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Junior Clinician Patient Education Materials

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Patient Education General Information

After taking history and physical exam of your patient, you will know your patient's pertinent health issues. With your senior clinician, choose from the following topics in the EHHAPP to focus your patient education. You can also ask the patient what s/he is interested in. During down-time in clinic (ie: while waiting for the attending), read through the information in the EHHAPP tabs, grab a pamphlet from the patient education binder, and use the following tips to organize your conversation with the patient.

If the patient speaks Spanish, do the lesson in Spanish or use the translator phone. If using a translator, allow for more time as using an interpreter takes twice as long.

General Tips for Patient Education

Introduce yourself to the patient and explain that you will be talking about ________.Go over information in EHHAPP, asking patient if s/he has questions as you go along.Ask your patient what his/her barriers are to eating healthy and exercising.Ask your patient what he ate in the past 24 hours, or to describe a typical meal.Help your patient establish specific goals (ie: "I will walk 20 minutes everyday this week." or "I will cut soda from my diet.")Hand out corresponding patient pamphlets from the Patient Education Binder and go over pamphlets with patient.

Note: The nature of EHHOP means that you may be interrupted during your lesson. If so, please be flexible and resume the lesson when you and the patient are both free.

For additional patient education materials, see here the drive!

Nutrition and Exercise

Nutrition

Tips for eating more healthily:

Eat smaller portions. Gradually cut your meals to a smaller portion size. Use smaller plates to make less look like more.Eat a balanced meal: Use My Plate (available in PE binder) to help organize your meals and keep them balanced.Prepare your meals in a more healthy way: Instead of frying your food, bake it, steam it, or roast it. Use less oil and less salt.Choose low-fat or fat-free options.Eat less salt - season your meals with other spices or hot sauce.Eat more fruits and vegetables - add a small salad to your meal, and eat some fruit at the end of your meal.Avoid unhealthy snacks like cookies and chips. Instead, eat some fruit or vegetables.Drink water instead of soda or juice.Stay active and exercise daily.

Exercise

Adults should get 30 minutes a day (total) of physical activity to stay healthy. Tips for exercising:

Start small: Start with short walks, then increase your pace and time as you feel comfortableTake the stairs instead of the elevatorGet off the subway one stop early and walk to your destinationWalk briskly when running errandsFind an exercise group or exercise with friends!

Be sure to mention that EHHOP has an Exercise Group that meets every Saturday during clinic. See "Exercise Group" in EHHAPP.

Available Resources

In the Patient Education Binder, you can find the following resources for your patient about Nutrition and Exercise, in both English and Spanish. Please make copies of the pamphlets in the binders and hand them to your patient. Feel free to go over the handouts with them as a part of your patient education.

"My Plate""Are you pouring on the pounds?" (Tips on cutting down sugary drinks)"How to Lose Weight and Keep It Off""Small Steps for Eating Healthy""Small Steps for Getting More Physical Activity""Make NYC Your Gym"

Tips for Patient Education

Ask your patient what his/her barriers are to eating healthy and exercising.Ask your patient what he ate in the past 24 hours, or to describe a typical meal.Help your patient establish specific goals (ie: "I will walk 20 minutes everyday this week." or "I will cut soda from my diet.")

Source: NYC Health Bulletin

Hypertension

Hypertension Basics

Blood pressure is the force of blood against your blood vessel walls as it circulates through your body. Blood pressure can cause health problems if it says high for a long time. High blood pressure can lead to heart disease and stroke, leading causes of death in the US.Anyone can get high blood pressure, but some people are more at risk than others.Age, sex, and race or ethnicity can increase your risk for high blood pressure.Physical inactivity and excess body weight can also increase your risk.You can work to reduce your risk by eating a healthy diet, maintaining a healthy weight, not smoking, and being physically active.Signs and Symptoms: High blood pressure usually has no signs or symptoms, so your doctor will check to make sure your blood pressure is not too high.Normal Blood Pressure: <120 Systolic / <80 Diastolic

Hypertension Management

Tips to manage or prevent high blood pressure:

Eat a healthy diet that includes more fruits and vegetablesCut down sodium (salt) intakeMaintain a healthy weightBe physically activeLimit alcohol useDo not smokePrevent and manage diabetes (see Diabetes tab)Check blood pressure regularly (such as at CVS pharmacy machines) and talk to your doctor when it becomes high. Your doctor may prescribe medication for you if you have high blood pressure.

