Outcome Statement:

Knowledge: health behaviors (p. 188)                                                                                               Leisure participation (p. 199)

     Description of healthy nutritional practices (2—4)                                                                                   Participate in activities other than regular work (1-4)

     Description of benefits of activity and exercise (2—4)                                                                              Reports of relaxation from leisure activities (1-4)

     Description of effective stress management techniques (2—4)

                                 Activities to meet outcome

                Individualize nursing activity

                             Evaluation of Outcomes

Nursing Intervention (p.---):

           Activities:

Utilize as many NICs as needed to select five appropriate activities for your patient

Health screening (p. 368)    

¨      Measure blood pressure, height, weight as appropriate.

Health education (p. 365)

¨      Identify internal or external factors that may enhance or reduce motivation for healthy behaviors.

¨      Formulate objectives

¨      Emphasize immediate or short term positive health benefits to be received by positive lifestyle behaviors rather than long term benefits or negative effects of non-compliance

Teaching: prescribed activity/exercise (p. 648)

¨      Inform patient of the purpose for and benefits of exercise

¨      Instruct patient how to safely progress activities

¨      Inform patient what activities are appropriate based on physical condition

¨      Assist the patient to incorporate activity/exercise into daily routine/lifestyle

¨      Provide information on available community resources to increase compliance with activity/exercise

Teaching: prescribed diet (p. 649)

¨      Instruct the patient about how to read labels and select appropriate foods

¨      Instruct the patient about how to plan appropriate meals

¨      Refer patient to dietician as appropriate

Teaching: disease process (p. 640)

¨   Appraise the patients current level      of knowledge related to disease    process

¨      Discuss lifestyle changes that may be required to prevent future complications and or control the disease process

¨  Identify possible etiologies

¨      Yearly exams, monthly weight checks to determine success of weight loss 

¨      Ask patient about motivations to increase exercise and reduce weight

¨      Ask patient what they would like to accomplish (wt. Loss, activity tolerance, decreased blood pressure are examples)

¨      Short term positives include increased activity tolerance, increased sleeping ability, increased self esteem, more energy

¨      Describe why activity will help reduce weight, increase energy and help reduce blood pressure

¨      Describe beginning, and intermediate level exercise (focus on safety and warning signs of overexertion – chest pain, elevated heart rate, numbness or tingling in fingers/hands, light headedness)

¨      Discuss the benefits of walking

¨      Describe the benefits of walking to work or taking the stairs at work or incorporating exercise into the lunch break

¨      Provide information on local health clubs, weight watcher groups

¨      Discuss label reading and choosing the most appropriate foods (include information on the healthiest fast food places)

¨      Discuss quick, nutritious easy meals to prepare

¨      Ask patient if he has further questions to determine the need for a referral

¨      Have the patient describe high blood pressure and the effects of high blood pressure

¨      Discuss diet, exercise and possible treatment with medication

¨      Identify diet, heredity, elevated    weight, and sedentary lifestyle issues

Was your outcome statement 1 achieved? (Circle one)

    One month later:   YES      NO No

Was your outcomes statement 2 achieved? (Circle one)   

    One month later:   YES      NO  No

Evaluate each individual indicator.  Was the level you identified achieved?  Give patient examples and explain:

Outcome 1:  Knowledge: health behaviors

Description of healthy nutritional practices=4

Description of benefits of activity and exercise=4

Description of effective stress management=3

Outcome 2:  Leisure participation

Participation in activities=2

Reports of relaxation=2

Examples:  although a description of his understanding of health behaviors was not fully articulated in the case study, the following information is useful in determining the level to which he is adhering to a change in health behaviors:

1.  Very interested in losing weight (although the motivation is somewhat short-term)

2.  Has started taking stairs in apartment (one flight)

3.  Expresses interest in playing basketball (although does not perceive he is physically ready)

4.  Interested in personal trainer; has not explored

5.  Has decreased fast food intake by 2-3 times per week; has incorporated breakfast, and packs lunch

6.  Acknowledges hypertension risks and ways to reduce

7.  Considering reducing stress through a job change

     8.  Recognizes/understands food pyramid and nutritional recommendations

     9.  Verbalizes understanding of activity recommendations

Modifications