Patient recognition of need for help. Resources provided on limited basis as
acceptable by patient.Initiation of nurse-patient relationship.
1. Assessment of prior knowledge and experiences.
2. Assessment of readiness to learn.
3. Involvement of patient in developing mutual
teaching goals.
4. Presentation of educational materials.
5. Discussion of pre-operative procedures.
6. Different options for diversions; patient
pathways.
Patient identifies problems to be worked on.
The patient has some working knowledge of the health care needs.
Trust level with nurse is in early stages and the patient will selectively begin to assimilate knowledge and accept interactions with nurse.
Imitative behavior begins and gradually switches to a creative constructive response.
1. Demonstration/return demonstration of neo-bladder care.
a. Bladder irrigation.
b. Maintaining tube patency.
c. Care and cleaning of equipment.
d. Knowledge of emergency situations.
2. Discussion on nutrition.
a. Re-assessment of prior eating habits; reduce “empty” calories.
b. Six small meals daily with attention to five food groups.
c. Fluid requirement 2 quarts daily.
3. Development of activity plan.
a. Rationale for exercise. b. Intensity and duration.
Comfort and trust level established. Patient takes advantage of services
offered by nurse and benefits from
relationship with nurse.
Some vacillation between dependence on
nurse and self-direction.
Focus on incorporating learned experi-
ences into future health status and quality of life (QOL).
1. Reaffirm patient’s knowledge and expertise. 2. Promote independence.
3. Identify available community resources.
4. Role playing.
5. Present theoretical complex situations and have patient problem solve.
Prior goals have been met and new goals are formed.
Patient experiences a sense of security because needs have been met in a timely manner.
Increase in self-reliance and decreased reliance and identification with urologic nurse.
1. Encourage participation in support group for continent diversions.
2. Identify QOL issues and discuss options. a. Nocturnal incontinence.
b. Sexual changes.
c. Alterations in body image.
d. Anxiety about cancer diagnosis.