More details

High blood pressure puts you at risk for stroke and heart attack. When you have high blood pressure, your blood vessel walls overstretch, making them more prone to rupture and small tears, where cholesterol and blood clots can collect, blocking the artery. It also creates more work for your heart to pump, which can damage your heart. Ultimately, as a result of high blood pressure, your organs do not receive enough oxygen from blood, resulting in tissue damage.Your doctor will measure your blood pressure at each visit using a blood pressure cuff. There are two types of blood pressure and both get measured by your doctor. The top number, the systolic blood pressure, is the pressure in your arteries when your heart pumps. The bottom number, the diastolic blood pressure, is the pressure in your arteries when your heart is at rest. Your doctor will use both numbers to determine whether you have high blood pressure or are at risk for it.Normal Blood Pressure: Systolic < 120 mmHg; Diastolic < 80 mmHgAt risk (prehypertension): Systolic: 120-139 mmHg; Diastolic: 80-89 mmHgHigh Blood Pressure: Systolic: >140mmHg; Diastolic: >90 mmHg

Available Resources

"Know the Facts about High Blood Pressure"

Source: CDC and American Heart Association

Diabetes

Diabetes Basics

Diabetes is a disease that prevents your body from using energy from the food you eat. Diabetes causes you to be unable to use insulin to digest sugar in your food, so the sugar stays in your blood. When you have a lot of sugar in your blood, this can create many health issues such as heart disease, stroke, eye problems, kidney problems, nerve damage, and gum disease with loss of teeth.With exercise, changes in diet, and help from your doctor, you can manage your diabetes and keep your blood sugar at a reasonable level. When your blood sugar is close to normal, you are more likely to have more energy, be less tired and thirsty and urinate less often, heal better, and have fewer problems with your eyesight, feet, and gums.

Diabetes Complications

If you do not manage your diabetes, you are more at risk for heart disease, stroke, kidney problems, skin problems, and nerve damage.You can also have eye problems and lose your vision.You are also more likely to get infections on your feet. Because of diabetes, the infections are hard to heal and can get worse, even leading to amputation in the worst case scenario. This is why it is important to check your feet for ulcers, and why your doctor will check your feet at your appointment.These are the many complications that can result from diabetes. However, diabetes can be controlled with diet and medication, allowing you to live a normal life. See "Diabetes Management" for more details.

Diabetes Management

Tips for managing your diabetes:

Planning what you eat and following a balanced meal plan. Use My Plate (available in PE binder) to help organize your meals and keep them balanced.Increasing physical activityTaking your medicine, if prescribed, and closely following the guidelines on how and when to take itMonitoring your blood sugar as prescribed by your doctorMonitoring your blood pressureKeeping your appointments with your health care provider

Diabetes Nutrition

To keep your blood sugar low, cut back on sugary drinks like soda and juice. Drink water instead.Eat a balanced meal that includes meats, vegetables, and fruit. Use My Plate (available in PE binder) to help organize your meals and keep them balanced.Choose food that is lower in calories, fat, sugar, and salt.Eat food with more fiber, like whole grain cereals, breads, crackers, rice, or pasta.

Available Resources

"4 Steps to Manage Your Diabetes for Life" - sections on Exercise and Nutrition for diabetes patients

Source: Cleveland Clinic, National Diabetes Education Program

Cholesterol

Cholesterol Basics

High cholesterol is leading cause of heart attack and stroke in the USA.When you have high cholesterol, the cholesterol can get stuck in your blood vessels, making it difficult for blood to circulate. If the blood vessel that gets clogged is in your heart or brain, you can get a heart attack or stroke.A heart attack is when a blood vessel bringing blood to your heart gets blocked, damaging part of your heart tissue. These blood vessels in your heart can get clogged by cholesterol.Similarly, a stroke is when a blood vessel in your brain gets blocked, damaging part of your brain.High cholesterol can be prevented and controlled with physical activity, a healthy diet, and a healthy weight.There are also medications that your doctor can prescribe you to keep your cholesterol low.People get high cholesterol from eating too much saturated and trans fats.Your doctor may order a lipid panel for you to measure your cholesterol level.

Managing Your Cholesterol Levels

Tips on keeping your cholesterol levels low:

Exercise! Get at least 30 minutes of physical activity at least 5 days a week. See "Nutrition and Exercise" section for more tipsKeep a healthy diet: limit or avoid food with saturated fat, trans fat, and high cholesterolCut back or quit smoking

More details

LDL = "bad" cholesterol. Ideal = <100, high = >160HDL = "good" cholesterol. Ideal = >60, low = <40Total cholesterol ideal = <200, high = >240

Available Resources

"Control Your Cholesterol: Keep Your Heart Healthy"

Source: NYU Health Bulletin