Name :Jo-Anne Elders

Student number :45300011

Module code :HSE2603
Assignment :02

Title: Asthma

1.
ACADEMIC HONESTY DECLARATION

Assignment: 02

I understand what academic dishonesty entails and am aware of the Universities’

policies in this regard.
I declare that this assignment is my own, original work. Where I have used someone
else’s work I have indicated this by using the prescribed style referencing. Every
contribution to, and quotation in, this assignment from the work or works of other
people has been referenced according to this style.
I have not allowed and will not allow, anyone to copy my work with the intention of
passing it off as his or her own work. I used and submitted my own work.

Name: Jo-Anne Elders

Student number: 45300011
Date: 10 October 2023

2.
 TABLE OF CONTENT

CONTENT PAGE

1. ASSIGNMENT COVER: Fully completed 1

2. HONESTY DECLARATION with a Selfie photo attached and the upper right corner of the 2
document, signed

3. CHECKLIST FOR THE LESSON PLAN: completed and signed 4

4. NINE (9) LESSON PLANS

4.1 Anatomy 5

4.2 Physiology 8

4.3 Formal lecture 11

4.4 Patient education 17

4.5 Case study 19

4.6 Personal analogy 21

4.7 Group discussion

23

4.8 Role play

25
4.9 Demonstration
28

3.
 CHECKLIST FOR LESSON PLAN
Duplicate this form and attach it to your submission. PLEASE USE

Assessment Criteria Mark allocated

LP1 LP2 LP3 LP4 LP LP6 LP7 LP8 LP9
5
Introduction/Preparation
 Applicable/relevant(critical)
 Capturing attention
Learning Outcomes
 Well formulated (specific,
measurable, assessable,
relevant and time bound)
Pre Knowledge questions
 Relevant
 Whole to particular
Content
 Sequential, relevant, up to
date
 Critical thinking/problem
solving (critical)
 Effective use of questions –
(variety, quantity and timing)
Media for content
 Appropriateness
 Creativity
 Effective use
Summary
 Covering the main points
(critical)
Evaluation
 Covering all outcomes
Assignment
 Relevant
 Clear instruction to students
Neatness
 Cover page
 Student identification
Total
LP: Lesson Plan

Student’s Signature……J.Elders……………
Facilitator’s Signature…………………………………………………
4.
LESSON PLAN: ANATOMY OF THE AIRWAY
Target Group: Second year students, second semester for education and training
as a nurse (General, Psychiatry and Community Health Nursing) and Midwife,
leading to registration (R425, 22February 1985, as amended).
Subject: Anatomy
Them: Asthma
Topic: Anatomy of the Bronchial tree

INTRODUCTION
Media: Realia: Tree branch
When you look at the bronchial tree you will notice that it resembles an upside-down
tree.

Outcomes
Media: PowerPoint
You must be able to:
 Define the bronchi and bronchioles
 Identify the position of the bronchi and bronchioles
 Describe the physical characteristics of the bronchi and bronchioles

5.
 ASSESSMENT OF PRIOR KNOWLEDGE
Media: PowerPoint/ White board
Question:
Identify the structures of the respiratory
system
Answer:
1.Oral cavity
2.Nasal cavity
3.Trachea
4.Bronchi
5.Lung
6.Bronchioles
7. Alveoli
8. Diaphragm

CONTENT
Media: PowerPoint, White board and posters
Definition of the bronchi and bronchioles:
The bronchi are the structure formed when the trachea sub-divides into left and right
bronchi.
The bronchi are the main passageway into the lungs.
The bronchi are plural for bronchus
Position of the bronchi
 The bronchi are found in the thoracic cavity, at about the level of the 5 th
thoracic vertebra

The right bronchus:

The right bronchus is wider, shorter and more vertical than the left bronchus.
It is approximately 2.5 cm long and divides into three branches, one to each lobe
after entering the right lung at the hilum.
Each branch then subdivides into numerous smaller branches called bronchioles.

The left bronchus:

This is about 5 cm long and is narrower than the right.
After entering the lung at the hilum it divides into two branches, one to each lobe.
Within a lobe, tertiary bronchi branch from the secondary bronchi.
Each branch then sub-divides into progressively smaller airways (bronchioles) within
the lung substance.

Physical characteristics of the bronchi

 They are line with ciliated columnar epithelium.
 The bronhi progressively sub-divide into bronchioles, terminal bronchioles,
respiratory bronchioles, alveolar ducts and finally the alveoli.
 The wider passages are called conducting airways because their function is to bring
air into the lungs, and their walls are too thick to permit gas exchange
6.
 The bronchi divide and becomes progressively smaller and its structure changes to
match their function.
 The cartilage is present for support in the larger airways only
 In addition, the bronchi contain cartilage rings like the trachea, but as the airways
divide, these rings become much smaller and plates and eventually disappears at
the bronchiolar level.
 As the cartilage disappears from airway walls, it is replaced by smooth muscles
which allows the diameter of the airways to be increased or decreased through the
influence of autonomic nervous system while regulating airflow within each lung.
 Finally, the ciliated epithelium is gradually replaced with non-ciliated epithelium. And
global cells disappear.

