Mary Smith is a 78-year-old resident of
Mary Smith is a 78-year-old resident of a long-term care facility. Mary has arthritis, walks the halls with her walker, and has a G-tube for feedings which she administers herself under the guidance of the nurse. She is able to drink oral fluids. She receives medication for her arthritis and rates her pain a 3 on a 0 to 10 scale but the arthritis in her knees and hips tends to increase her pain to a 7 or 8 when she walks too far. She has a history of constipation; takes Metamucil twice a day and occasionally needs an enema and is able to toilet herself. Mary plays bingo and attends the weekly sing-along. Recently Mary is having nightmares about dying and is having difficulty coping with the idea she is nearing the end of life. She doesn’t want to die until she becomes a great-grandmother at least once. She has three children and six grandchildren. Rose Garcia, is a 67-year-old resident of a long-term care facility. She has arthritis, has difficulty moving, but walks with the assistance of the nursing assistant. She has a G-tube feeding the nurses administer. Rose rates her arthritis pain at 1 on a scale of 0 to 10. She has alternating constipation and diarrhea and is incontinent of urine. Rose states Mary Smith told her to take Metamucil when she has constipation. Rose asks the nurse if she can have the Metamucil. She finds herself sleeping most of the day, doesn’t know why she is so tired, and resists getting out of bed to go to the community room for meals and activities. Rose is an atheist and is well adjusted to her stage in life. She believes life is beautiful and she is happy experiencing all phases of life, even the end. Her daughter visits her every week and often brings her two grandchildren. Task: Identify issues or concerns you have for each of these patients then organize them according to Maslow’s Hierarchy of Human Needs. Categorize the identified patient needs using the following criteria (NCSBN, n.d.). Explain your rationale. First-order priority need – immediate threat to health, safety, or survival. Second-order priority need – actual problem for which immediate help has been requested by the patient or family. Third-order priority need – actual or potential issue that the patient or family is not aware of. Fourth-order priority need – actual or potential issue that is anticipated in the future and for which help will be needed.
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