Chapter 4: Health of the Individual, Family, Community and Environment

What are basic human needs?

Needs that are common to all people, and meeting these needs is essential for the health and survival of all people

What is the most essential of all physiological needs? Why?

Oxygen because all body cells require it for survival

What are physiological needs?

Oxygen, water, food, elimination, temperature, sexuality, physical activity, and rest

What are cohabiting families?

People who choose to live together for a variety of reasons, including relationships, financial need, or changing values; include unmarried adults living together and communal or group marriages.

What are the five major areas of family function?

Physical, economic, reproductive, affective and coping, and socialization

What are safety and security needs?

Protection from potential or actual harm; Security in health, employment, property, family and social stability

How does a family function with *affective coping*?

Provide emotional comfort to family members and help members establish their identity and maintain it in times of stress.

How does a family function *physically*?

Provides a safe, comfortable environment necessary for growth, development, and rest or recuperation

How does a family function *economically*?

Provides financial aid to family members and also helps meet society's needs.

What was Duvall's theory? (Of Duvall and Miller 1984)

States that all families have certain basic tasks for survival and continuity, as well as specific tasks related to developmental stages throughout the life of the family. If the family does not meet certain developmental tasks, societal disapproval may lead to intervention by children's services, social services, police departments, welfare facilities, or health departments.

What are some nursing considerations for family and nursing care?

Support systems, availability of childcare, time for leisure and recreation, struggles to meet financial commitments, and changing role models.

How does a family function with *socialization*?

Teaches; transmits beliefs, values, attitudes, and coping mechanisms; provides feedback; and guides problem solving

What are self esteem needs?

The need for a person to feel good about themselves, to feel pride and a sense of accomplishment, and to believe that others also respect and appreciate those accomplishments.

What are self-actualization needs?

The need for people to reach their full potential through development of their unique capabilities

What is community-based nursing?

The provision of acute care and care for chronic health problems to individuals and families in the community

If a person's social needs are not met, what might happen?

They may often feel lonely and isolated. They may withdraw physically and emotionally, or they may become overly demanding and critical.

How does a family function *reproductively*?

To have and raise children.

What does Maslow's hierarchy allow the nurse to do?

To locate the patient on the health-illness continuum and to incorporate the human dimensions and health models into meeting needs

What is the "nuclear family"?

Traditional family composed of two parents and their children

What are love and belonging (social) needs?

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.

______________ products are eliminated from the body through the skin, lungs, kidneys, and intestines.

Waste

How can a nurse assess a patient's nutritional status?

Weight, muscle mass, strength, and laboratory values.

Where can a nurse apply Maslow's hierarchy?

When performing ADPIE

Many single-parent families are headed by _____________

Women

Environmental ___________ to accessing health care within a community may include lack of transportation, distance to services, and location of the services.

barriers

The ___________ family may be composed of biologic parents and children, adoptive parents and children, surrogate parents and children, or step-parents and children.

nuclear

A person's _________ support systems are made up of all the people who help meet financial, personal, physical, and emotional needs.

social

What are the 7 qualities of self actualization?

1. Acceptance of self and others *as they are* 2. Focus of interest on problems outside ones self 3. Ability to be objective 4. Feelings of happiness and affection for others 5. Respect for *all people* 6. Ability to discriminate between good and evil 7. Creativity as a guideline for solving problems and pursuing interests

Friedman and associates (2003) identified the importance of family-centered nursing care in four ways. What were they?

1. Family is composed of interdependent members who affect one another. If some form of illness occurs in one member, all other members become involved in the illness. 2. Because there is a strong relationship between the family and the health status of its members, the role of the family is essential in every level of nursing care 3. Level of health of the family and in turn each of its members can be significantly improved through health promotion activities. 4. Illness of one family member may suggest the possibility of the same problem in other members.

Arrange the following in order from most basic to least basic in the hierarchy of need: 1. Food 2. Relationships 3. Security

1. Food 2. Security 3. Relationships

Maslow's Hierarchy of Needs is based on a theory that something is a basic need if it meets what 6 characteristics?

1. Its lack of fulfillment results in illness 2. Its fulfillment helps prevent illness or signals health 3. Meeting it restores health 4. It takes priority over other desires and needs when unmet 5. The person feels something is missing when the need is unmet 6. The person feels satisfaction when the need is met

What are the building blocks to Maslow's hierarchy of needs?

1. Physiological 2. Safety 3. Social/Belonging 4. Esteem 5. Self-actualization

What is ideal body temperature?

98.6 Fahrenheit or 37 Celsius

A nurse is practicing community-based nursing in a mobile health clinic. Which example best demonstrates community-based nursing? a. Caring for a mother and her child who have diabetes b. Providing shelter for vulnerable populations within the community c. Providing local same-day surgery facilities d. Assisting families in crisis and overseeing the crisis hotline

A Community health nursing focuses on whole populations within a community, and 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.