SUMMARY
Definition of the bronchi:
Main passage into the lungs. It the structure that forms when the trachea sub-divides
into a left and right bronchus.
The position of the bronchi:
In thoracic cavity at the level of the 5th thoracic vertebra.
The physical characteristics of the bronchi:
line with ciliated columnar epithelium

ASSESSMENT
Media: PowerPoint
Q: Describe the physical characteristics of the bronchi
A: the thoracic cavity at the level of the 5th thoracic vertebra
ASSIGNMENT
Media: PowerPoint
Q: Describe the structure of the alveoli
Due date:10/10/2023

List of sources
Marieb, EN. & Hoehn, K. 2010. Human anatomy and physiology. 8th ed. St.
Fransisco: Pearsons.
Seeley, RR.,Stephens, TD. & Tate, P. 2010. Anatomy and physiology. New York:
McGraw hill.
Waugh, A. Grant, A. Ross and Wilson. Anatomy and Physiology in Health and
Illness. 12th ed. Churchill Livingston: Elsevier 7.
LESSON PLAN: PHYSIOLOGY
Duration: 10 minutes
Target Group: Second year students, second semester for education and training
as a nurse (General, Psychiatry and Community Health Nursing) and
Midwife, leading to registration (R425, 22February 1985, as amended)
Subject: Physiology
Theme: Asthma
Topic: Mechanism of breathing

INTRODUCTION
Media: Realia, Poster

Our lungs were never taught how to breathe, although there are some things we
need to be taught in order to survive in life. As humans one doesn’t need how to
smell, see or breathe to perform any functions. It is imperative how we comprehend
functioning since it is a mechanism that facilitate our survival.

Objectives
Media: PowerPoint

Students shall be able to:

Describe the process involve in the mechanism of breathing
8.
Assessing prior knowledge
Q: Identify one of the main functions of the respiratory system
A: the respiratory system is taking the oxygen from the atmosphere and expelling
carbon dioxide produced in the cells of the body.
Q: Describe the term respiratory rate
A: it is the total number of breaths or respiratory cycles that occur per minute

CONTENT
Media: Poster of the Alveoli, PowerPoint

Mechanism of breathing

The process of respiration is controlled by

certain centres in the medulla oblongata. During inspiration, the chest cavity
expands, the diaphragm contracts and becomes flatter. The thoracic cavity expands
along its length. Then the Intercostal muscles contract and pull the ribs upwards. The
chest cavity eventually enlarges both interiorly and posteriorly.
Air is then breathed in through the nose and mouth to the lungs which expand
because the atmospheric pressure decreases. Pressure outside the lungs is higher
compared to the inside of the lungs which makes air to rush into the lungs. The
movement of the diaphragm and intercostal muscles during inspiration causes the
pressure to drop as the thoracic cavity enlarges.
The pressure lowers to the level below the atmospheric pressure and this results in
air being drawn into the trachea, bronchi, to bronchioles then the alveoli.
During expiration, the diaphragm and intercostal muscles relax, the air spaces
become smaller and air is forced out and the lungs return to their original size. This
eventually causes the alveolar pressure to exceed the atmospheric pressure and
then air flows from the alveoli to the atmosphere.

9.
Summary
Mechanism of breathing:
During inspiration, the chest cavity expands, the diaphragm contracts and becomes
flatter. With inspiration, the atmospheric pressure is greater than the air in the lungs,
volume of air in the lungs increase and pressure decrease below the atmospheric
pressure. This results in air being drawn into the trachea, bronchi, bronchioles and
then alveoli. On the other hand, during expiration, the diaphragm and intercostal
muscles relax, the air spaces become smaller and air is forced out of the lungs. This
cause the alveolar pressure to exceed the atmospheric pressure and air flows from
the alveoli to the atmosphere. During inhalation, oxygen diffuses through the walls of
the alveoli and capillaries into the red blood cells and to the rest of the body. Carbon
dioxide produced by the bodies tissue returns to the alveoli and diffuses into the air
spaces to be removed by expiration.

