ch4- health of the individual, family, and community
The mother of three young children makes the following statements to the nurse working in community health. Drag and drop each statement in the order of priority from Maslow's basic priorities to Maslow's more complex priorities. Use all options.
1. "Sometimes we run out of food the day before I get paid." 2. "There have been two murders in our neighborhood in the last year." 3. "My teenage son is so quiet. He works and goes to school all the time and doesn't have time for friends." 4. "I keep my kids' clothes clean, but we don't have money for the latest styles." 5. "I try to get along with our neighbors, but they are from a strange culture with weird ideas." "Sometimes we run out of food the day before I get paid," is an issue of physiologic health and reflects the most basic of Maslow's hierarchy of needs. "There have been two murders in our neighborhood in the last year," reflects a safety and security issue which is Maslow's second level. "My teenage son is so quiet. He works and goes to school all the time and doesn't have time for friends," reflects an absence of love and belonging that is the third level of Maslow's hierarchy. "I keep my kids' clothes clean, but we don't have money for the latest styles," may reflect a potential issue with self-esteem which is the fourth Maslow level. "I try to get along with our neighbors, but they are from a strange culture with weird ideas," reflects an inability to accept others as they are which is an issue with self-actualization.
During the nurse's admission interview the client says, "I don't get too much rest because I am in nursing school and work full time to support myself and my kids." The nurse classifies this statement as an issue at which level of Maslow's basic needs? A- Physiologic B- Safety and security C- Love and belonging D- Self-esteem
A Rest is a basic physiologic need, because it allows time for the body to rejuvenate and be free of stress. Lack of sleep and rest may become a safety issue if not addressed. Love and belonging is related to acceptance in a group. Self-esteem is related to how one sees one's self.
A new graduate nurse asks a nurse manager working at the community health center, "I've heard people talk about community health nursing and community-based nursing. Is there a difference?" Which response by the nurse manager would be appropriate? A- "Community health nursing involves care for entire populations whereas community-based nursing focuses on individuals and families in that population." B- "There really isn't any difference between the two at all. Both terms are used to denote health care for all groups of people." C- "Community health nursing focuses primarily on providing care to people in their homes and living in a specific community." D- "Community health nursing emphasizes the need to address the cultural differences among the individuals and families in the community while community-based nursing does not."
A In contrast to community health nursing, which focuses on whole populations within a community, community-based nursing is centered on the health care needs of individuals and families. Nurses practicing community-based nursing provide interventions to manage acute or chronic health problems, promote health, and facilitate self-care. Nursing care provided within a community must be culturally competent and family centered.
During the nurse's admission interview the client says, "I don't get too much rest because I am in nursing school and work full time to support myself and my kids." The nurse classifies this statement as an issue at which level of Maslow's basic needs? A- Physiologic B- Safety and security C- Love and belonging D- Self-esteem
A Rest is a basic physiologic need, because it allows time for the body to rejuvenate and be free of stress. Lack of sleep and rest may become a safety issue if not addressed. Love and belonging is related to acceptance in a group. Self-esteem is related to how one sees one's self.
A couple with adolescent children is most likely to focus on which developmental task? A- Strengthening the marital relationship B- Establishing a mutually satisfying marriage C- Adjusting to retirement D- Coping with loss of energy and privacy
A The couple in a family with adolescents and young adults likely has a developmental task to strengthen marital relationships. Establishing a mutually satisfying marriage and coping with the loss of energy and privacy are tasks for a couple with young children. Adjusting to retirement is a developmental task for older adults.
The nurse is implementing care for several clients. Which client is the nurse helping to reach the highest level of Maslow's hierarchy of basic human needs? A- The nurse provides privacy for the client and family during times of prayer. B- The nurse teaches the son how to perform passive range of motion with the father. C- The nurse teaches the daughter how to do a finger-stick blood glucose level check for the mother. D- The nurse allows the family to sit quietly at the client's bedside after visiting hours.
A The nurse who provides privacy for the client and family during times of prayer is helping the client to reach self-actualization, the highest level on the hierarchy. The most basic level in the hierarchy, physiologic need of physical activity, would be addressed when the nurse teaches the son how to perform passive range of motion. By teaching the daughter how to do the client's finger-stick blood glucose level check, the nurse is meeting the client's physical safety needs. The nurse facilitates meeting the love and belonging needs of the client when allowing the family to sit quietly at the bedside after visiting hours.
The parents of a blended family have a baby boy age six months who is due for immunizations. The clinic closest to their home has recently closed, and they feel intimidated by the prospect of going to the large, university hospital near their home. Which type of factor is the primary influence on this aspect of the family's health? A- Community health care structure B- Economic factors C- Family risk factors D- Lifestyle influences
A The size, location, and services of health care offerings in a geographical area are components of the community health care structure and its influence on health. Family functioning, lifestyle, and economic considerations are not primary influences on the family's actions.
The nurse is reviewing the health care records of several families from the health care clinic. Which families should the nurse identify as being at risk for factors affecting their health? Select all that apply. A- A family that is vegan B- A family that uses herbal medicine C- A family that fasts for religious purposes D- A family that receives public assistance E- A family that has vaccinated their children F- A family that is headed by a single mother
A, B, C, D, F A vegan diet affects health because it is low in protein, which is a dietary necessity. Use of herbal medicine and fasting for religious purposes can pose health risk factors, so the nurse should further assess the impact of these factors on the family members' overall health. A family on public assistance is in a lower socioeconomic status. A family headed by a single parent may have financial concerns and role shifts (i.e., having the roles of both parents). A family that has had their children vaccinated has no risk factors that would affect their health.
