The document focuses on competency-based instruction in medical-surgical nursing, specifically regarding the care of post-operative patients who have undergone below-the-knee amputation due to diabetes mellitus. It outlines declarative and procedural knowledge required for nursing care, including assessments, complications, pain management, mobility rehabilitation, and health education strategies. The learning outcomes emphasize preparing nursing care plans, implementing appropriate interventions, and assessing the effectiveness of the care provided.

1. Competency - based Instruction (FACILITATING LEARNING) Presented by: Ellen Brigoli Nonita Legaspino Dave Jay Manriquez Rowell Panuncial

2. Subject: Medical-Surgical Nursing (Ortho) Degree: MN-MSN UNIT: Nursing Care Management ( Care of client with Physiologic and Psychosocial alterations ) Caring of Post/Op patient who undergone Below -the -knee Amputation due to Diabetes Mellitus in preventing Post/Op complications and its psychosocial effects on the client.

3. Declarative Knowledge Declarative Knowledge Declarative Knowledge Declarative knowledge a.1 To define Amputation a.2 To identify the risk factors/causes that leads to amputation a.3 To describe the levels of Amputation a. Local b. Systemic a.4 To compare the two types of Amputation a. Open (guillotine) b. Closed (flap) a. Identify anatomic and physiologic factors that contributes amputation 1. Assessment and Management of patients who undergone Below-the-Knee Amputation Learning Outcome Instructional Objectives Elements Competencies

4. Declarative Knowledge Declarative Knowledge b. To identify the complications that may occur after an amputation a. Infection b. Delayed healing c. Phantom limb pain and Phantom limb sensation d. Hemorrhage c. To distinguish each of the diagnostic tests according to appropriate functions a. Doppler flowmetry b. Segmental blood pressure determination c. Transcutaneous partial pressure O2 reading d. Angiography e. Blood Chemistry f. Vascular Doppler Ultrasonagraphy b. Recognize the possible complications of Post/Op Below-the-Knee Amputation c. Review different laboratory exam/diagnostic appropriate for Post/Op Below-the-Knee Amputation Learning Outcome Instructional Objectives Elements Competency

5. Declarative Knowledge a. To prepare a specific Nursing Care Plan for a patient with an amputation given a hypothetical situation a. Pain Control a. 1 Pharmacologic interventions a.2 Non- pharmacologic interventions b. Physiological care (Post-Op) c. Care of Stump d. Mobility and Rehabilitation e. Discharge Planning a. Identify functional Nursing Diagnosis that is applicable 2. Formulate a Nursing Diagnosis for Post/Op patient with Below-the-Knee Amputation Learning Outcomes Instructional Objectives Elements Competency

6. Declarative Knowledge Declarative Knowledge Declarative Knowledge Declarative Knowledge Declarative Knowledge a. To enumerate the different interventions to reduce anxiety b. To perform techniques on Stump care c. To practice the correct use of crutches and crutch-walking in mobilization a. one-point gait b. two-point gait c. three-point gait d. four –point gait e. swing to f. swing through d. To implement nursing interventions that is appropriate for the patient condition e. To assess the effectiveness of nursing interventions to the expected outcome a. Explains interventions to patients and family b. Identify proper techniques on stump care c. Practice the correct use of crutches and crutch-walking in mobilization d. Implements nursing interventions that is safe and comfortable e. Performs nursing activities effectively and in a timely manner 3. Implements planned nursing care to achieve identified outcomes Learning Outcome Instructional Activities Elements Competency

7. Procedural Knowledge Procedural Knowledge Procedural Knowledge Procedural Knowledge Procedural Knowledge a. To assess patient health needs, like changing the limb dressings after 3 days or whenever the dressings is very soak already with blood b.1 To assess for any signs of hemorrhage at the limb dressings b.2 To assess for pain such as phantom limb pain and psychologic effect of BKA such as phantom limb sensation which is normal to amputated patient b.3 To place patient in supine position and place a side rail on the affected side to prevent falls b. 4 To assess patient diet by giving him the right kind of foods, like avoiding sugars, promoting fiber rich foods and avoiding alcohol a. Identify the first and the least priority needs of the patient b. Determine the appropriate nursing care to be provided of Post/Op BKA patient 4. Setting priorities in nursing care of Post/Op BKA based on patients needs by collaborating with patients and other members of the health team Learning Outcome Instructional Activities Elements Competency

8. Declarative Knowledge Strategic Knowledge Strategic Knowledge Strategic Knowledge a. To assess the patient ability to learn by asking his/her carrier education b. To define patient and family major concerns or fears to learn about any misinformation that may be unnecessarily contributing to feelings of anxiety c. To state the importance of listening to the health teaching rendered in promoting wellness d. To assess the effectiveness of health education rendered through patient and family’s positive regards (like letting them ask questions, clarifications regarding his/her condition) a. Determine the patient ability to learn with his/her carrier education b. Defines relevant information c. State the importance of having a health teaching in promoting wellness d. Monitors patient and family’s responses to health education 5. Develops health education plan by doing bedside health teaching involving the patient and immediate significant others in explaining his conditions and some measures to prevent complications based on assessed and anticipated needs Learning Outcomes Instructional Objectives Elements Competency

9. Thank You Very Much FIN….