The nurse is making rounds and finds her older adult patient sobbing and obviously upset. She states that her doctor told her that she has cancer, and she does not want to die. "What's the sense?" she says. "I might as well die. I'm going to anyway
I guess that shows how useless I really am. Nobody wants an old lady around." The nurse notices that the patient's respirations have increased, and the tip of her nose and ear lobes are becoming cyanotic. The nurse assesses the patient and finds that the patient's pulse rate is over 150 beats per minute. According to Maslow's hierarchy of needs, the nurse should first
a. Call the physician to request a psychiatric consult.
b. Reassure the patient that she has value as a human being.
c. Place the patient on oxygen and try to calm her.
d. Call the patient's family to help her realize that she is wanted.
ANS: C
Maslow's hierarchy is useful in setting patient priorities. Basic physiological and safety needs are usually the first priority. These include physiological needs such as air, water, and food. Cyanosis and fast heart rate are indicators of physiological stress and must be dealt with first, or the patient may not survive. The second level includes psychological security. A psychiatric consult would come after physiological stabilization. The third level includes love and belonging needs that would also need to be addressed, and the family may be helpful in dealing with this, once the patient is stabilized. The fourth level involves self-esteem, which would also need to be addressed.
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