SAMPLE ANSWER FOR THE FIRST CASE:

Diane War, 45 years old, in room 605, is a patient of Dr Smith’s.

She has impaired skin integrity related to her lack of knowledge about finger cut in diabetic people. She has a previous history of high blood pressure and obesity. She complains of lesion in her finger nails of her left hand. She also complains of headache and general malaise. Her skin is cold and sweating. She was ordered a urinalysis, which was negative and glycemia, which showed 7.5 mmol per liter.

The doctor has ordered new tests: urea, creatinine and uric acid.

She should not have anything by mouth tomorrow.

Oral Pactice

Exercise 1 is a nurse-doctor role play. It aims at giving practice in this kind of professional activity as part of the nurses’ training. The conversation is about diabetes as it is the main topic of the unit. The teacher should emphasize the use of the correct question patterns and a logical report of the patient’s problem. As students work in pairs, the teacher can guide their talks as a way to monitor the activity.

Students pair for the role play. Some students can dramatize this in front of the whole class.

ANSWERS: Any logical, linguistically coherent sentences

Exercise 2 presents a brief report of a case. This exercise allows the students to find out the connection between the patient’s problem and Diabetes Mellitus, so it is a good activity for the whole class to speculate on and discuss. This exercise can be developed as a class activity and after the discussion, students work out the conversation in pairs.

ANSWERS

Mr. Chao Lee, a 57 year-old male has been admitted twice from the emrgency room with ulcers in his left foot. He has a history of hypertension and was diagnosed with diabetes and retinopathy.

Priority nursing diagnosis altered comfort related to pain. He has complained of pain and has a fever of 39°C. He was medicated with Dipirone and Benadryl at 2 pm and at 8 pm. He is injected sodium procaine penicillin b.i.d. His foot has got worse. Plan is to be consulted with ...

Any logical, linguistically coherent questions and answers for the follow-up role play.

Exercise 3 is an activity for the development of oral skills. Students have to decide and give opinions in this problem-solving task. They can work in 3 teams. One team works out the first case and discusses the most appropriate management for the patient. Another team works with the second case and develops their discussion on the management, as team one. The other team analyzes the two cases and decides who should be the first patient to receive treatment.

As a whole class activity the leader of each team can appoint a speaker to present the result of their discussion and the rest of the class can give opinions.

3a ANSWERS: Any logical, linguistically coherent sentences 3b ANSWERS

Case 1: The first thing to do is to give her a glass of sugary water Case 2: To perform Benedict and Imberg tests

Writing

Exercise 1 reminds the students of the SOAP NOTE, as this was introduced in the previous unit. Students read the chart in silence, emphasizing what each letter stands for, that is, S -O -A –P. To check whether they actually remember, the teacher can ask these questions:

1. According to the nursing process you follow, what does each letter mean to you?

2. Is the S used to specify what the patient exactly says or the nurse’s interpretation of the problem?

3.Can the letter O be used to represent the result of physical exam?

4.What about the letter A? Is it used to include the nurse’s actions?

5.Is letter P used to express expectations in the patient’s follow-up?

For exercise 2 students work individually, in pairs or in small groups.

After they have written the SOAP NOTE, they go to the board to write their answers or they may exchange notebooks if they have worked individually. This gives partners / classmates the opportunity to correct their own answers.

ANSWERS

S- “I’ve lost about 80% of my weight lately” “I’ve been treated with insulin for a month, but I haven’t checked my level of blood sugar”

O- 52 years old, hypoglycemic shock. Glycemia decreased. IV Dextrose 5% administered

A- Nutrition altered: more than body requirements r/t metabolic disorders. Patient has improved

P- Follow doctor’s instructions for treatment. Keep the patient’s level of blood sugar within normal limits.

Exercise 3 has the purpose of practicing the report writing as a way to establish phoneme-grapheme correspondence. This exercise can be worked out in teams and can be corrected as a whole class activity. A competition can be held, and the best report can be selected and rewarded.

ANSWERS

Ten-year-old child admitted because he has lost 10 pounds of weight. He has fainted and lost muscle power. His grandparents are diabetic. A test of glycemia was ordered and results showed elevated levels.

He had a fever of 38.6°, so treated with Dipirone and a warm bath.

Body temperature altered r/t a septic process. For tomorrow the doctor has ordered urinalysis, urine culture and WBC to rule out dia-betes.

Exercise 4 could be an additional exercise to be done in class or could be given as homework

ANSWERS: Any logical, linguistically coherent sentences, following the studied format