Multiple research studies have concluded that family processes, such as the quality of parenting and harmony between parents, rather than family structures, contribute to what?

A child's well-being

What is a blended family?

A family consisting of a couple and their children from this and all previous relationships; step-children, step-siblings

What is the extended family?

A family that extends beyond the nuclear family, including grandparents, aunts, uncles, and other relatives, who all live nearby or in one household.

What is Maslow's hierarchy of needs?

A hierarchy of basic human needs that describes which needs of a person are the most important at any given time

Housing Community/neighborhood Climate Are all *environmental needs* within what dimension? A. Environmental B. Sociocultural C. Physical D. Intellectual and Spiritual E. Emotional

A. Environment

What are some characteristics of a healthy community?

Access to health services for all community members, has roads/schools/playgrounds, maintains a safe and health environment

A nurse is prioritizing nursing care for patients on a medical-surgical unit. Which nursing interventions address patients' physiologic needs? Select all that apply. a. Preventing falls during admission b. Administering oxygen to a patient with shortness of breath c. Providing a magazine for a patient without visitors d. Assisting a patient who had a stroke eat their dinner e. Facilitating a visit from the patient's significant other e. Referring a patient to a cancer support group

B, D Physiologic needs—oxygen, water, food, elimination, temperature, sexuality, physical activity, and rest—must be met at least minimally to maintain life. Providing food and oxygen are examples of interventions to meet these needs. Preventing falls helps meet safety and security needs; providing art supplies may help meet self-actualization needs; facilitating visits from loved ones helps meet self-esteem needs; and referring a patient to a support group helps meet love and belonging needs.

Relationships with others Communications with others Support systems Being part of a community Feeling loved by others Are all *love and belonging needs* within what dimension? A. Environmental B. Sociocultural C. Physical D. Intellectual and Spiritual E. Emotional

B. Sociocultural

How does a nurse assess a patient's oxygen needs?

By assessing skin color, vital signs, anxiety levels, responses to activity, restlessness, and mental responsiveness.

How can a nurse help meet a patient's self-actualization needs?

By focusing on the person's strengths and possibilities rather than on problems.

How can a nurse help meet a patient's self esteem needs?

By respecting patient values and beliefs, encouraging patients to set attainable goals, and facilitating support from family, friends, or significant others.

A nurse working in a new community performs an assessment to determine the health of the community. What finding indicates a healthy community? a. Meets all the needs of its inhabitants b. Mixes residential and industrial areas c. Offers access to health care services d. Consists of modern housing and condominiums

C A healthy community offers access to health care services to treat illness and to promote health. A healthy community cannot usually meet all the needs of its residents, but should be able to help with health issues such as nutrition, education, recreation, safety, and zoning regulations to separate residential sections from industrial areas. The age of housing is irrelevant as long as residences are maintained according to code.

After receiving a change-of-shift report, the nurse on a medical-surgical unit sets initial priorities for care. According to Maslow's hierarchy of needs, which patient requires immediate assessment? a. Patient requesting help to phone family to ask them to visit b. Patient who needs education on changing their wound dressing prior to discharge c. Patient who calls for assistance because they are breathing fast and feel faint d. Patient who needs assistance to walk to the bathroom to void

C The nurse prioritizes the patient with rapid breathing who feels faint, who may need oxygen or additional assistance with physiologic needs. Family visits help meet love and belonging needs, while assisting the patient to prevent falls and proper dressing change technique meets safety and security needs.

A nurse caring for patients in a long-term care facility develops strategies to help patients achieve Maslow's highest level of needs: self-actualization. Which concepts will the nurse incorporate when planning care? Select all that apply. a. Humans are born with a fully developed sense of self-actualization. b. Self-actualization needs are met by depending on family, friends, and others for help. c. No matter the patient's age, the self-actualization process continues throughout life. d. Loneliness and isolation occur when self-actualization needs are unmet. e. A person achieves self-actualization by focusing on problems outside self. f. Self-actualization needs may be met by creatively solving problems.

C, E, F Self-actualization, or reaching your full potential, is a process that continues throughout life. A person achieves self-actualization by focusing on their unique capabilities, being creative, and demonstrating the capacity for happiness and affection for others. 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.

Breathing Circulation Temperature Intake of food and fluids Elimination of wastes Movement Are all *physiological needs* within what dimension? A. Environmental B. Sociocultural C. Physical D. Intellectual and Spiritual E. Emotional

C. Physical

*Definition:* a specific population or group of people living in the same geographic area under similar regulations and having common values, interests, and needs *Word:* ______________

Community

What are dyadic families?

