which one is the highest priority??

[Kathyz]

I just started my nursing program 7 weeks ago. We use Maslow's Hierarcy to prioritize. I can't figure out this question; I'm stuck between 2 answers.

"The client w/ TB is to be discharged home w/ community health nursing follow-up. Of the following interventions, which would have the HIGHEST priority?

1. offering the client emotional support

2. teaching the client about the disease and its treatment

3. coordinating various agency services

4. assessing the client's enviornment for sanitation

I'm thinking #4 and my husband is leaning toward #2.

What do you guys think?

Thanks,

Kathy

[Tiwi]

I just started my nursing program 7 weeks ago. We use Maslow's Hierarcy to prioritize. I can't figure out this question; I'm stuck between 2 answers.

"The client w/ TB is to be discharged home w/ community health nursing follow-up. Of the following interventions, which would have the HIGHEST priority?

1. offering the client emotional support

2. teaching the client about the disease and its treatment

3. coordinating various agency services

4. assessing the client's enviornment for sanitation

I'm thinking #4 and my husband is leaning toward #2.

What do you guys think?

Thanks,

Kathy

I think #4. The highest priority is looking at physiological needs. This means assessing the environment. Assessment comes before planning, therefore #3, coordination is out as that is maintaining safety. #2 is hard to define, but it is educating about the physiological needs.

Thus my opinion is #4. Let us know the answer, because it is tricky...

[Daytonite, BSN, RN]

um i say four.. just a guess.

swtooth

sorry to duck in here again, but critical thinking is very simply making judgments based on facts rather than making random guesses based on nothing.

by maslow, continuity of care is a safety and security issue. emotional support comes under love and belonging which on his pyramid is above safety. knowledge is a cognitive need according to maslow and is placed at the top of his pyramid over esteem needs. joking aside, and going strictly by maslow, the safety need here wins out. as far as option 4 is concerned, the parameters of the question already tell you that they are looking for an intervention. while assessments are sometimes also interventions, they are interventions when the assessment is part of evaluating or monitoring the patient's progress in order to compare it to a previous level of assessment. this answer choice is clearly an initial assessment which puts it in step #1 of the nursing process.

this is the pyramid from top to bottom:

• self-actualization (morality, creativity, acceptance of facts, problem solving, lack of prejudice)
  
• esteem (confidence, achievement, respect of others, respect by others)
  
• love/belonging (friendship, family, sexual intimacy)
  
• safety (security of body, security of resources, security of family, security of health, security of property)
  
• physiological (breathing, food, water, excretion, sex, sleep, homeostasis)

for those of you who have a copy of saunders comprehensive review for the nclex-rn examination, 3rd edition, by linda anne silvestri, look on page 71 regarding discharge planning. it states, in this order: "the nurse should anticipate the client's discharge needs and make the referral as soon as possible (involve the client and family in the referral process)." and follows with, "the nurse needs to educate the client and family regarding care at home." clearly, contacting the outside agencies is a priority according to silvestri.

[Scrubz]

I need to get that NCLEX review book!

[moongirl]

I need to get that NCLEX review book!

I have it.. thats why I chose #3 as the correct answer

[CRNI-ICU20]

I say 3.....the hospitalization has taken care of the other things.....

[nservice]

My first guess was #2. I don't think assessing his home for sanitation is important for his care. A dirty house didn't cause TB. I'm not sure assessing the home sanitation is taking care of his pysiological needs as much as it is a safety thing. The way I read the question, the coordination of the health nurse had already been done. Maybe I'm wrong about that...hmmmm. I think teaching him about his disease and treatment is more of a safety issue for him and his family/friends to prevent spread of the disease. My eyes are crossing now, but I'm gonna stick with #2.

[EricJRN, MSN, RN]

I noticed a shift in opinions on this thread, so I just thought I'd cast my vote: I'm still liking #4.

While I know that assessment usually occurs early in the nursing process, we can't assess everything right away, so I don't think the time for that has passed. When the patient presents to the ER with hemoptysis, we don't drive out and look for trash in the house, for example.

We know that sanitation is a particularly big issue in preventing the spread of TB. If we begin coordinating resources for discharge without assessing the home, we may not connect the patient with a complete set of resources.

[West_Coast_Ken, BSN, RN]

"The client w/ TB is to be discharged home w/ community health nursing follow-up. Of the following interventions, which would have the HIGHEST priority?

1. offering the client emotional support

2. teaching the client about the disease and its treatment

3. coordinating various agency services

4. assessing the client's enviornment for sanitation

"The client is to be discharged home..." ie this client is still in the hospital.

Discharge instructions are a key aspect of the RN role and very important for a pt with TB.

#2.

[Kathyz]

The answer is #2. Here's what my teacher said:

"The answer is #2. This is the most important thing the nurse has to do, because if it is not completed, the pt will infect everyone around him."

Thanks, everyone, for your input! :smilecoffeecup:

[Tiwi]

The answer is #2. Here's what my teacher said:

"The answer is #2. This is the most important thing the nurse has to do, because if it is not completed, the pt will infect everyone around him."

Thanks, everyone, for your input! :smilecoffeecup:

Now you are going to start off a philosophical discussion! I still would have thought #4, simply because Maslow's scale is directed towards the safety of the individual, not of those around him...

Anyway, thanks for the input/question. It's really got us all thinking...

[NaomieRN]

I say 2

[morte, LPN, LVN]

the answer depends from whose viewpoint we are looking......if it is the hospital nurse, i would pick 3, because 1+2 should be fete accompli.....and 4 is not for you to do, but for the HH nurse......now if it is from the HH nurse viewpoint, it would be 4......