Assessment
Media: PowerPoint
Q: Describe the difference between inspiration and expiration
A: Inspiration is an active process as it brings air into the lungs. Expiration is a
passive process as it expels air out of the lungs.
Q: Which of these does NOT occur in expiration
a) Rib cage gets smaller, b) diaphragm relax, c) diaphragm contracts and move
down
A: c) diaphragm contracts and move down

Actualisation
SANC R2598: 2 (k) the facilitation and maintenance of bodily regulatory mechanisms
and functions in a patient. 6 (b)skilled in the diagnosing of individual, family, group
and community health problems.
Assignment
Q: Describe the process of gas exchange in the alveoli
Due date:15/10/2020

SOURCES
Carrie A Brown. Cindy M. Anderson. Lippincott Williams & Wilkins, 2007.
Pathophysiology: Functional Alterations in Human Heath: Philadelphia. 10.
Marieb, EN. & Hoehn, K. 2010. Human anatomy and physiology. 8th ed. St.
Fransisco: Pearsons.
Seeley, RR.,Stephens, TD. & Tate, P. 2010. Anatomy and physiology. New York:
McGraw hill.

LESSON PLAN: FORMAL LECTURE

Target group: Second year students for education and training as a nurse
(General Psychiatry and Community health nursing) and
midwife, leading to registration (R425, 22 February 1985, as
amended).
Subject: Medical surgical nursing
Them: Asthma
Topic: Management of a patient of a patient with asthma

INTRODUCTION
Enter the room while coughing, with difficulties in breathing. Ask the students what
are those signs and symptoms mimic?

OBJECTIVES
Media: PowerPoint
At the end of this lecture the students should be able to:
 Define Asthma
 Describe the nursing management of a patient with asthma
 Identify the risk factors of Asthma
 Describe the pathophysiology of Asthma
 Describe the clinical manifestations of Asthma
 Describe the diagnosing of asthma
 Describe pharmacological management of a patient with Asthma
 Complications of asthma

ASSESSMENT OF PRIOR KNOWLEDGE

Media: PowerPoint, White board and Poster
11
 Describe the main function of the bronchi
The bronchi act as the extension of the windpipe that shuttle air to and from the
lungs, for gas exchange, with oxygen going to the lungs and carbon dioxide leaving
the lungs.

CONTENT
Media: PowerPoint and Poster

Definition of Asthma
Asthma is a prolonged inflammatory disorder of the airways that often leads to
narrowing and production of extra mucus. It is characterised by recurrent episodes of
wheezing, breathlessness, chest tightness and coughing.

NURSING MANAGEMENT OF A PATIENT WITH ASTHMA

Nursing diagnosis, interventions and rationale
Ineffective airway clearance related to bronchoconstriction and bronchospasms and
increased mucus. Ineffective breathing related to impaired lung expansion.

 Assess the patient’s respiratory status, including vital signs, breathing sound,
SaO2, and skin colour at least every 4 hours. Early identification of respiratory
compromise allows intervention before tissue hypoxia is significant.
 Place in fowler’s or high fowler’s position. Encourage frequent position
changes and ambulation as allowed. The upright position promotes lung
expansion and to facilitate the movement of secretions.
 Increase fluid intake to help liquidity or thin the mucus.
 Provide endotracheal suctioning as needed to remove secretions and improve
ventilation.
 Provide a fluid intake of at least 2500 to 3000 ml, per day. A liberal fluid intake
helps liquefy secretions, facilitating their clearance.
 Administer prescribed medications as ordered, and monitor their effects. If the
infecting organism is resistant to the prescribed antibiotic, little improvement
may be seen with treatment. Bronchodilators help maintain open airways but
may have adverse effect such as anxiety and restlessness.
 Administer oxygen as ordered as oxygen increases the alveolar oxygen
concentration.
 Teach patient relaxation techniques such as visualization and meditation as
these help to reduce anxiety and slow the breathing pattern.

Risk factors of Asthma

 Allergens: to things in the air like trees, grass, and weed pollens, mould, animal
dander, dust mites, and cockroach droppings
 Genetic component: having a blood relative (such as parent, grandparents or
sibling) with asthma
 Environmental factors: such as air pollution
12
 Respiratory viruses: in asthma, airways are overly sensitive to viral infections
such as cold
 Emotional stress: anxiety may aggravate asthma symptoms
 Being a smoker or exposure to second-hand smoke: irritates and inflames the
airways
 Food and food-additives: may cause skin irritation that can lead to asthma attack
 Medication: aspirin can precipitate asthma
 Exposure of occupational triggers: exposure to wood dust, chemical fumes and
vapours used in farming, hairdressing and manufacturing.

