. Does the urine have an odor?
. Is it dark amber or bloody?
. Is it cloudy; does it have sediment
l Is there pain, burning, or difficulty
. Does the patient have diarrhea, soft
stools, or constipation?
. What is the color of the stool?
. Does it contain blood, pus, fat, or
. Does the patient have hemorrhoids,
fistulas, or rectal pain?
l Vagina or Penis:
. Are there ulcerations or irritation?
. Is there a discharge or foul odor?
. If there is a discharge present, is it
bloody, purulent, mucoid, or
watery? What is the amount?
. Is there associated pain?
. If pain is present, where is it
. Is it constant or intermittent?
. Is it tingling, dull, aching, burning,
gnawing, cramping, or crushing?
. Food and Fluid Intake:
. Is the patients appetite good, fair, or
. Does the patient get thirsty often?
. Does the patient have any kind of food
. Is the patient presently taking any
. If so, what, why, and when last taken?
. Does patient have medications with
. Does patient have any history of
medication reactions or allergies?
As mentioned earlier in this chapter, patient
education (health education) is an essential part
of the health care delivery system. In the Navy
Medical Department, patient education is defined
as the process that informs, motivates, and helps
people to adapt and maintain healthful practices
and life styles. Specifically, the goals of this
. To assist individuals to acquire knowledge
and skills that will promote their ability to
care for themselves more adequately
. To influence individual attitudinal changes
from a disease to a health orientation
. To support behavioral changes to the ex-
tent that individuals are willing and able
to maintain their health
All health care providers, whether they
recognize it or not, are teaching almost constantly.
Teaching is a unique skill that is developed
through the application of principles of learning.
Patient teaching begins with an assessment of the
patients knowledge. Through this assessment,
learning needs are identified. For example, a
diabetic patient may have a need to learn how to
self-administer an injection. After the learners
needs have been established, goals and objectives
are developed. Objectives inform the learner of
what kind of (learned) behavior is expected. Ob-
jectives also assist the health care provider in
determining how effective the teaching has been.
These basic principles of teaching/learning are ap-
plicable to all patient-education activities, from
the simple procedure of teaching a patient how
to measure and record his or her fluid intake/out-
put to the more complex programs of behavior
modification in situations of substance abuse (i.e.,
drug or alcohol) or weight control.
As a member of the health care team, you
share a responsibility with all other members of
the team to be alert to patient education needs,
to undertake patient teaching within the limitation