Cebu Normal University Graduate School

HEALTH TEACHING PLAN FOR CVA PATIENT (USING BEHAVIORAL SYSTEM MODEL)

Submitted by: Mark Lester D. Dalanon, RN

Objectives
GENERAL: At the end of the health teaching, the patient and his/her family will be able to gain the essential knowledge about CVA and its management, the skills of performing necessary measures to manage it as well as preventive measures to curb further complications, and have the attitude to always maintain and monitor good health practices. SPECIFIC: After the 45 mins. of health teaching the patient and his/her family will be able to: Knowledge: Know and understand CVA by means of defining CVA, giving its signs and symptoms, giving its management as well as its preventive measures. Skills: Demonstrate the first aid measures in CVA, and choose foods that are apt to the condition. Attitude: Always adhere to the special diet with regards to the condition, and to always report to the physician if signs and symptoms reappear or complications appear.

Methodology
The health teaching will be conducted by means of using visual aids as well as roleplaying to support the patients understanding and demonstrate the necessary skills in managing CVA and discussion of the necessary information regarding CVA. We will be basing our general health teaching according to the 7 Behavioral Subsystems which are the Adaptive Subsystem, Sexual Subsystem, Aggressive / Protective Subsystems, Dependency Subsystems, Eliminative Subsystems, Achievement Subsystems and Injestive Subsystems.

BEHAVIORAL SUBSYSTEM Affiliative Subsystem Sexual Subsystem Aggressive / Protective Subsystems Dependency Subsystems Eliminative Subsystems Injestive Subsystems Achievement Subsystems

GENERAL HEALTH TEACHINGS SOCIALIZATION SEXUAL ACTIVITY TRANSFERRING/ AMBULATION SOCIALIZATION & GROOMING BOWEL MOVEMENT DIET TRANSFERRING/ AMBULATION & HYGIENE

Patient Health Teaching

GENERAL HEALTH TEACHINGS
TRANSFERRING/ AMBULATION

SPECIFIC HEALTH TEACHINGS

1. Encourage patient to use the stronger side (if appropriate) as best as possible. 2. When transferring to wheelchair, always place chair on patients stronger side at slight angle to bed and lock brakes. 3. Instruct s/o to stand on patients weak side and place hand under patients weak arm. Encourage to use ambulation devices such as canes, walkers and crutches.

_________________________________ DIET

_____________________________
1. Encourage pt. to eat soft foods to chew and swallow it easily. 2. Instruct to eat on the unaffected side of the mouth and hand. 3.Ensure pt. to wear dentures and eyeglasses if needed. 4.Provide pt. appropriate utensils such as drinking straw, food guard, rocking knife, nonskid place mat to aid in self-feeding. 5.Place patient in optimal position for feeding, preferably sitting up in a chair; support arms, elbows, and wrists as needed. 6.If patient has visual problems, instruct the pt. about the placement of the food in the plate. 1. Place the patient in wheelchair or stationary chair. This assists with support when dressing. Dressing can be fatiguing. 2. Encourage use of clothing one size larger. This ensures easier dressing and comfort. 3. Suggest elastic shoelaces or loop and pile closures on shoes. These eliminate tying. 1. Instruct patient to select bath time when he or she is rested and unhurried. Hurrying may result in accidents and the energy required for these activities may be

GROOMING

HYGIENE

substantial. 2. Provide patient with appropriate assistive devices (e.g., long handled bath sponge; shower chair; safety mats for floor; grab bars for bath or shower). These aids in bed bathing. 3. Encourage patient to comb own hair (a one-handed task). Suggest hairstyles that are low maintenance. This enables the patient to maintain autonomy.

BOWEL MOVEMENT

1. Offer bedpan or place patient on toilet every 1 to 1 hours during day and three times during night. This eliminates incontinence. Time intervals can be lengthened as the patient begins to express the need to toilet on demand.

SEXUAL ACTIVITY

1. Instruct patients they should take it one step at a time. Make sure that they are relaxed. Be aware that the recovery process after stroke is a long path and it might be understandably impossible to have sex right after it. 2. Inform the patient that in several cases a part of the body remains paralyzed. This should not be an obstacle; the most difficult seems to be getting adapted mentally to those changes. However, the patient and his/her partner are still the same persons so it doesnt really matter from a purely physical point of view. 3. Convey to patients, is that an amazing and satisfactory sex life is still totally possible after stroke. That they should not believe myths that say sex after stroke is forbidden because it leads to another stroke. Patients should simply make sure that they and his/her partner are feeling comfortable, take it easy, and everything will be just fine. 1. Encourage patient to join organizations or groups that offers support for those people who have the same disease condition 2. Have the family or significant others be supportive to the patient's condition by conveying appreciation or positive reinforcement if the patient is maintaining good health practices

SOCIALIZATION