Pathophysiology of Asthma

Media: PowerPoint/Poster

Inhalation of allergens or irritants occurs. In response to exposure to these triggers,

the bronchi go into contract of bronchospasms. Sensitized mast cells on the
bronchial mucosa release inflammatory mediators such as histamine and
prostaglandins. Resident and infiltrating inflammatory cells also produce
inflammatory mediators such as cytokines, bradykinis and growth factors.
These mediators stimulate the parasympathetic receptors and bronchial smooth
muscle to produce bronchoconstriction and also increase capillary permeability
which allows plasma to escape and lead to mucosal oedema.
Inflammation soon follows, which further narrows the airway and excessive mucus
production, which leads to coughing and other breathing difficulties. This results in
asthma attack. The attack is prolonged by exposure to the trigger and inflammatory
cells are activated and damage the airway. 13
Limited expiratory airflow traps air in the narrowed airway, trapped air mix with
inspired air in the alveoli reducing its oxygen tension and gaseous exchange across
the alveolar capillary membrane. This results in alveoli distension, reducing blood
flow and affect gaseous exchange further.
CLINICAL MANIFESTATION
Media: PowerPoint and white board
 Chest tightness
 Cough
 Dyspnoea
 Wheezing
 Tachypnea and tachycardia
 Anxiety
 Use of accessory muscles
 Respiratory retraction

Diagnosis
 Arterial blood gases which may show hypoxia with low PCO2 and mild respiratory
alkalosis and elevated PH.
 Skin test may be done to identify allergens that might trigger the attack
 Lung function test used to evaluate the degree of airway obstruction.
 Chest x-rays may also be performed
 Spirometry- this test is used to assess how well your lungs work by measuring
how much air you inhale and how quickly and how much air you exhale.

Pharmacological management of a patient with asthma

Prevention and long-term control are key in stopping an asthma attack. Treatment
usually involves learning to recognise the triggers and taking steps to avoid them.
Pharmacological management also depends on the patients age, symptoms and
asthma triggers and what works. There are two general classes of asthma
medication namely quick relief medication such as bronchodilators for immediate
relief of asthma symptoms and long acting control medication to achieve and
maintain control of persistent asthma

14
Quick relief medication Long acting control medication
 is used for raped ease of  keep asthma under control on a day to day basis
symptoms during an asthma  Corticosteroid medications have a relatively low ris
attack of side effects and are generally safe for long-term
 they open swollen airways that use.
limits breathing  Types of long acting control medication include:
 quick relief bronchodilators  Rhinocort, Pulmicort, Flovent, Theophylline is daily
include Ventolin, Asthavent and basis and helps keep the airways open by relaxing
oral or intravenous the airways.
 corticosteroids (prednisone).

Complications of asthma
Badly controlled asthma can lead to:
 Fatigue
 Permanent lung problems such as high blood pressure, weight gain or diabetes
 Psychological problems such as anxiety and depression
In rare cases a number of serious respiratory conditions like:
 Respiratory failure (dangerously low oxygen or dangerously high carbon dioxide
in the blood)
 Asthmaticus (severe asthma attack that do not respond to treatment)
 Pneumonia (infection of the lung)
 Atelectasis (partial or incomplete inflation of the lung)

SUMMARY
Media: PowerPoint
We discussed the following aspects:
 Definition of Asthma:
Asthma is a prolonged inflammatory disorder of the airways that often leads to
narrowing and production of extra mucus
 Risk factors of Asthma:
Allergens, obesity, smoking, air pollution, medication, food additives,
emotional stress, genetic components
 Pathophysiology of Asthma:
Exposed to triggers, airway inflamed. Hypersecretion of the mucosa and
airway muscle constrict causing swelling of the bronchial membranes.
Narrowing of the passages occur resulting in shortness of breath.
 Clinical manifestations:
Cough, tightness of chest or pain, dyspnoea, wheezing, anxiety, tachycardia
 Diagnosis:
Arterial blood gases, allergy skin test, lung function test, chest x-rays and
spirometry 15
 Nursing and pharmacological management:
Monitor vital signs, fowler or semi-fowler’s position, endotracheal suctioning,
increase in fluid intake, administer prescribed medication and oxygen. Lastly,
teach relaxation and meditation techniques.
Long acting control medication to keep asthma under control on a day to day
base and quick relief medication such as bronchodilators for quick relief of
symptoms.
 Complications of asthma:
Badly control; fatigue, prolonged lung problems, other medical conditions.
Serious conditions: respiratory failure, asthmaticus, pneumonia, atelectasis
Actualisation
SANC R2598: Scope of practice; The diagnosing of a health need and the
prescribing, provision and execution of a nursing regimen to meet the need of a
patient or group of patients or, where necessary, by referral to a registered person.
Assessment
Media: PowerPoint
Q: Define asthma
A: Asthma is a prolonged inflammatory disorder of the airways that often lead to
narrowing and production of extra mucus
Q: List five risk factors for a patient with asthma
A: Allergens, Obesity, Smoking, Medication, Air pollution

