Ethnocultural, Legal, and Ethical Considerations Flashcards
During a home visit, an older adult woman tells the home care nurse that she has been taking 6+ acetylsalicylic acid tablets per day for her ‘bad bones’. The nurse continues with a thorough assessment and makes the decision to double the prescribed dose to help minimize the patient’s ‘bad bones’. Which of the following statements correctly describes the scenario?
a) The ‘right’ to the right dosage of a drug is being violated.
b) The nurse should make her own decision to change the specific dosage of drug.
c) The nurse is following one of the ‘10 rights’ of drug administration - specifically the right to fairly safe standards of care.
d) The nurse is planning to give medications within the guidelines of professional autonomy, such as deciding on a dosage not ordered.
a) The ‘right’ to the right dosage of a drug is being violated.
Which of the following ethnocultural beliefs would most likely influence the health of a 59yr old female Chinese patient?
a) X-rays are seen as a break in the souls integrity.
b) Hospital diets are interpreted as being healing and healthful.
c) The use of heat may be important practice for this patient.
d) Being hospitalized is a source of peace and socialization for this ethnoculture.
c) The use of heat may be important practice for this patient.
A patient is being counselled for possible participation in a clinical trial for a new medication. After meeting with the physician, the nurse is asked to obtain the patient’s signature on the consent forms. Which of the following does this ‘informed consent’ indicate?
a) Once therapy has begun, the patient cannot withdraw from the clinical trial.
b) the patient has been informed of all the potential hazards and benefits of the therapy
c) No matter what happens the patient will not be able to sue the researchers for damage.
d) the patient has received only the information that will help to make the clinical trial a success.
b) the patient has been informed of all the potential hazards and benefits of the therapy
A Japanese patient describes a family trait that m,manifests frequently: she says that members of her family often have strong reactions after taking certain medications, but her White friends have no problems with the same dosages of the same medications. Because of this trait which of the following statement applies?
a) She may need smaller doses of the medication
b) She may need higher doses of the medication
c) She should not receive these medications because of potential problems with metabolism
d) These situations vary greatly, and her accounts may not indicate a valid cause for concern.
a) She may need smaller doses of the medication
A new drug has been approved for use and the drug manufacturer has made it available for sale. During the first 6 months, Health Canada receives reports of severe adverse effects that were not discovered during the testing and considers whether or not to withdraw the drug. Which phase of investigational drug studies does this illustrate?
a) Phase 1
b) Phase 2
c) Phase 3
d) Phase 4
d) Phase 4
Discuss the impact of ethanocultural practices as they relate to safe and effective drug therapy.
- Ethnocultural factors are important to holistic nursing care because they affect a patient’s health, health beliefs, and health care practices, including drug therapy. The nurse needs to acknowledge and accept the influences of a patient’s cultural beliefs, values, and customs to prevent a conflict from arising between the goals of nursing and health care and the dictates of a patient’s ethnocultural background. Specifically in reference to cultural influences and drug therapy, medication response depends greatly on one’s adherence with treatment. Adherence may vary depending on a patient’s cultural beliefs, experiences with medications, expectations, family expectations, family influence, and level of education. However, adherence is not the only factor affected by cultural influence on drug therapy. Health care professionals must also be aware that some patients subscribe to other therapies, including natural health products and homeopathic remedies, which can inhibit or accelerate drug metabolism and alter the response to a drug.
The concept of polymorphism is important to consider. Factors contributing to drug polymorphism may be generally categorized as environment (diet, nutritional status), ethnicity, and genetics. For example, malnutrition, with deficiencies in protein, vitamins, and minerals, may alter the functioning of metabolic enzymes, thus affecting the body’s ability to absorb or eliminate a medication. Genetic factors also influence how various cultures respond to drugs. Some patients are slow acetylators of drugs, which causes elevated drug concentrations because of changes in metabolism. Some patients are more rapid acetylators and metabolize drugs more aggressively, resulting in decreased drug concentrations.
Choose at least 2 of the terms in legal and ethical principles: Common legal and ethical-related terms on pg. 67 and apply the concepts to an example of drug administration and nursing.
- Answers will vary widely. Some suggestions follow:
• Autonomy is essential to nursing, but it is important to consider that as a nurse, one must function within the scope of practice as a nurse. Nurses practise autonomy when they decide to administer or withhold drugs on the basis of a professional assessment of the patient.
• Issues of confidentiality are paramount in today’s health care environment. For example, the Health Insurance Portability and Accountability (HIPAA) standards address how to maintain privacy despite electronic transfer of confidential patient information.
• Nonmaleficence: nurses should strive to administer drugs safely and without harm to the patient.
• Veracity: telling the truth is important during patient teaching, in obtaining informed consent, when investigating new drugs, and in cases of medication error.
