Chapter 4

5. A nurse works with families in crisis at a community mental health care facility. What is the best broad definition of a family? A father, a mother, and children A group whose members are biologically related A unit that includes aunts, uncles, and cousins A group of people who live together and depend on each other for support

A group of people who live together and depend on each other for support

Which patient need has the highest priority? A patient who needs to ambulate to prevent DVT A patient who is in isolation and feels lonely A patient who recently lost her husband An elderly patient who is at risk for falls

A patient who needs to ambulate to prevent DVT rationale: PHYSIOLOGIC NEED. at bottom of hierarchy meaning highest priority!

The nurse caring for families in a free health care clinic identifies psychosocial risk factors for altered family health. Which example describes one of these risk factors? The family does not have dental care insurance or resources to pay for it. Both parents work and leave a 12-year old child to care for his younger brother. Both parents and their children are considerably overweight. The youngest member of the family has cerebral palsy and needs assistance from community services.

Both parents work and leave a 12-year old child to care for his younger brother. rationale: Inadequate childcare resources is a psychosocial risk factor. Not having access to dental care and obese family members are lifestyle risk factors. Having a family member with birth defects is a biologic risk factor

The nurse is prioritizing nursing care for a pt in a long term setting. Which examples of nursing interventions help meet physiologic needs? Select all that apply. Preventing falls in the facility Changing a pts oxygen tank Providing materials for a pt who like to draw Helping a pt to eat his dinner Facilitating a visit from a spouse Referring a pt to a cancer support group

Changing a pts oxygen tank Helping a pt to eat his dinner

Describe each level of Maslow's hierarchy of basic human needs. Explain nursing care necessary to meet needs in each level of Maslow's hierarchy.

Chapter 4 objectives

A nurse is providing care based on Maslow's hierarchy of basic human needs. For which nursing activities is this approach useful? Making accurate nursing diagnosis Establishing priorities of care Communicating concerns more concisely Integrating science into nursing care

Establishing priorities of care

A nurse is practicing community-based nursing in a mobile health clinic. What would be the central focus of this nurse's care? Individual and family health care needs Populations within the community Local health care facilities Families in crisis

Individual and family health care needs rationale: In contrast to community health nursing, which focuses on populations within a community, community-based nursing is centered on individual and family health care needs. Community-based nurses may help families in crisis and work in health care facilities, but these are not the focus of community-based nursing.

A visiting nurse performs a community assessment in an area of the city in which the nurse will be working. What is one element of a healthy community? Meets all the needs of its inhabitants Has mixed residential and industrial areas Offers access to health care services Has modern housing and condominiums

Offers access to health care services

The nurse caring for patients in a long-term care facility knows that the highest level on Maslow's hierarchy of needs is self-actualization needs. Which statements accurately describe the achievement of self-actualization? Select all that apply. Humans are born with a fully developed sense of self-actualization. Self-actualization needs are met by depending on others for help. The self-actualization process continues throughout life. Loneliness and isolation occur when self-actualization needs are unmet. A person achieves self-actualization by focusing on problems outside self. Self-actualization needs may be met by creatively solving problems.

The self-actualization process continues throughout life. A person achieves self-actualization by focusing on problems outside self. Self-actualization needs may be met by creatively solving problems. rationale: Self-actualization, or reaching one's full potential, is a process that continues throughout life. A person achieves self-actualization by focusing on problems outside oneself and using creativity as a guideline for solving problems and pursuing interests. Humans are not born with a fully developed sense of self-actualization, and self-actualization needs are not met specifically by depending on others for help. Loneliness and isolation are not always the result of unmet self-actualization needs.

A nurse performs an assessment of a family consisting of a single mother, a grandmother, and two children. Which interview questions directed to the single mother could the nurse use to assess the affective and coping family function? Select all that apply. Who is the person you depend on for emotional support? Who is the breadwinner in your family? Do you plan on having any more children? Who keeps your family together in times of stress? What family traditions do you pass on to your children? Do you live in an environment that you consider safe?

Who is the person you depend on for emotional support? Who keeps your family together in times of stress? rationale: The five major areas of family function are physical, economic, reproductive, affective and coping, and socialization. Asking who provides emotional support in times of stress assesses the affective and coping function. Assessing the breadwinner focuses on the economic function. Inquiring about having more children assesses the reproductive function, asking about family traditions assesses the socialization function, and checking the environment assesses the physical function.

