Prioritizing According to Maslows

[Esme12, ASN, BSN, RN]

First, to write a care plan there needs to be a patient, a diagnosis, an assessment of the patient which includes tests, labs, vital signs, patient complaint and symptoms. 

Maslow's hierarchy of needs is a based on the theory that one level of needs must be met before moving on to the next step.

• self-actualization – e.g. morality, creativity, problem solving.
• esteem – e.g. confidence, self-esteem, achievement, respect.
• belongingness – e.g. love, friendship, intimacy, family.
• safety – e.g. security of environment, employment, resources, health, property.
• physiological – e.g. air, food, water, sex, sleep, other factors towards homeostasis.

Assumptions

• Maslow's theory maintains that a person does not feel a higher need until the needs of the current level have been satisfied.

b and d needs

Deficiency or deprivation needs

The first four levels are considered deficiency or deprivation needs (“d-needs”) in that their lack of satisfaction causes a deficiency that motivates people to meet these needs

Growth needs or b-needs or being needs

• The needs maslow believed to be higher, healthier, and more likely to emerge in self-actualizing people were being needs, or b-needs.
• Growth needs are the highest level, which is self-actualization, or the self-fulfillment.
• Maslow suggested that only two percent of the people in the world achieve self actualization. e.g. abraham lincoln, thomas jefferson, albert einstein, eleanor roosevelt.
• Self actualized people were reality and problem centered.
• They enjoyed being by themselves, and having deeper relationships with a few people instead of more shallow relations with many people.
• They tended to be spontaneous and simple.

Application in nursing

• Maslow's hierarchy of needs is a useful organizational framework that can be applied to the various nursing models for assessment of a patient's strengths, limitations, and need for nursing interventions.

Care plan basics:

Every single nursing diagnosis has its own set of symptoms, or defining characteristics. They are listed in the nanda taxonomy and in many of the current nursing care plan books that are currently on the market that include nursing diagnosis information. You need to have access to these books when you are working on care plans. There are currently 188 nursing diagnoses that nanda has defined and given related factors and defining characteristics for. What you need to do is get this information to help you in writing care plans so you diagnose your patients correctly.

Don't focus your efforts on the nursing diagnoses when you should be focusing on the assessment and the patients abnormal data that you collected. these will become their symptoms, or what nanda calls defining characteristics.

Here are the steps of the nursing process and what you should be doing in each step when you are doing a written care plan:

1. Assessment (collect data from medical record, do a physical assessment of the patient, assess adls, look up information about your patient's medical diseases/conditions to learn about the signs and symptoms and pathophysiology)
2. Determination of the patient's problem(s)/nursing diagnosis (make a list of the abnormal assessment data, match your abnormal assessment data to likely nursing diagnoses, decide on the nursing diagnoses to use)
3. Planning (write measurable goals/outcomes and nursing interventions)
4. Implementation (initiate the care plan)
5. Evaluation (determine if goals/outcomes have been met)

[CaringGerinurse525]

Thanks Esme I guess I should have been more clear. We are not actually creating a Care Plan as of now...I have a resident at an efc that is 76 years old and has dementia. We have two worksheets to complete the first is our assessment and our clusters with conclusions which let me to the nandas I listed. My lady is in the very first level of dementia and is very well adjusted because she has been in the facility since 2007.

The second worksheet we have to complete is the list with the nandas, the priority of care and maslows hiearchy. I listed them in order according to what I saw of importance. I was not sure if I correctly ordered them. I understand the hiearchy but im confused why risk for falls is after risk for activity intolerance.

Thanks for your response!

[Esme12, ASN, BSN, RN]

Nursing Student 2187 said:

I have a project due Tuesday where I have to rank my NANDAS in the priority of care as well as according to Maslow's Levels. I am confused about the physical ones...here is what I have so far... Does this look right? Nanda, Priority of Care, Maslow's level Self-care deficit #1 Physiological Risk for Falls. #4 safety and security Risk for impaired skin integrity. #2 physiological Risk for infection. #5 safety and security Risk for activity intolerance. #3 physiological Risk for compromised resilience. #6 safety and security Risk for impaired social inter. #7 love and belonging Risk for powerlessness. # 8 self-esteem

Think if it was your Grandma......what would be important to you. Safety is huge for the elderly. Many times they are fine u and then they fall and their physical condition deteriorates from there.....they slowly decline and pass away. The risk to her health is greater with the fall due to her activity intolerance.....it can cause a hip fracture, head bleed, take away independence. Activity intolerance may cause the fall but safety precautions can prevent the fall. Which is causing the most risk to the patients life

Look at Maslow's to tell you which priority precedes the next. Don't forget Erickson growth and development

[born_this_way]

Thank you for the tip. I am preparing for the NCLEX-PN and found this post very helpful

[moorerochester]

So I guess on my last test when I chose muscle weakness over dysrythmia for HRF injury rt hypokalemia, that was a mistake? Should I always base test answers on Maslow as well?