The nurse receives a client assignment. Which client should the nurse see first? A- A client with right-sided heart failure with crackles in the lower lung bases bilaterally and 1+ pitting edema to the lower extremities B- A client admitted with pneumonia, who is restless and diaphoretic with an oxygen saturation of 90% C- A client with a history of stroke and right-sided weakness admitted for a new urinary tract infection D- A client admitted for chronic angina who is scheduled for an angiogram this afternoon
B According to Maslow's hierarchy of needs, first-level physiological client needs are most important. These needs are those that are necessary to sustain life, such as breathing and eating. Using Maslow's hierarchy, along with airway, breathing, and circulation (ABCs), assists the nurse to prioritize care when given a client assignment. The client who is experiencing acute respiratory issues with pneumonia who is restless, diaphoretic, and exhibiting an oxygen saturation level of 90% requires priority assessment and intervention. The other clients listed are not currently in acute distress.
A nurse is implementing interventions that focus on protecting a client from physical and emotional harm. Which category of needs is the nurse addressing? A- Physiologic B- Safety and security C- Love and belonging D- Self-esteem
B Safety and security needs have both physical and emotional components. Physical safety and security means being protected from potential or actual harm. Emotional safety and security involves trusting others and being free of fear, anxiety, and apprehension. Physiologic needs are the most basic in the hierarchy and the most essential to life. They must be met at least minimally to maintain life. Love and belonging needs include the understanding and acceptance of others in both giving and receiving love, and the feeling of belonging to groups such as families, peers, friends, a neighborhood, and a community. Self-esteem needs include the need for a person to feel good about himself or herself, to feel pride and a sense of accomplishment, and to believe that others also respect and appreciate those accomplishments.
The nurse is caring for an 85-year-old client hospitalized for dehydration. The nurse notices that the client is shivering and takes the client's temperature. The nurse notes an oral temperature of 97.8°F (36.6°C). The client also reports being "chilly." Which nursing action is most appropriate? A- Notify the physician. B- Offer the client an extra blanket. C- Increase the client's oral fluid intake. D- Assess the client's respiratory rate.
B Thermoregulation is a physiological need. The human body functions within a narrow temperature range with an oral temperature of 97.5 to 99.5°F (36 to 38°C). Homeostatic mechanisms and adaptive responses, such as shivering (to increase body temperature) or sweating (to reduce body temperature), help to maintain body temperature. Offering the client a blanket is appropriate because the external body covering will increase the client's low body temperature. Notifying the physician is not necessary because the temperature is within normal range. A normal or low temperature is not an indicator of dehydration, so increasing the intake of oral fluids is not necessary. A normal or low temperature is not an indication of respiratory distress, so an assessment of the client's respiratory rate is not necessary.
The nurse on the elective surgery floor receives a report that describes the client's abdominal wound dressing as having a moderate amount of yellowish and bloody drainage on it and a very foul smell. In planning for a dressing change, it is most important for the nurse to perform which action? A- Change the abdominal dressing more frequently. B- Apply extra gauze dressings to the wound to absorb the drainage. C- Wash the nurse's hands before and after the dressing change. D- Use sterile gloves to change the abdominal dressing.
C Physical safety and security mean being protected from potential or actual harm. The abdominal dressing with a foul smell indicates the presence of bacteria. It is most important for the nurse to prevent the spread of infection to the nurse and others and to protect the client. Proper hand washing before and after the dressing change to prevent the spread of infection is a nursing activity that will meet these physical safety needs. the nurse may use nonsterile gloves to change the dressing, however, sterile gloves would not be required in this situation. Changing the abdominal dressing more frequently or applying extra gauze to absorb the wound drainage will not prevent the spread of infection to other clients or staff.
A client with persistent nausea is diagnosed with somatization. What is the appropriate nursing action when the client reports nausea? A- Immediately administer an antiemetic. B- contact the primary care provider C- sit with the client and ask them about their feelings D- explain that the physical symptoms are all in their head
C Somatization is manifesting an emotional stress through a physical disorder. Treating the nausea with an antiemetic will not get at the root cause of the emotional issue. Contacting the primary care provider is not appropriate, as the diagnosis of somatization is present. Explaining that the physical symptoms are all in the client's head is not therapeutic. Sitting with the client to explore what is really going on is most appropriate nursing response.
A nurse is reviewing a journal article about basic human needs and how they can be applied as a framework for prioritizing nursing care. Place the interventions listed below in order of priority, based on client needs. Use all options.
1. Ensuring adequate fluid intake 2. Encouraging the client's spiritual practices 3. Referring the client to a support group 4. Encouraging the client to set attainable goals 5. Providing education focusing on the client's strengths to maximize potential
A nurse is caring for an adolescent who has just lost a leg in a motor vehicle accident. Which human need would the nurse most likely need to address? A- Love and belonging needs B- Safety and security needs C- Self-actualization needs D- Self-esteem needs
D The options listed are stages of Maslow's hierarchy of needs. The adolescent would have issues and concerns in the self-esteem stage. Self-esteem needs would include fear, sadness, loneliness, and accepting self; all would be appropriate with this client. Love and belonging would focus on the sociocultural aspect and would include areas such as relationships with others, communication with others, support systems, being part of a community, and feeling loved by others. Safety and security would focus on the environmental aspect and would include areas such as housing and community/ neighborhood to name a few. Self-actualization needs are in the intellectual and spiritual dimension and would include areas such as thinking, learning, decision making, values, beliefs, and helping others.