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

physiological needs (Maslow)

Oxygen - most essential water food elimination temperature sexuality physical activity rest

Community factors affecting health

Social support systems Community health care structure - urban vs rural Economic resources Environmental factors - quality of air and water

A nurse is practicing community based nursing in a mobile health clinic. What typically is the central focus of this type of nursing care? A. Individual and family health care needs B. populations within the community C. local healthcare facilities D. families in crisis

a 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 healthcare facilities, but these are not the focus of community based nursing

A nurse perform an assessment of a family consisting of a single mother, grandmother, and two children. Which interview questions directed to the single mother could the nurse use to assess the effective and coping family function? Select all that apply. A. Who is the person you depend on for emotional support? B. Who is the breadwinner 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? F. Do you live in an environment that you consider safe?

a, d 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 effective and coping function. Assessing the breadwinner focuses on the economic function. Inquiring about having more children assesses the reproductive function, asking about family traditions assess the socialization function, and checking the environment assesses the physical function.

family

any group of people who live together and depend on one another for physical, emotional, or financial support

The nurse caring for patients post operatively uses careful hand hygiene and sterile techniques with handling patients. Which of Maslow's basic human needs is being met by this nurse? A. Physiologic B. Safety and security C. self-esteem D. love and belonging

b By carrying out careful hand hygiene and using sterile technique, nurses provide safety from infection. And example of a physiological need is clearing a patient's airway. Self esteem needs maybe 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 patients family to arrange a visit.

The nurse caring for families in a free clinic identifies psychosocial risk factors for altered family health. Which example 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 a younger brother C. both parents and their children are overweight D. the youngest member of the family has cerebral palsy and needs assistance from community services

b Inadequate child care 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.

A nurse uses Maslow's hierarchy of basic human need to direct care for patients on an intensive care unit. For which nursing activities is this approach most useful? A. Making accurate nursing diagnoses B. establishing priorities of care C. communicating concerns more concisely D. integrating science into nursing care

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

The nurse is prioritizing nursing care for a patient in a long-term care facility. Which examples of nursing interventions help meet physiological needs? Select all that apply. A. Preventing Falls in the facility B. changing a patient's oxygen tank C. providing materials for a patient who likes to draw D. helping a patient eat his dinner E. facilitating a visit from a spouse F. 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

A visiting nurse working in a new community performs a community assessment. What assessment finding is indicative of a healthy community? A. It meets all the needs of its inhabitants B. it has mixed residential and industrial areas C. it offers access to healthcare services D. it consists of modern housing and condominiums

c A healthy community offers access to healthcare services to treat illness and to promote health. A healthy community does not 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 ones. The age of housing is irrelevant as long as Residences are maintained properly according to code.

extended family

includes aunts, uncles, and grandparents

Maslow's Hierarchy of Needs

level 1: Physiological Needs level 2: Safety and Security level 3: Relationships, Love and Affection level 4: Self Esteem level 5: Self Actualization

single-parent family

may be separated, divorced, widowed, or never married

family functions

physical, economic, reproductive, affective and coping, socialization

nuclear family

traditional family; two parents and their children

blended family

two parents and their unrelated children from previous relationships

examples of community factors affecting health

- # and availability of healthcare - institutions and services - housing codes - police and fire departments - nutritional services for low-income - infants, mothers, children, and elderly - separation of residential and industrial areas - waste disposal - air and water polution - food sanitation - health education - recreational opportunities - violent crimes or drug use

Biologic Risk Factors

- Birth defects - intellectual disability - Genetic predisposition to certain diseases, including cardiovascular diseases and cancer

Psychosocial risk factors

- Inadequate childcare resources, when both parents work, for preschool and school-aged children - Inadequate income to provide safe housing, food, clothing, and health care - Conflict between family members

environmental risk factors

- Lack of Knowledge or finances to provide safe and clean living conditions - Work or social pressures that cause stress - Air, water or food pollution

lifestyle risk factors

- Lack of knowledge about sexual and marital roles, leading to teenage marriage and pregnancy; divorce; sexually transmitted infections; child, spouse, or elder abuse; and lack of prenatal or childcare - Alterations in nutrition—either more or less than body requirements at any age - Chemical dependency, including the use of alcohol, drugs, and nicotine - Inadequate dental care and hygiene - Unsafe or unstimulating home environment

Meeting Basic Human Needs

- People's behaviors, feelings about self and others, values, and priorities all relate to physiologic and psychosocial needs. - These basic human needs are common to all people; meeting these needs is essential for the health and survival of all people. - A person can meet some needs independently, but most needs require relationships and interactions with others for partial or complete fulfillment. - Satisfying one's needs often depends on the physical and social environment, especially one's family and community.

Self-actualization (Maslow)

- acceptance of self and others as they are - focus of interest on problems outside oneself - ability to be objective - feelings of happiness and affection for others - respect for all people - ability to discriminate between good and evil - creativity as a guideline for solving problems and pursuing interests

developmental risk factors

- families who have new babies, especially if support systems are unavailable - older adults, especially those living alone or on a fixed income - unmarried adolescent mothers who lack personal, economic, and educational resources

Self-Esteem Needs (Maslow)

- need for a person to feel good about oneself, to feel pride and a sense of accomplishment, and to believe that others also respect and appreciate those accomplishments - positive self esteem facilitates the person's confidence and independence - factors affecting self esteem: - role changes (man has a heart attack and can longer support the family, so wife has to get a job) - body image changes (mastectomy)

safety and security needs (Maslow)

- second in priority - have both physical and emotional components - being protected from potential or actual harm - examples of interventions to meet these needs: - using proper hand hygiene to prevent infection - using electrical equipment properly - administering medications knowledgeably

love and belonging needs (Maslow)

- third priority needs, often called higher-level needs - understanding and acceptance of others in both giving and receiving love - the feeling of belonging to groups such as families, peers, friends, a neighborhood, and a community - unmet needs produce loneliness and isolation - examples of interventions to meet these needs: - including family and friends in care of a patient - establishing a trusting nurse-patient relationship

characteristics of basic needs/Maslow

-Their lack of fulfillment results in illness. -Their fulfillment helps prevent illness or signals health. -Meeting basic needs restores health. -Fulfillment of basic needs takes priority over other satisfactions when unmet. -A person feels something is missing when a need is unmet. -A person feels satisfaction when a need is met.

family stages

Couple and family with children Family with adolescents and young adults Family with middle-aged adults Family with older adults

risk factors for altered family health

Lifestyle risk factors Psychosocial risk factors Environmental risk factors Developmental risk factors Biologic risks

A nurse is caring for patients in a long-term care facility uses available resources to help patients achieve Maslow's highest level of needs: self actualization needs. Which statement accurately describes these human needs? 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 others for help C. 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 ones 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 interest. 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 works with families in crisis at a community mental health care facility. What is the best broad definition of a family? A. A father, a mother, and children B. a group whose members are biologically related C. a unit that includes aunts, Uncles, and cousins D. a group of people who live together and depend on each other for support

d Although all responses may be true, the best definition is a group of people who live together and depend on each other for physical, emotional, or financial support.

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, which developmental task would the nurse assess for the couple? 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 homebase and strengthening marital relationships are tasks of the family with adolescents and young adults. Coping with loss of energy and privacy as a task of the family with children.