Kaplan question: Pain and Maslow

Nursing Students NCLEX

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Specializes in ICU.

I'm going through the Kaplan PN book, and it says that the NCLEX sees pain as a psychosocial need. Following Maslow, you would take care of physical needs before psychosocial needs like pain.

Here's the question: you are taking care of a patient with cancer who has been weakened by chemo. What is your first priority?

1) assess for pain

2) determine if the patient is hungry or thirsty

3) explore feelings about dying

4) observe client's self-care abilities

Then, Kaplan's rationale is that #1 is correct. Untreated pain affects all biological/physiological needs. So, treating pain comes first.

This last rationale makes sense to me. And of course in the real world I think I would be more concerned about treating pain than finding them a meal, but I'm not in the real world yet. :)

So the rationale and the Maslow decision tree seem to be in conflict to me. Can you help me understand?

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Specializes in ICU.

Wait - assess for "hunger or thirst" does not mean assess for "life threatening starvation or dehydration."

That must be it, right? :)

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Specializes in ICU.

And I think I'll just keep talking to myself here to say "Meloney, stop playing around with your NCLEX toys, stop procrastinating on allnurses, and go study for your actual A&P final."

Oh, OK.

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pain!

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Specializes in Cardiac Care.

Well, I'm thinking that assessing for pain would be the priority. I think that's interesting about pain being considered a psychosocial need, instead of a physiological one. I was taught that pain assessment was to be done at every contact with the patient; it's considered the 5th vital sign.

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Specializes in ICU.

It says "while pain certainly has a physiological component, reactions to pain are considered 'psychosocial' on this exam and will be a lower priority {than physiological needs}."

I'm not trying to defend this argument... just don't understand the seeming conflict in rationales.

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Specializes in Cardiac Care.

I agree with you; I don't understand the rationale for anything other than the pain assessment.

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Hi Meloney,

When I look at your question and read it, the first thing I did was see that all the options are Assessments.

If you follow the decision tree, when you have all assessment, you basically just have to pick the one that makes sense to you and that would be beneficial to your patient.

The stem says that the patient is weakened by Chemo. Ask yourself "what do I know about chemo patients?" LABS ARE LOW, and THEY EXPERIENCE ALOT OF PAIN...Also you have to remember "FIRST PRIORITY"

Go through each choice

A) If I assess for pain, that might help the patient with chemo related issues that might help with weakness so I'll keep that option.

B)If I determine if the pt is hungry or thirsty, is that going to help with the weakness, MAYBE , but it wouldn't be my first priority

C)Explore feelings of dying.. Nobody said the pt was dying, she's just weak from chemo. Throw that one out.

D)Observe her self care abilities. If I observe her, it will just confirm what we already know. She's weak. NOT A PRIORITY..

So if you eliminate choices then you can say for example A and B, were your last two choices, but which is PRIORITY..

A) would be. That's usually how I approach questions. I have to break them down without reading into the question. Just look at the information given.

That's how I approach questions. Hope that was helpful.

KEKE

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Specializes in ICU.

keke, that explanation IS really helpful. Thank you so much!

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This is confusing me! I've been on the job, and we are required to assess for and intervene for pain, and we better document it. Psychosocial stuff can usually be treated secondarily, because most of the time we don't have the resources, (especially time) to handle the physical stuff. And, as well, as usual, I am on this site, procrastinating from studying for NC3 exam for Excelsior. No wonder I never make any progress anymore always finding something interesting on allnurses!

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unless pain is assess and treated feeding the patient will be very difficult due to the pain

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Specializes in Hospital Education Coordinator.

I can pretty much guarantee that "assessment"wins over other choices most of the time. Nursing process!

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