Chapter 5 & 24: Culture & Hospitalized Patient

Question 1

Cast

Answer 1

plaster encasement to help the body heal by holding injured bone or joints in place

Question 2

Comatose

Answer 2

state of unconsciousness; unable to respond to voices or things around the environment
- won’t reply to any stimuli; even central pain

Question 3

Decerebrate

Answer 3

abnormal body posture where arms and legs are held straight out, toes pointed downward, and head and neck arches backward with tightened, rigid muscles; indicative of severe damage in brain

Question 4

External FIxator

Answer 4

device used to immobilize a body part following a fracture or certain orthopedic problems to allow bone healing

Question 5

Glasgow Coma Scale

Answer 5

international tool used to measure the level of consciousness for traumatically injured patients

Question 6

Mandibular Pressure

Answer 6

application of pressure on the mandible at the angle of the jaw

Question 7

Nasal Cannula

Answer 7

small plastic tube connected to two short prongs that are inserted into the nares to supply oxygen directly from a flow meter or through humidified air to the patient

Question 8

Never Events

Answer 8

errors in medical care that are clearly identifiable, preventable, and serious in their consequences for patients, and that indicate a real problem in the safety and credibility of a health care facility

Question 9

Semicomatose

Answer 9

imprecise term for a state of drowsiness and inaction, in which more than ordinary stimulation may be required to evoke a response, and the response may be delayed or incomplete`

Question 10

Current Shift Assessment

Answer 10

patient assessment completed at the beginning of each shift to develop a plan of care

Question 11

Decorticate

Answer 11

abnormal body posture where person is stiff with bent arms, clenched fists, and legs held out straight
- arms bent in toward the body and wrists and fingers are bent and held on the chest
- indicates severe brain damage

Question 12

Obtunded

Answer 12

state similar to lethargy in which the patient has a lessened interest in the environment, slowed responses to stimulation, and tends to sleep more than normal with drowsiness in between sleep states

Question 13

Sequential Compression Devices

Answer 13

mechanical prophylactic(prevention) treatment to reduce the incidence of venous thromboembolism (VTE) by enhancing the blood flow in the deep veins of the leg

Question 14

Stuporous

Answer 14

not fully conscious

Question 15

Thrombo Emboli Deterrent Stockings

Answer 15

stockings designed and worn to support the venous and lymphatic drainage of the leg to help stop blood clots from forming

Question 16

What is culture ?

Answer 16

knowledge, belief, art, morals, laws, customs, and any other capabilities and habits acquired by a person as a member of society
- shared beliefs and values

Question 17

What is Ethnicity ?

Answer 17

characteristics that a group may share
- language/dialect, race, religious beliefs, geographic orgin, etc
- internal sense of distinctiveness

Question 18

What is spirituality ?

Answer 18

born out of each person’s unique life experiences and his or her personal effort to find purpose and meaning in life
- life meaning, purpose and connection to others
- nonreligious systems of beliefs and values
- metaphysical or transcendental phenomena

Question 19

What are some barriers to assessing spiritual needs ?

Answer 19

Personal/Individual Barriers:
- nurses may see the patient’s spiritual needs as a private or family matter and not their responsibility
- Nurse discomfort, embarrassment, or uncertainty of their own spirituality
- Nurse may feel uncomfortable with situations that result in spiritual distress (suffering, grief)
Knowledge Barriers:
- Nurse lack knowledge of spiritual and religious beliefs of others
- Nurse may have minimal education on spiritual assessment

Question 20

What are some important things to remember about cultural assessment ?

Answer 20

• be sensitive
• ask questions
• gather info specific to the individual patient
• avoid stereotyping
• document your assessment findings so all members of healthcare team have your data from your cultural assessment

Question 21

What are the components to developing cultural competence ?

Answer 21

• cultural desire
• cultural awareness
• cultural knowledge
• cultural skill
• cultural encounters

Question 22

What is cultural desire ?