Couples who choose not to have children

A nurse in a family-centered health clinic is assessing a new family composed of two parents and three preschool children. Which value does the nurse include in a family-centered approach to health care? a. Each person in the family will be evaluated and treated independently of the others. b. Time will be saved as there is only one clinic to contact for health problems. c. All members of the family can be part of health-related decisions. d. Interdependence of family members affects them in illness and health.

D Families likely share beliefs and values about health and illness. The nurse can help reduce risk for all family members at any level of development and recognizes interdependence of families affect one another in illness and health promotion.

A nurse working in an "Aging in Place" facility interviews a married couple in their late 70s. Based on Duvall's Developmental Tasks of Families, what developmental task is most appropriate for the nurse to assess? a. Maintenance of a supportive home base b. Strength of the marital relationship c. Ability to cope with loss of energy and privacy d. Adjustment to retirement years

D 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.

Thinking Learning Decision making Values Beliefs Fulfillment Helping others Are all *self-actualization needs* within what dimension? A. Environmental B. Sociocultural C. Physical D. Intellectual and Spiritual E. Emotional

D. Intellectual and Spiritual

Conditions such as severe diarrhea or vomiting can lead to what?

Dehydration

Disruption in the water balance of the body results in either _____________ or ____________.

Dehydration, edema

Fear Sadness Loneliness Happiness Accepting self Are all *self-esteem needs* within what dimension? A. Environmental B. Sociocultural C. Physical D. Intellectual and Spiritual E. Emotional

E. Emotional

Diseases of the cardiovascular or renal system, trauma, and other factors can lead to what?

Edema

How does a nurse help meet emotional needs of the patient?

Encouraging spiritual practices that provide strength and support, by allowing as much independent decision making and control as possible, and by carefully explaining new and unfamiliar procedures and treatments.

*Definition:* Aspect of human health determined by physical, chemical, biologic, and psychosocial factors in the environment *Word:* _______________ _________

Environmental health

How does the body maintain thermoregulation? (Homeostasis)

Evaporation, perspiration, radiation, and insulation

What are binuclear families?

Families in which divorced parents assume joint child custody

*Definition:* Any group of people who live together and depend on one another for physical, emotional, and financial support. *Word:* ________________

Family

Like intake and output, _________ and ___________ are related physiologic needs, with a balance maintained through digestive and metabolic processes

Food, elimination

How does a nurse assist in providing the patient with *safety* needs?

Hand hygiene, proper use of equipment, safe patient transport, teaching patients about care and safety

What kind of nursing interventions would help a patient meet social/love and belonging needs?

Including family and friends in the care of the patient, establishing a nurse-patient relationship based on mutual understanding and trust, referring patients to specific support groups

Rosa and Hasmiller (2020) offer a distinctive invitation for the nursing profession to do what?

Innovate, collaborate, and lead in making improvements toward collective health and well-being while capitalizing on the gains of the past century.

________ and _________ of fluids is essential to life

Intake, output

Nurses practicing community-based nursing provide interventions to do what?

Manage acute or chronic health problems, promote health, and facilitate self-care.

How can a nurse assess a patient's intake and output balance?

Measuring intake and output, testing the resiliency of the skin, checking the condition of the skin and mucous membranes, and weighing the patient

nurse performs an assessment of a family consisting of a single parent, a grandparent, and two children. What interview questions will the nurse direct toward the mother to best determine the family's affective and coping functions? Select all that apply. a. Who is the person you depend on for emotional support? b. Who is the person you depend on for financial support in your family? c. Do you plan on having any more children? d. Who keeps your family together in times of stress? e. What family traditions do you pass on to your children?

A, D The five major areas of family function are physical, economic, reproductive, affective and coping, and socialization. Affective areas of function include feelings and coping, assessed by determining who provides emotional support in times of stress. Assessing the financially responsible individual 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.

A nurse provides care for postoperative patients using meticulous hand hygiene and aseptic technique. Which of Maslow's basic human needs is the nurse addressing? a. Physiologic b. Safety and security c. Self-esteem d. Love and belonging

B By using meticulous hand hygiene and aseptic technique, nurses prevent infection, which falls under safety. An example of a physiologic need is clearing a patient's airway. Self-esteem needs may be met by allowing an older adult to talk about a past career. An example of helping meet a love and belonging need is contacting a hospitalized patient's family to arrange a visit.

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

B Inadequate childcare resources are 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 factor.

Nurses in a long-term care facility use Maslow's hierarchy of basic human needs to plan care for their patients. What is the expected outcome when using this hierarchy? a. Accurate nursing diagnoses b. Clear priorities of care c. Concerns communicated concisely d. Integration of science into nursing care

B Maslow's hierarchy of basic human needs is useful for establishing priorities of care.