate Leg and perform the V. Learning demonstration and
Exercise following simple Assessment 10 minutes Sharing
exercises to  Proper Demonstration
improve of Leg Exercise
circulation.
2. Bend knee and
raise foot and
hold it a few
seconds, then
extend leg and
lower it to the
bed.
3. Do it five times
with one leg, then
repeat with other
leg.
4. Then trace circles
with the feet by
bending them
down, in toward
each other, up,
 and then out.
5. Repeat these
movements five
times.

1. Turn on your side

with the
uppermost leg
5. Demonstrate flexed mot and VI. Learning Demonstration- Return
turning to the supported on a Assessment 5 minutes demonstration and
Side pillow.  Proper Demonstration Sharing
2. Grasp the side rail of Turning to the side
as an aid to
maneuver to the
side.
3. Practice
diaphragmatic
breathing and
coughing while on
your side.

1. Turn on your side.

2. Push yourself with
one hand as you
6. Demonstrate swing your legs VII. Learning Demonstration- Return
Getting out of Bed out of bed. Assessment 5 minutes demonstration and
 Proper Demonstration Sharing
of getting out of bed
Reference: Melter, S. C., Bare, B. G., & HInkle, J. L. (n.d.). Brunner & Suddarth's Textbook of Medical-Surgical Nursing (11th ed., Vol. 1). Wolters Kluwer.

TOPIC #5: PREOPERATIVE PSYCHOSOCIAL INTERVENTIONS TO ALLEVIATE ANXIETY

General Objective: After 45 minutes of student nurse-patient lecture demonstration, the client will be able to apprehend and apply coping strategies to alleviate anxiety.
Specific Objectives:
- To describe anxiety and its possible effects
 - To determine the cognitive coping strategies
LEARNING OBJECTIVES LEARNING CONTENT LEARING ACTIVITY TIME ALLOTED TEACHING STYLE EVALUATION
Within 45 minutes of I. Attention 5 minutes Sharing and Discussion After 45 minutes of
student nurse-patient Catching student nurse-patient
lecture demonstration, the Activity lecture demonstration, the
client will be able to : - Have you client was able to
experienced apprehend and apply
anxiety? coping strategies to
alleviate anxiety.
1. Describe anxiety Anxiety is the subjective II. Lecture Proper 10 minutes Interactive Lecture
and its possible unpleasant feeling of Definition of
effects. dread over something Anxiety
unlikely to happen, such as
the feeling of imminent
death.   It is often
accompanied by
restlessness, fatigue,
problems in concentration,
and muscular tension.
Severe anxiety can cause
unpleasant symptoms and
stress. Typical symptoms
include palpitations,
nausea, an upset stomach,
shortness of breath and
sleep problems. Anxiety
can make pain worse, as
well as making it harder to
cope with the pain. It can
produce aggressive
reactions that result in
increased stress
experienced, thus causing
more difficult pain
management in the
 postoperative period.

2. Determine the Cognitive strategies may III. Learning 30 minutes Interactive Lecture using
cognitive coping be useful for relieving Assessment visual and audio materials
strategies tension overcoming  Providing the
anxiety, decrease fear and Cognitive Coping
achieving relaxation. Strategies
Examples of such
strategies are :
 Imagery: The
patient
concentrates on a
pleasant
experience of
restful scene.
 Distraction: The
patient thinks of
an enjoyable story
or recites a
favorite poem or
song.
 Optimistic self-
recitation: The
patient recites
optimistic
thoughts ( “ I know
all will go well”)
 Music therapy

Reference: Melter, S. C., Bare, B. G., & HInkle, J. L. (n.d.). Brunner & Suddarth's Textbook of Medical-Surgical Nursing (11th ed., Vol. 1). Wolters Kluwer.