Assignment
Describe the pharmacological management of a patient with asthma (20 marks)
Due date:16/10/2020

Sources
Berman, A. & Synder, S. 2014. Kozier & Erb’s fundamentals of nursing: concepts,
process and practice. 9th ed. New Jersey: Pearson.
LeMone, P. Burke, K. & Bauldoff, G. 2014. Medical-Surgical nursing: Critical
thinking in patient care. New Jersey: Pearson.
Smeltzer, S. Bare, B. & Hinkle, J. 2014. Brunner & Suddarth textbook of Medical and
Surgical Nursing. 13th ed. Lippincott and Wilkins.
Waigh, A. & Grant, A. 2014. Anatomy and physiology in health and illness. 12 th ed.
New York: Elservier

16

LESSON PLAN: HEALTH

EDUCATION FOR PATIENT
Target group: A group of patients with pneumonia who came for treatment
Subject: Medical surgical nursing
Theme: Asthma
Topic: Health education
Outcomes
At the end of the session:
The patient should be able to modify lifestyle in order to prevent complications of
asthma.

Introduction
Good day ladies and gentleman! Welcome to this education session and allow me to
introduce myself. I am Jo-Anne Elders the facilitator of the day. I’m glad to have you
all here to listen to me.
Today I will be informing you about the things to do in order to promote quality
management and the preventing of complications of asthma.

Prior knowledge
Media: poster

Content
Media: Pamphlet – about asthma management tips

 Patient should stop smoking as it aggravates the problem

 Try to avoid exposure to irritants such as dust, pollens and polluted areas
 Be sure to always have a quick-relief inhaler with you
 Refrain from vigorous exercises as there can be activity intolerance
 Patient should take deep breaths and cough several times each hour to loosen up
mucus and get it out of the lungs
 Don’t sleep or lie on cloth-covered cushions or furniture
 Use a vacuum with a double layered bag or filter
 Use dust proof covers on your mattress and pillows and wash the sheets and
blankets on bed once a week in hot water
 Take your asthma medication exactly as your provider explained to you
 Drink a lot of water and fluids as this thin and loosen up the mucus in the airway
 Pets with fur or feathers are triggers for some people, therefore, keep pets out of
your bedroom and off your bed
 If you have pets, have someone bathe them every week and brush them regularly
17

Summary
 Stop smoking
 Avoid irritants
 Have inhaler always at hand
 Avoid vigorous exercises
 Deep breaths
 Adhere to asthma treatment
 Keep pets outside of house
 Use dust proof covers on your bedding
 Drink water and fluids
 Asked someone to vacuum your house
 Don’t sleep or lie on cloth-covered cushions or furniture
 Wear a dust mask if dusting
 Cover the air vents in bedroom
 Ask someone else to bathe your pets regularly

Assessment
Let’s now list the things we have talk about that help us to prevent asthma attack and
prevent complications

Conclusion
Thank you for listening and for giving me the opportunity, we should all try and
implement all the things we have talk about for a better life and management of
asthma.

Sources
GEYER, N. MOGOTLANE, S. & YOUNG, A. 2013. Juta’s Manual of Nursing Volume
1 (2nd Edition).
WATSON, J.E. 2015. Medical-Surgical Nursing and Related Physiology (2 nd Edition).

18

LESSON PLAN: Case Study

Target Group: Second year students, second semester for education and
training as a nurse (General, Psychiatry and Community and
Community Health Nursing) and Midwife, leading to registration
(R425, 22 February 1985, as amended).
Subject: Professional ethic and practice
Theme: Asthma
Topic: Patient care against hospital policy

OUTCOMES:
Media: PowerPoint
After the lesson the student must be able to:
 Distinguish relevant and irrelevant information
 Define the real problem and list sub problems
 Generate a variety of ideas/solutions
 Examine their own and others view points
 Recognise personal values that may influence their ideas and decisions
 Explore ethical principles that nurses have to consider
 Reflect on the possible consequences of ideas/solutions
 Evaluate the final decision by debating the advantages and disadvantages and
effectiveness in the specific situation

CONTENT
Scenario:
A patient is brought by his family and admitted in the medical ward with dyspnoea,
coughing, and respiratory distress. On examination, the test such as arterial blood
gases, lung function test, chest x-ray and spirometry are done. The results obtained
confirm that the patient is asthmatic. The results are explained to the patient and he
is told that he has to start treatment as soon as possible. The patient is however in
denial, saying it is not possible because no one in his family has ever suffered from
such. He adds that he is possibly bewitched and would rather seek for alternatives
from traditional healers. The professional nurse and doctors advise the patient that
its very crucial that he start his treatment as soon as possible to avoid more
complications. The patient however insists and forcefully demands for discharge.
Putting the patients’ condition into consideration, patient is in respiratory distress and
must be put on oxygen and start treatment as soon as possible.
Will you make him sign refusal of treatment forms and discharge him?
But his health is at risk, will you admit the patient against his wish and violate his
right to making independent decisions?
How will you handle this situation?

