In planning teaching strategies for the client with chronic renal failure, the nurse must keep in mind the neurologic impact of uremia. Which teaching strategy would be most appropriate?
A. Providing all needed teaching in one extended session.
B. Validating frequently the client’s understanding of the material.
C. Conducting a one-on-one session with the client.
D. Using videotapes to reinforce the material as needed.
Correct Answer: B. Validating frequently the client’s understanding of the material.
Uremia can cause decreased alertness, so the nurse needs to validate the client’s comprehension frequently. Assess the extent of impairment in thinking ability, memory, and orientation. Note attention span. Uremic syndrome’s effect can begin with minor confusion, irritability, and progress to altered personality or inability to assimilate information and participate in care. Awareness of changes provides opportunity for evaluation and intervention.
Option A: Because the client’s ability to concentrate is limited, short lessons are most effective. Communicate information and instructions in simple, short sentences. Ask direct, yes, or no questions. Repeat explanations as necessary. May aid in reducing confusion, and increases the possibility that communications will be understood and remembered.
Option C: If family members are present at the sessions, they can reinforce the material. Provide SO with information about the patient’s status. Some improvement in mentation may be expected with the restoration of more normal levels of BUN, electrolytes, and serum pH.
Option D: Written materials that the client can review are superior to videotapes, because the clients may not be able to maintain alertness during the viewing of the videotape. Provide a quiet or calm environment and judicious use of television, radio, and visitation. Minimizes environmental stimuli to reduce sensory overload and confusion while preventing sensory deprivation.
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