HUMAN NEEDS THEORY The explication of human needs in the concept of personhood and nursing.

. Need motivates the behaviour of a person. According to Maslow, basic needs are inactive or functionally absent in the people.

*Basic needs met = Health *Basic needs not met = Illness Needs are hierarchical. Maslow also specified cognitive and aesthetic needs. Cognitive Needs To know and understand To be curious To explain To organize To analyze To look for relations and meanings

Aesthetic Needs Order Symmetry Closure Beauty

Application to Nursing: Recognition of human needs is crucial in nursing care.

 The behaviour of the client reflects their needs. Nurses must coordinate interventions to promote need attainment

The theory has been used in organizing nursing curricula and in assessing health and giving care. The need to maintain life and physical integrity is the first priority when its in jeopardy. Nurses must not only focus on physiologic needs. Psychiatric nurses must also integrate clients cognitive needs.

GENERAL SYSTEMS THEORY A way of viewing a person, families, groups, and society. It was introduced in 1928 by Ludwig Von Bertalanfy. A system is a set of components or units interacting with each other within a boundary that filters the kind and rate of flow of inputs and outputs to and from the system. Systems are arranged in hierarchical manner. Systems are capable of self-regulation thru feedback. Systems can be explained thru HOLISM or SYNERGISM. Holism or Synergism the whole is greater than the sum of its parts. Boundaries keep out not necessary and bring in necessary; separates the system from their environment; easily defined in physical and biological systems; difficult to delineate in social systems.

2 Types of System 1. Open System open to the exchange of matter, energy, and information about their environment. Example, biological and social systems.

Characteristics: In a dynamic relationship with the environment. It receives input. Inputs are resources needed by the system. Inputs are transformed in a process called throughput and are exported as output.

Engenders Negentropy. Seeks equilibrium and homeostasis thru feedback that results to healthy steady state. Feedback can be Positive or Negative. Characterized by equifinality which indicates that goals or purposes may be achieved by many potential means.

2. Closed System Engenders Entropy. Repetitious; with a direct cause and effect relationship.

Application to Nursing: Each client is viewed holistically. Clients are open systems and must not be treated isolated. Family involvement is an essential component of clients system. Nurses must enlist familys input on the treatment plan. Nurses must assess familys knowledge about patients condition, health practices and strength to evaluate familys capability and needs for teaching. Mental illness is viewed as the result of inadequate resources and neurobiological processes and systems gone awry. PSYCHOBIOLOGICAL FRAMEWORK

Neuroanatomy and Neurophysiology Nervous System Central Nervous System brain and spinal cord Peripheral Nervous System nerves and ganglia

Brain 3 to 4 pounds in weight and contains 100 billion neurons.

3 Parts of the Brain: 1. Cerebrum

 It is divided into 2 hemispheres that are connected to each other by Corpus Callosum. The hemispheres are composed of: a) Nervous System Pathways b) Cerebral Cortex c) Limbic Structures d) Basal Ganglia

Diencephalon Composed of: Thalamus major relay nuclear area to and from the cerebral cortex. Hypothalamus maintains homeostasis and controls the autonomic nervous system. - moderates body temperature, gastrointestinal and cardiovascular activity. -controls hunger, thirst, endocrine system, emotion and sexual pleasure. Epithalamus contains pineal body.

2. Brainstem Composed of: Midbrain continuation of CNS below cerebrum; 1.5 cm in length and is narrow. Composed of: Red Nuclei Substantia Nigra Pons bridge between midbrain and medulla oblongata. 2. 5 cm long anterior to cerebellum.

Some pathways from cerebral cortex terminate here. Projects motor and posture information to cerebellum.

Medulla Oblongata 3 cm long and connects cervical spine to the brain. Reticular Formation scattered neuronal pathway on brainstem responsible for regulatory functions.

3. Cerebellum has 2 hemispheres separated by a central portion called vermis. Neurotransmitters 1. Dopamine responsible for motor movement, sensory integration, cognition, memory, and emotional behaviour. Metabolized by Monoamine Oxidase. Synthesized at substantia nigra. Adrenergic 5 significant receptors: D1 converts ATP to CAMP by stimulating adenylate cyclase. D2 inhibits adenylate cyclase and has an increased affinity with dopamine. Results to brain reward syndrome with cocaine, alcohol and opiate. D3 improves cognitive and emotional function. D4 like d2 and d3 D5 like d1 Receives sensory input from muscles and signals from cerebral cortex indicating directions. Modifies movements through sending final signal to cerebral motor cortex via thalamus.

2. Norepinephrine noradrenaline, related to dopamine. Precursor of epinephrine Fight or flight

Alteration causes anxiety.

3. Serotonin secreted by upper pons. Targets basal ganglia, limbic system and cerebral cortex. Modulates wakefulness and alertness and transmits oain. Alteration causes depression.

4. Gamma- Aminobutyric Acid Inhibitory neurotransmitter or neuromodulator. Conteracts norepinephrine, dopamine preventing disorganized an frenzied responses to stimuli. Decreased GABBA results to anxiety disorders or panic symptoms.

5. Glutamate and N-methyl-D-aspartate Major excitatory neurotransmitter in mammals. Activates ionotropic receptors including N-methyl-Daspartate. Hypofunction results to schizophrenia and anxiety.

Clinical Application Schizoprenia enlarged ventricle size related to neurodevelopmental reasons which is characterized by failed developmet of brain surrounding the ventricles and occupation of ventricles of empty spaces by enlarging or also known as increased ventricular brain ration (VBR). Decreased cerebral blood flow to prefrontal areas of the cortex resulting to declined frontal cognitive functions such as organizing, planning, learning, problem solving, and critical thinking. Altered or decreased dopamine.

Mood Disorders Decreased norepinephrine and serotonin. Pharmacological treatment is aimed at restoring these on their optimum levels.

 Anxiety Disorders Decreased GABBA. Over sympathetic stimulation by increased levels of norepinephrine, epinephrine and dopamine.

Dementias Brain atrophy which manifests microscopically as neurofibrillary tangles and amyloid plaques. Enlarged ventricles, narrowed gray matter, widened sulci and decreased width of gyri. Loss of cholinergic problems which plays a major role in memory problems.

AIDS/HIV Disease HIV attacks the brain in by weakening and destruction of T4 lymphocytes which results to exposure of brain to pathogens and by direct attack on neuronal cell bodies and white matter. The attack on white matter is the reason for frequent misjudging of AIDS to multiple sclerosis.

Degenerative Diseases Degeneration of basal ganglia] Deterioration of substantia nigra which is the chief synthesizing site of dopamine in the brain. This leads to bradykinesia, tremor, and rigidity.

Anorexia Nervosa Damaged hypothalamus.