Identify the parameters involved in the situation

1 The parameters involve the following
The problem: the problem in this case is to save life of a patient who is in respiratory
distress and denial of having been diagnosed with asthma. 19
The people who are involve in the decision
Includes:
 The patient
 The family
 The healthcare providers: nurses and doctors
2 Identify the problem
Facts are given in the scenario
The problem is that the patient is diagnosed with asthma but he is in denial and
doesn’t want to take treatment but rather prefers assistance from a traditional healer.
Sub-problem
The sub-problems are forcing the patient to take treatment and be hospitalised
3 Generation of ideas or alternative solutions/possible solutions
Students are asked to brainstorm ideas but not having judgment
 The patient should be given treatment
 The nurses should respect the patients’ right to autonomy
 Consider the patient’s responsibilities and rights during their care

4 Evaluation of alternatives
Positive and negative consequences for each solution are discussed as well as the
ethical issue. Ethical principles and the patients’ rights are integrated with each
solution. The consequences of each solution are also weighed to find the appropriate
solution.

Decision making
The group should select the solution with the more positive and less negative
consequences for this situation.

Evaluation of decision
Now let us look at our outcomes and see if we met them all
Did we:
 Identify the major problem and sub-problems
 Generate ideas that leads to solutions
 Identify values that can affect the decisions and their ideas
 Examine ethical principles relating them to the problem and the suggested
solutions
 Evaluate the alternative solutions by discussing the consequences of each
solution and then weigh them to find the appropriate solution.
 Evaluate final decision be debating the advantages, disadvantages and the
consequences of each solution.

SOURCES
Mulaudzi, FM. Mokoena,JD &Troskie R. 2010. Basic nursing ethics in practice. Cape
Town: Heinemann
Muller, M.2009. Nursing dynamics. 4th ed. Cape Town: Heinemann 20
Jooste,K. 2010. Principles and practice of nursing and health care: Ethos and
Professional Practice,

LESSON PLAN: PERSONAL ANALOGY

Target group: Second year students, second semester for education and
training as a nurse (General, Psychiatry and Community and
Community Health Nursing) and Midwife, leading to registration
(R425, 22February 1985, as amended).
Subject: Medical nursing
Theme: Asthma
Topic: Alveoli
Outcomes
Media: PowerPoint, Poster of the Alveoli
You must be able to:
Describe the structure of the alveoli
Describe the functions of the alveoli

Content
Media: Poster of the alveoli

Realia: Have a bucket of grapes.

Good day. You are probably wondering what the grapes are for. Well, if you notice
the grapes are all stuck together, like a family, like siblings. So just like the alveoli,
this grape- like structures are pouching along the walls of the alveolar sacs and
alveolar ducts. We are always clustered in bundles and perform our roles
communally. We belong to a family called the respiratory system and here we have
sisters and brothers namely: the nose, larynx, pharynx, trachea, bronchi, bronchioles
and lungs.
We don’t work in isolation but rather work hand in hand like siblings, that is the
bronchi and bronchioles who are closely attached to us. We live inside the lungs with
each other, more like conjoined twins, forming the terminal part of the bronchial tree.
We are heavily clustered, and we are about 300 million in the adult lung.
The surface also consists of respiratory membrane: which is a thin membrane
consisting of the squamous alveolar epithelial cell, squamous pulmonary capillary,
endothelial cell and their fused base membranes are about 0.5µm thick for effective
gaseous exchange during respiration. 21
We are privileged to be in the human body since we offer loyal services that no other
member of the body can, by providing you with oxygen and keeping all other organs
alive. We love and cherish man and that is why we offer our services with utmost
selfless, obedience and love.
Follow-up discussion
Obtain feedback from the students with regard to how the lesson was and if the
lesson objectives were met from the analogy.
Assessment
Define the alveoli
Describe the characteristics of the alveoli

Sources
Brown, C.A. Anderson, C.M. Williams, L.& Wilkins. 2007.
Pathophysiology:Functional Alterations in Human Health: Philadelphia
Marieb, EN. & Hoehn, K. 2010. Human anatomy and physiology. 8th ed. St.
Fransisco: Pearsons
Seeley,RR. & Stephens, TD. & Tate, P. 2010. Anatomy and physiology. New York:
McGraw hill.
Waigh, A & Grant, A. 2014. Anatomy and physiology in health and illness. 12th ed.
New York: Elservier.
22