Answer 22

an internal motivation to develop skills interacting with people from other backgrounds
- be respectful of different cultures and let go of your own biases/prejudices

Question 23

What is cultural awareness ?

Answer 23

a process of self-reflection of one’s own culture and their reactions to people from other backgrounds
- assess your own belief’s and cultural heritage
- this can influence the way you hear and understand others
- identify your feelings gained from experiences from different cultures
- you are aware of your own strengths and weaknesses

Question 24

What is cultural knowledge ?

Answer 24

a process to intentionally learn about beliefs, customs, traditions of people from other backgrounds
- participate in lifelong learning to appreciate cultural preferences
- helps your provide an insight into the differences and similarities among people
- don’t assume that all people from a particular group are the same
- use your knowledge as a foundation for learning about beliefs, values, and customs of each patient

Question 25

What is cultural skill ?

Answer 25

the ability to assess and interpret information, adapt communication style, establish relationships
- perform a culturally based health assessment
- interpreter may be necessary

Question 26

What is cultural encounters ?

Answer 26

the interaction with individuals from diverse cultural backgrounds
- use knowledge of health beliefs, practices and communication patters when interacting with health care consumer

Question 27

What is FICA ?

Answer 27

spiritual assessment tool
- what is your FAITH tradition ?
- how IMPORTANT is your faith to you ?
- what is your CHURCH or COMMUNITY of faith ?
- how do your religion and spiritual beliefs APPLY to your health ?
- how can we ADDRESS your spiritual needs ?

Question 28

What do you assess in a patient with a nasal cannula ?

Answer 28

• respiratory effort and O2 sat
• any sputum
• skin of nares and behind of ears for redness and signs of pressure from prongs and tubing

Question 29

What do you assess in a patient with a oxygen mask ?

Answer 29

• use of accessory muscles to breathe or tripod sitting
• inspect skin of face for redness or indentation from facemask and behind helix of ears for signs of pressure

Question 30

What do you assess in a patient with a tracheostomy ?

Answer 30

can’t speak since air goes through tube and not vocal cords
- tube held in place with tie around their neck that warms and humidifies the air
- respiratory effort
- amount and color of secretions suctioned from tube
- inspect skin around tube for redness, excoriation, or skin breakdown

Question 31

What do you assess in a patient with a chest tube ?

Answer 31

tubs work with gravity or suction
- assess pain from surgical site
- dressing around tube should be intact and dry
- don’t remove dressing unless surgeon is ready to remove the tubes
- color and amount of drainage noted

Question 32

What do you assess in a patient with a gastrostomy tube ?

Answer 32

• inspect oral mucous membranes for moisture
• inspect skin around tube for redness, edema, and drainage
• gingiva and oral mucous membrane should be pink and moist

Question 33

What do you assess in a patient with a nasogastric tube ?

Answer 33

• inspect skin of nose with tube for redness from pressure
• inspect tape attacking the NG tube to ensure its secure

Question 34

What do you assess in a patient with a wound drain ?

Answer 34

• assess the site of drain insertion for leakage, redness, or irritation
• is drain is secure with tape or suture
• patency of drain

Question 35

What do you assess in a patient with a ostomy ?

Answer 35

• inspection of stoma
• inspect skin around stoma
• inspect character of stool and colostomy appliance
• skin around stoma should be red and moist without lesions, irritation, and be intact

Question 36

What do you assess in a patient with a cast ?

Answer 36

• assess circulation, movement, and sensation of fingers/toes distal to cast
• assess capillary refill
• temp and color of skin

Question 37

What do you assess in a patient with a external fixator ?

Answer 37

is metal wiring that holds bones in place while they heal
- assess circulation, movement, and sensation of limb
- capillary refill
- inspect insertion site for infection (redness, edema, irritation)

Question 38

What do you assess in a patient who is unconscious ?

Answer 38

• ensure they are breathing
• use Glasgow Coma test
• assess vital signs