Chapter 5: Basic Human Needs
Homelessness
An extreme form of poverty defined by lack of permanent shelter to live in. **These people are often mired at the lower levels of the basic needs hierarchy**
Hierarchy of Needs
Established in 1943 by Abraham Maslow, the hierarchy categorizes human needs from the most basic vital needs, survival needs (necessary to life), up through higher-level needs such as beauty, love, and learning
Esteem Needs
Fourth level of Maslow's hierarchy. Includes self-esteem, confidence, achievement, respect of and by others. Nursing Interventions: -Promoting positive self-image after surgery -Encouraging an individual's progress in rehab -Providing an opportunity for bonding with a new infant
Needs -KEY CONCEPT
Homelessness is a threat to the person's basic need for warmth, shelter, and safety. If a person is responsible for others, such as children, the threats multiply. The higher needs of self-esteem or aesthetics cannot be addressed at all.
Abuse - NURSING ALERT
If you, as a nurse, do not report suspected abuse, you could be subject to arrest and civil penalties
Needs - KEY CONCEPT
Prioritization of needs is an extremely important concept of nursing.
Security and Safety Needs
Secondary needs freedom from harm, healthcare, shelter Nursing Interventions: -Checking ID before administering meds -Taking defective equipment from a room and reporting the defect -Monitoring the client's safety while in the shower, ambulating in the hall, or getting out of bed -Performing a safety check in the home environment -Reporting abuse to the proper authority
Community needs
The community has basic needs concerning the welfare of all its residents. These needs include: Public health measures, access to healthcare, maintenance services (water, electricity, and waste disposal), safety (seat belts, police, highways), and emergency services (ambulance & fire).
Family needs
The family unit has needs that must be met for life to run smoothly. The highly functioning family also works toward common goals as a group.
Self-actualization Needs
The fifth step in Maslow's hierarchy, concerning the need to realize one's potential. Nursing Intervention: -Acknowledging the accomplishments of the individual
Maslow's theory of needs
These needs are common to all people regardless of age, sex, race, social class, and state of health.
Love Needs
Third level of Maslow's hierarchy of needs need for affection, feelings of belongingness, and meaningful relations with others societal and spiritual needs Nursing Interventions: -Allowing the client's family to visit -Encouraging the family to participate in the care of the client -Allowing religious leaders and friends to visit and perform religious rites -Being sensitive to a client's particular needs as they relate to his/her role in society
Shelter
a place that provides protection from weather, such as a house **A lack of adequate shelter may not always be life threatening, but it will thwart the ability of a person to progress toward a higher level of needs.**
The 5 levels of Maslow's Hierarchy of Needs
1. Physiological needs (Basic needs) 2. Safety needs (Basic needs) 3. Love and Belonging needs (Growth needs) 4. Esteem Needs (Growth needs) 5. Self-actualization (Growth needs) A person must satisfy lower level needs before moving on to meet higher-level growth needs. After meeting lower levels of needs, a person scan reach the highest level of self-actualization.
The nurse is caring for a client who is recovering from a recent stroke and is unable to move the left side of the body. Based on Maslow's hierarchy of needs, which nursing action will take priority in the care of this client? a. Ensuring the client is eating and drinking b. Instituting fall precautions c. Assisting with education regarding sexual activity d. Providing care with hygiene
Answer: a Cognitive Level: Analyze Explanation: Using Maslow's hierarchy of needs, survival needs, such as and fluids will take priority. The client may have difficulty with feeding and should be assisted. With the limited mobility, the client may become tired ar not eat or drink sufficient amounts that can cause malnutrition and dehydrat This would be a priority for the client prior to safety, cleanliness, and sexual gratification.
The nurse is observing a client to determine belonging needs. Which question will the nurse ask? a."Which type of medications are you taking?" b. "Are you having difficulty breathing?" C."Do you have a history of falling?" d. "Are you feeling isolated or upset?"
Answer: d Cognitive Level: Apply Explanation: In many cases, nursing priorities can be determined by observation. You may be able to determine the client's survival, safety, or belonging needs by looking at the client. Survival needs-is the client lacking oxygen? The nurse looks for cyanosis (blueness of the skin) and difficulty breathing. Safety needs-is the Flient likely to fall? The nurse looks for an unsteady gait, bruising on the limbs, or a history of paralysis. Belonging needs--Is the client crying, depressed, or angry? The nurse looks for isolation from others or an inability to control frustrations. Listening to the client is also helpful. The client may tell the nurse that they is hungry, thirsty, or in pain. Meeting needs is a process; it is never static. In addition, needs are interrelated and some needs depend on others.
Nursing relationship to Basic Needs - KEY CONCEPT
Nursing is concerned with helping clients meet their physical, spiritual, and psychological needs. Much of nursing deals with assisting clients to meet basic needs that they cannot meet independently.
Physiological Needs
Primary needs - without them, a person will die. Air, nutrition, water, elimination, rest and sleep, activity and exercise, sexual gratification, and thermoregulation MUST BE MET FIRST IN ORDER TO MAINTAIN LIFE Nursing Interventions: -Administer oxygen -Assist with feeding -Assist with hygiene and elimination -Maintaining warmth for a newborn
Abuse
physical or emotional harm to someone Any type of abuse is a threat to the basic need for safety and security. If a person feels unsafe, they cannot pursue higher level needs.
5) A client is having a surgical procedure. Which intervention provided by the nurse can help the client feel safe and aid in postoperative recovery? a. Explain the procedure before surgery b. Inform the client that they will be alright c. Call a family member prior to the client entering the surgical suite d. Make sure all insurance information has been obtained
Answer: a Cognitive Level: Apply Explanation: The nurse can explain to clients their surgical procedure before surgery, as well as any other treatments or medications. Such discussion can help clients feel safer and can aid in postoperative recovery.
The nurse is obtaining data from a 5-year-old child admitted with fractured ribs from an alleged fall. The child states to the nurse, "I was bad and my dad punished me by pushing me down the steps." Whic action by the nurse is priority? a. Nothing. It will just create problems for the chi b. Report the statement to child protective service c. Confront the parent with what the child stated. d. Talk to another coworker about the situation.
Answer: b Cognitive Level: Analyze Explanation: The nurse must report the statement to child protective services. If you, as a nurse, do not report suspected abuse, you could be subject to and civil penalties.
The nurse is assisting a client who is recovering from a hip replacement in the home setting. The nurse offers suggestions for safety adaptations. Which suggestions by the nurse would be most helpful in addressing the client's safety needs? Select all that apply. a. Encourage ambulation and exercise. b. Adjust the temperature in the home for comfort. c. Remove scatter rugs. d. Use a night light. e. Have a shower chair when bathing.
Answer: c, d, e Cognitive Level: Analyze Explanation: Safety adaptations are made for age, whether the person is old or very young. The person who is physically challenged often needs special adaptations. The nurse may assist in removing threats to safety from the client's environment. Encouraging ambulation and exercise addresses rehabilitation but does not address safety needs. Adjusting the temperature in the home for comfort does not address safety.