LESSON PLAN: Small Group Discussion

Target group: Second year students, second semester for education and training
 as a nurse (General, Psychiatry and Community and Community
Health Nursing) and Midwife, leading to registration (R425,
22February 1985, as amended).
Subject: Ethics and professional practice
Theme: Asthma
Topic: Ethical issues

OUTCOMES
Media: PowerPoint
Students shall be able to:
 Debate whether the patient should proceed to smoke or not
 Discuss the applicable ethical issues concerning care of this patient
 Describe the patients’ rights charter that concern this particular patient
Physical environment
Classroom with chairs and no tables in between with group members facing each
other

INTRODUCTION
Psychological preparation
As an icebreaker, students to introduce themselves and quickly talk about their
hobbies and give one interesting fact about themselves! Whilst introducing
themselves students will be assured that the educator will withhold judgement
expressed during the group discussions and will be encouraged to feel free to
participate in the discussions.

Working Rules and Norms

Everyone must participate and no student will be able to dominate the discussion
and when getting off the point, the educator will bring them back to focus on the
relevant issues to be discussed.

Stages in Group Discussion

Monitor stages, do not provide answers

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Problems that might be encountered
Domination by some, shy students who do not participate, discussion may be side
tracked.

Ending the discussion

Students will be warned 10 minutes before the end of the discussion. A summary of
the main points made by the students will be read by them.
CONTENT
Media: PowerPoint

Scenario
A 29-year old patient, known as an asthma patient, is admitted in the unit with an
asthmatic attack. The patient was accompanied by his wife. Patient is put on oxygen
immediately and nebulising is administered afterwards to reduce symptoms. After a
few days, being hospitalise he becomes much more stable, and mobilising more in
the ward. He walked up to the student nurse that was taking care of him and asked
her if he can go out for a smoke break. He adds that he doesn’t feel well because he
hasn’t been able to smoke in the past 3 days. The student nurse shows empathy and
is glad that he was honest, then gave him education about the importance of the
medication and advises him that he should stop smoking. The patient was not happy
and screams on top of his voice that he has rights and knows what he is doing,
walking closer to the student nurse, the professional nurse in charge heard the
screams and intervene.

How will you deal with the situation?

Will you just allow this patient to just smoke despite the previous asthmatic attack?
Will you request the family to convince the patient to gradually reduce smoking?
Or will you use force to stop the patient from smoking?

Aspects to be discussed
 Can the patient be told to forcefully quit smoking?
 What does the hospital policy say about such circumstances?
 What about the possibility of violating the patients’ rights?
 What if the patient is allowed to smoke, and gets another asthmatic attack?
 What about the patient’s family, how would this situation affect them?

CONCLUSION
Let’s go back to the outcomes and see whether they have been met and all points
are dealt with.

24
SOURCES
Mulaudzi, FM. Mokoena,JD &Troskie R. 2010. Basic nursing ethics in practice. Cape
Town: Heinemann
Muller, M.2009. Nursing dynamics. 4th ed. Cape Town: Heinemann
Jooste,K. 2010. Principles and practice of nursing and health care: Ethos and
Professional Practice, management, staff development and research. Pretoria: Van
Schaik
University of South Africa. Department of Health Studies. 2011. Only Study guide for
HSE2603.Pretoria.
LESSON PLAN: Role Play
Target Group: Second year students, second semester for education and training
as a nurse (General, Psychiatry and Community and Community Health Nursing)
and Midwife, leading to registration (R425, 22February 1985, as amended).
Subject: Professional practice
Theme: Asthma
Topic: Effective patient communication

OUTCOMES:
Media: Transparency
After the lesson the student must be able to:
 To ensure the patients fears are allayed
 Displays empathy to the patient about his/her fears of having bloods taken
 Show respect to the patient at all times
 Demonstrate effective communication and listening skills
 Be able to handle a situation
 Identify the impact of poor interpersonal communication skills

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Scenario
A 65-year old patient is admitted in a medical unit with an acute asthmatic attack. On
examination, the patient is very unstable, breathless and dyspnoeic. The emergency
team decides to carry out immediate nebulisation along with other intervention on the
patient. After a few hours, the patient gets more stable. He is however still
hypoxic since the mucous membranes are cyanosed. The patient is later put on
oxygen in order to improve the body’s oxygen saturation. The patient however
constantly pulls the oxygen mask from his nose saying its uncomfortable, but finds it
impossible to breath on his own. The staff nurse explains to him that he needs to be
on oxygen for some time in order to improve oxygen saturation and reduce possible
complications and respiratory failure which is life threatening. The patient however
refuses to listen and insist to go home.
The staff nurse gets angry and tell the patient that he will delay his recovery and will
be kept in the hospital longer if he doesn’t cooperate.
You passing the patients room and listen to the staff nurse attitude towards the
patient. You asked to assist the patient by entering the room and confronting the
patient politely about the reason for giving him oxygen. You also monitor the
saturation and explain the ranges to the patient. He calms down; you call the staff
nurse to apologise to the patient. The nurse apologise for not being patient, and not
showing empathy towards her patient. The atmosphere is more settled now and the
situation is back to normal as the patient becomes very cooperative.

