DEPARTMENT OF NURSING UNIVERSITY COURSE: Topic: I.

TOWSON

NURS 351 Nursing Practice I: Health promotion Across the Life Span Weight Bearing Exercises: Prevention of Bone Loss and Muscle Atrophy Client Identifying Data: Client: The elderly, ranging from young-old to old-old adults. Setting: Nursing Facility Developmental Stage: Integrity vs. Despair

II.

Nursing Diagnosis: Knowledge deficit related to prevention of osteoporosis and muscle atrophy. Long-Term Nursing Goal (Outcome): After 15 minutes of teaching, the clients will understand the different methods to prevent bone loss and muscle atrophy, and be able to perform weight bearing exercises.

III.

Short-term Nursing Goals (Outcomes): After completing the 15 minute teaching session, clients will be able to a. Verbalize the importance of bone and muscle strength. b. Explain what Osteoporosis is. c. Understand what weight-bearing exercise is. d. Verbalize methods, other than weight-bearing exercises, to help prevent osteoporosis. e. Correctly perform weight- bearing exercises that were taught.

IV.

Related Content a. Explain importance of bone and muscle strength (Exercise sampler: building hip strength, 2005) 1. Increased prevention of falls 2. Improved balance and coordination

b. Identify what Osteoporosis is (Wrotny, 2005) 1. Human bone disease 2. Many contributing factors; disuse, smoking, female 3. Low mineral density 4. Deterioration of the bone 5. Increased risk of fracture c. Identify what weight bearing-exercise is (Exercise sampler: building hip strength, 2005) 1. Exercise/activity working against gravity 2. Strengthens the bones and muscles 3. Stimulates growth of new bone tissue 4. Walking, jogging, climbing stairs d. Identify ways other than exercising to prevent osteoporosis (Wrotny, 2005) 1. Adequate Vitamin D- The body makes Vitamin D after having the skin exposed to sun light. Ten to fifteen minutes per day. 2. Adequate Calcium- Drink milk; non-fat, skim, or whole. IV. Related Content: continued e. How to perform hip extension exercise (Exercise sampler: building hip strength, 2005) 1. Obtain one chair and two ankle weights that suit your preference 2. Wrap one ankle weight around each ankle and stand behind chair 3. With your hands on the back of the chair, raise one leg straight behind you, and lift as high as possible without bending the knee 4. Pause, then slowly lower your leg and return to starting position

5. Repeat 2 sets of 8 to 15 repetitions f. How to perform a front lunge exercise (Exercise sampler: building hip strength, 2005) 1. Put the chair to your left side with left hand holding on to it 2. Step forward with right foot and plant right heel on the ground 3. The right knee should be directly above the right ankle 4. Hips should not go below the knee 5. Pause, and then push back forcefully. 6. Two sets of 8 repetitions on each leg. g. How to perform a dumbbell squat exercise (Exercise sampler: building hip strength, 2005) 1. Obtain two dumbbell weights that suit your preference 2. Hold weight in each hand 3. Slowly bend the knees and lower your buttocks to about 8 inches 4. Pause, and then slowly return to a straight-standing position 5. Perform two sets of 8 to 15 repetitions V. Methods Our group integrated a variety of weight-bearing exercises that would promote range of motion. Keeping in mind geragogy, we will attempt to stimulate elders to learn new concepts (Kozier, Erb, Berman & Snyder, 2008). We took into account the developmental stage of the learners and incorporated safety precautions to fit their needs. a. Before we begin the presentation, we will make sure to provide a social, emotional, and physical environment conductive to successful learning. Our ideal environment will have limited distractions, adequate lighting and ventilation, and provide physical and psychological comfort to the learner (Kozier, et al, 2008).

b. To begin, we will introduce ourselves and establish a positive teacher-learner relationship (Kozier, et al, 2008). Then, we will present our purpose and learning objectives to explain what the viewer can expect to learn from our presentation. c. First, we will start the informative part of the lecture. It will explain what weight-bearing exercise is and the importance of maintaining bone and muscle strength to prevent osteoporosis. d. To accommodate different learning styles, we not only wanted to provide a lecture for the auditory learners, but also include a demonstration for the visual learners. The demonstration will include one group member as the speaker, one group member as the nurse, and one group member as the patient. Group members will act out a real life scenario and perform the exercises. e. The acting skit will enable the viewers to see the correct technique of each weight-bearing exercise. It will also serve as a multisensory teaching strategy because perception is influences by the senses (Kozier, et al, 2008). f. After our visual demonstration concludes, we will determine the clients readiness to get up and practice the exercises. To do so, we will assess the learners motivation to actively get involved (Kozier, et al, 2008). g. If the viewers are ready, we will encourage them to imitate our exercises. According to behaviorism theorist Skinner, it is essential for learners to have this trial and error period to reflect on what they learned. Behaviorism theorist Bandura, adds that most learning comes from observational learning like modeling (Kozier, et al, 2008). h. Group members will promote proper technique and use positive reinforcement such as praise and encouragement to foster repetition (Kozier, et al, 2008). i. We will then summarize the key points we want our viewers to remember from the presentation. Repetition facilitates retention of newly learned material so key facts will be remembered longer (Kozier, et al, 2008). To conclude the presentation, we will have a question and answer that will enable the viewers to clarify issues. We will promote discussion to encourage the viewers to seek answers to concepts that were not fully understood.

j.

VI. Teaching and Learning Principles: a. The learner will be more likely to understand and remember the information because it directly relates to them and their daily functioning (Kozier, et al, 2008). b. By actively participating and modeling us, the students will not only involve all of their senses but they will have a personal reference to recall (Towson University Department of Nursing, 2010). c. Positive reinforcement helps motivate the learner to remember the information and perform the skills correctly (Kozier, et al, 2008). d. The environment was conducive to learning because it provided a relaxed and comfortable atmosphere (TU Department of Nursing, 2010, pg. 16). e. We will present the information in an entertaining way in form of a comedic skit in order to promote attentiveness and a positive attitude towards learning. f. We will have the students practice the skills as a group in order to practice the skills and be physically involved in the presentation. g. To help the students better understand to our topic, we will provide simple definitions of osteoporosis and weight bearing exercises and provide both verbal and visual examples (Towson University Department of Nursing, 2010). VII. Evaluation: By the end of the teaching session, the clients should be able to answer the questions listed below. a. Why are bone and muscle strength important? b. What is osteoporosis? c. What are weight-bearing exercises? d. What additional methods can help prevent osteoporosis? The students will also be able to correctly demonstrate and instruct how to perform weight bearing exercises. In order to evaluate how well the students learned teaching methods for weight bearing exercises, we will have the perform the exercises as a group while our group members critique.

VIII. Resources: Exercise sampler: building hip strength. (2005, December). Harvard Womens Health Watch, 13 (4), 4-6. Retrieved from CINAHL Plus with Full Text. Kozier, B., Erb, G., Berman, A., & Snyder, S. (2008). Fundamentals of nursing: Concepts, process, and practice. New Jersey: Pearson. Towson University Department of Nursing. (2010). Health promotion across the life span. NURS 351: Nursing Practice I: Health Promotion Course Packet (pp. 718). Towson, MD: Towson University Bookstore. Wrotny, C. (2005). Osteoporosis: what women want to know. MEDSURG Nursing, 14(6), 405-7,415. Retrieved from CINAHL Plus with Full Text.