Shuba and Raul are a couple in their late seventies. According to Duvall, which developmental task is appropriate for this older adult family? Maintain a supportive home base Strengthen marital relationships Cope with loss of energy and privacy Adjust to retirement

adjust to retirement rationale: . The developmental tasks of the family with older adults are to adjust to retirement and possibly to adjust to the loss of a spouse and loss of independent living. Maintaining a supportive home base and strengthening marital relationships are tasks of the family with adolescents and young adults. Coping with loss of energy and privacy is a task of the family with children.

Stage 1: Adult is newly married, with no children The person assumes the spousal role Stage 2: First child is born Role of parent is added. Stage 3: Oldest child is between 2 and 6 Role of parent changes Stage 4: Oldest child is in school Parental role changes again Stage 5: Oldest is an adolescent Parental role changes again Stage 6: Oldest child leaves home Parental role involves helping child become independent Stage 7: All children have left home Sometimes called the post-parental stage Stage 8: One or both spouses have retired

duvall 8 stages

self-actualization

full potential acceptance of self and others as they are; focusing on problems outside the self strengths and abilities

what is an example of an attainable goal for a patient?

give a patient a few days to learn how to inject themselves with medication. something like that may not take a few hours to learn

love and belonging needs:

including family and friends in care of patient establishing a trusting nurse-patient relationship referring patients to support groups

what occurs when love and belonging needs are not met?

loneliness and isolation

Think back to Samuel Kaplan, the man caring for his wife with Alzheimer disease. The nurse could refer Mr. Kaplan to a support group for caregivers of patients with Alzheimer disease to help meet Mr. Kaplan's needs. this fits under what level of hierarchy...

love and belonging

what is the most essential physiological need?

oxygen

physiologic needs:

oxygen: most essential water food elimination temperature sexuality physical activity rest

Think back to Samuel Kaplan, the older man caring for his wife with Alzheimer disease at home. The nurse assesses the effect of providing this care on his activity, rest, and sleep patterns, thereby developing an appropriate plan of care for Mr. Kaplan to ensure that his needs are met as well. this fits under what level of hierarchy...

physiologic rationale: Physical activity and rest are also basic physiologic needs. Physical activity depends on intact and functioning neuromuscular and skeletal systems. Rest and sleep allow time for the body to rejuvenate and be free of stress. Individual requirements for rest and sleep vary widely, but the adverse health effects of deprivation have been well documented

what are maslows hierachy needs starting at lower level needs to higher level needs?

physiologic safety and security love and belonging self-esteem self-actualization

what needs must be met at least minimally to maintain life?

physiologic needs

Recall Rolanda Simpkins, the 16-year-old girl described at the beginning of the chapter requesting information about contraception. The nurse can use knowledge about Rolanda's sexuality and sexual practices to help determine the most appropriate method of contraception for her. this fits under what level of hierarchy...

physiologic needs rationale: Sexuality is an integral component of each person and may be affected by physical and emotional illnesses. Sexual practices depend on a variety of factors, such as a person's age, sociocultural background, self-esteem, and level of health.

what factors affect self-esteem?

role change body image changes respecting patient's values and beliefs encouraging patients to set attainable goals

what needs has both physical and emotional components?

safety and secuirty needs

The nurse caring for patients postoperatively uses careful hand hygiene and sterile techniques when handling patients. Which of Maslow's basic human needs is being met by this nurse? Physiologic Safety and security Self-esteem Love and belonging

safety and security

A nurse who focuses attention on the strengths and abilities of patients rather than their problems is helping them to achieve which of Maslow's basic human needs? A. Self-actualization B. Self-esteem C. Love and belonging D. Safety and security E. Physiologic

self actualization Rationale: To meet patient self-actualization needs, nurses provide a sense of direction and hope, and maximize patient potential. Self-esteem needs are met by respecting patient values and beliefs and setting attainable goals for them. Love and belonging needs are met by including family and friends and establishing caring relationships with patients. Safety and security needs are met by encouraging spiritual practices and independent decision making. Physiologic needs are needs that must be met to maintain life.

During a clinic visit, a diabetic patient expresses difficulty with his prescribed dietary recommendations but also recognizes that he needs to be more careful or "I'll end up losing a leg or having trouble seeing because of this disease." A nurse coach recognizes that the patient is the best expert about his own health and listens carefully as he reviews his eating habits and discusses what he thinks he needs to do differently. Based on assessment data and the patient's desire to change his behavior, the nurse and patient together create an action plan to begin the process of change and move toward the optimal way for him to achieve his goals. this fits under what level of hierarchy...

self-actualization

what does a positive self esteem facilitate?

the person's confidence and independence

safety and security needs:

using proper hand hygiene using electrical equipment properly adminstering medications knowledgeably, moving and ambulating patients skillfully, trusting others and being free of fear and anxiety