Patient:
You keep on removing the mask. You feel more anxious with the mask on.
Staff nurse:
You get very angry and tell the patient not to remove the oxygen mask again since
this might cause some complications. You tell the patient that his actions will lead to
reduced recovery and longer period of hospitalisation.

Second year student:

You go in to attend the situation. You sit with the patient and explain the reason for
giving the oxygen. You also monitor the saturation and explain the ranges to the
patient. The patient is more calm and understand the situation better; you call the
nurse to apologise.

Follow up discussion
De-rolling
All the role players explain how they felt during the argument.
Everyone should explain why they acted the way they did in the role play.

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Attitude and Emotions
What were the Levels of communication used by the student nurse?
Was empathy and respect shown towards the patient?
Did the student pay attention to the patient?
Did the student allow the patient to express herself?

Attitude of the third year student nurse

Did the student clarify the reason for giving oxygen to the patient?
Did the student show care and respect to the patient?
What was the patient’s response after the discussion?

SOURCES
Mulaudzi, FM. Mokoena,JD &Troskie R. 2010. Basic nursing ethics in practice. Cape
Town: Heinemann
Muller, M.2009. Nursing dynamics. 4th ed. Cape Town: Heinemann
Jooste,K. 2010. Principles and practice of nursing and health care: Ethos and
Professional Practice, management, staff development and research. Pretoria: Van
Schaik
University of South Africa. Department of Health Studies. 2011. Only Study guide for
HSE2603.Pretoria.

27
LESSON PLAN: DEMONSTRATION
Target group: Second year students, second semester for education and
training as a nurse (General, Psychiatry and Community and
Community Health Nursing) and Midwife, leading to registration
(R425, 22February 1985, as amended).
Subject: Medical surgical nursing
Theme: Asthma
Topic: Administration of inhaler

OUTCOME
At the end of the session the student should be:
Explain the procedure to the patient
Able to competently administer an inhaler
Avoid medical legal hazards
Educate the patient on how to self-administer

Introduction
Patients that is diagnosed with asthma do not always have the knowledge to know
when they will have the asthma attack.
That is why it is important to give education to the patient with the first visit and again
after that, until they understand the importance of adherence and to be competent in
administration of inhalers to provide fast acting relief. Asthma inhalers works by
delivering medication to the lungs in the form of a bronchodilator.
The drug (that comes in a powder form) cause the bronchial muscle to relax, more
air moves into the body and opens the airway, if it is administered the correct way.

Administration of inhaler
Preparation
 Wash hands and sanitise
 Check the expiry date of the asthma pump
 Check the mouth piece to see if it is clean
 Determine the amount of medication remaining in the inhaler canister
 Test the inhaler by doing a “test fire”
 Review instructions and technique to be used as per manufacturer’s instructions
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Procedure
 Introduce yourself to the patient
 Identify the patient
 Check the prescription to ensure correct medication, correct dose and the correct
patient receive it.
 Explain the procedures and ask permission
 Wash hands or disinfect it to prevent cross infection
 Ensure privacy
 Ensure the canister is firmly and fully inserted in the inhaler
 Remove the mouthpiece cap. Holding the inhaler upright shake the inhaler
 vigorously for 3 to 5 seconds to mix the medication evenly.
 Ask the patient to exhale comfortably
 Hold the canister upside down

 Put the mouthpiece far enough into the mouth

 Close the mouth, press down once on the canister and inhale slowly of 3 to 5
 seconds deeply through the mouth
 Hold your breath for 10 seconds or as long as possible to allow it to reach
deep airways
 Remove the inhaler from mouth
 Exhale slowly through pursed lips
 Repeat the inhalation as ordered
 Rinse mouth after wards to avoid irritation by remaining medication
 Clean the mouthpiece with mild soap and water
 Store the canister at room temperature
 Wash hands
 Record and assess for any abnormalities

Summary
Allow students to ask questions
Students are allowed time to practice

SOURCES
GEYER,N. MOGOTLANE, S. & YOUNG, A. 2013. Juta’s Manual of Nursing Volume
1 (2nd edition).
WATSON, J.E. 2015. Medical-Surgical Nursing and Related Physiology (2 nd edition)

Name: Jo-Anne Elders

Student number: 45300011 29