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IM1 Exam 6 > Spirituality/Diversity > Flashcards

Spirituality/Diversity Flashcards

1
Q

Tx Administrative Code Title 22 Examining Board Chapter 217 Rule 217.11

A

provide without discrimination, nursing services regardless of age, disability, economic status, gender, national origin, race, religion, health problems, or sexual orientation of the client served

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2
Q

ANA Code of Ethics for Nurses

A

the nurse, in all professional relationships, practices with compassion and respect for the inherent dignity, worth, and uniqueness of every individual, unrestricted by considerations of social or economic status, personal attributes, or the nature of health problems

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3
Q

professional nursing pledge

A
  • in the full knowledge of the responsibilities I am undertaking, I promise to care for my patients with all the knowledge, skills, and understanding I possess, without regard to race, color, creed, politics, social status…
  • I will respect, at all times, the dignity and religious beliefs of the patients under my care…
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4
Q

spirituality

A

complex concept that is unique to each individual and is dependent upon a person’s culture, development, life experiences, beliefs, ideas about life

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5
Q

spirituality can include

A

the chart that has
- connectedness
- meaning and purpose in life
- inner strength and peace
- faith and hope
- transcendence and self-transcendence

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6
Q

spiritual wellness

A
  • awareness of one’s inner self
  • connection to a higher being, nature…
  • values
  • highly individualized
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7
Q

spiritual wellness attributes

A
  • harmony
  • purpose
  • self acceptance
  • clear values
  • positive outlook
  • peace
  • balance
  • growth
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8
Q

spiritual wellness

A
  • positive effect on health
  • enhanced quality of life
  • accept hardship and even mortality
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9
Q

types of spirituality

A
  • religious
  • non-religious
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10
Q

spirituality and religion

A
  • spirituality is found in all human cultures
  • expressed differently in religious faiths
  • spirituality does not have to include religion
  • being spiritual does not mean practicing religion
  • congruency: being spiritual but not practicing religion, without religious practice
    chart:
  • spirituality: where do I find meaning, how do I feel connected, how should I live
  • religion: what practices, rites, or rituals should I follow, what is right or wrong, what is true and false
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11
Q

spirituality and health

A
  • reduces stress
  • improved health outcomes with chronic conditions (cancer, arthritis, diabetes)
  • helps with pain management
  • comfort for the dying and bereaved
  • enhances recovery from illness and surgery
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12
Q

spirituality and health details

A
  • decreases anxiety, depression, anger, discomfort, and feelings of isolation
  • decreases alcohol and drug abuse
  • decreases blood pressure and risk of heart disease
  • increases ability to cope
  • increases feeling of hope, optimism, freedom from regret, inner peace and satisfaction with life
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13
Q

spirituality in healing process

A
  • enhances comfort
  • provides inner peace
  • helps patients come to terms with disability and death
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14
Q

spirituality and relationships

A
  • relationships include: self, family, friends, loved ones, consider how you relate to the world around you
  • aspects of relationships that effect spirituality: love, hurt, trust, mistrust, communication
  • reflect: your closest relationships
    (if patient had hurt and mistrust in relationships, it is going to be hard to connect at nurse-patient level with them)
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15
Q

example of spiritual wellness

A

despite suffering,
- feeling connected to others who are suffering
- feeling support, love, and room in my heart for others
- keep up the fight to endure, pushing beyond limitations
- transform this world into a place of wholeness and mutual support

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16
Q

spiritual distress

A

the state in which the individual experiences or is at risk for experiencing a disturbance in his belief system that is the source for his strength and hope - Carpenito
(patient believes they are being punished or their beliefs may have left them)

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17
Q

spiritual distress characteristics

A
  • concern with the meaning of life, suffering and/or death
  • concern about belief system
  • anger toward God/religious representatives
  • no longer participates in religious practices
  • concern about his/her relationship with God
  • questions meaning of own existence
  • feels guilt, shame, remorse
  • feels helpless and hopeless
  • seeks spiritual assistance
  • demonstrates gallows humor: they got bad diagnosis and make a joke about it, you don’t have to laugh or say anything
  • suffers from sleep disturbances
  • alterations in mood or behavior
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18
Q

spiritual assessment

A
  • faith/belief
  • life and self-responsibility
  • connectedness to God or higher power and others
  • life satisfaction
  • culture
  • fellowship and community
  • ritual and practice
  • vocation
    (do this on admission both times (to hospital and to unit)
    connectedness to god or higher power - how they identify religiously)
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19
Q

nursing care

A
  • nurse-patient relationship
    – compassionate presence
    – active listening to fears, hopes, dreams and pain
    – respect
    – freedom of choice
    – no judgement
  • use of support systems
  • diet
  • prayer/mediation
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20
Q

nursing action

A
  • offer to contact the pastoral care department
  • plan activities to promote healing of body, mind and spirit
  • offer to teach relaxation, guided imagery, and mediation technique
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21
Q

religion

A
  • organized beliefs and worship
  • “state of doing”
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22
Q

agnostic

A

person who believes that nothing is known or can be known of the existence or nature of God or of anything beyond material phenomena
- claims neither faith nor disbelief of God
(God could or couldn’t exist but can’t know so not sure)

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23
Q

atheist

A

person who disbelieves or lacks belief in the existence of God or gods and an ultimate reality
(God does not exist)

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24
Q

roman catholicism

A
  • may desire Eucharist or mass daily
  • Sacrament of the Anointing of the Sick
  • Last Rites
  • Baptism of infants if prognosis is grave
  • Praying the Rosary
  • meat free diet on Friday’s during lent
  • birth control may be prohibited
  • confession
25
Q

Mormonism/Church of Latter Day Saints

A
  • Joseph Smith: prophet
  • healthful living (no tea, alcohol, coffee or tobacco)
  • believe in Jesus
  • forgiveness of sins
  • baptism for the newborn
  • last rites
  • communion
    (believe in Jesus but not that he is the savior, he did walk the earth - possibly baptism at 8 yrs old)
26
Q

jehovah’s witness

A
  • do not celebrate birthdays or holidays
  • refusal of blood products/no blood in food
  • does not believe in immediate afterlife
  • Jehovah is god - there is no trinity
    (no trinity: no father, son, holy spirit,
    blood cooked out of food, not rare,
    receiving someone else’s blood is going against God’s will like transplants)
27
Q

mennonites

A
  • christian
  • pacifism
  • many speak low German and/or Spanish
  • modest apparel for women
  • caps indicate submission and headship order:
    God > man > woman
    (may have to use translator that is family member bc low German is like German mixed with Spanish,
    woman in submission = married, defer to man for speaking,
    gender-congruent care and family member may want to bathe them)
28
Q

islam (muslim)

A
  • may engage in prayer 3-5 times a day facing Mecca
  • face, hands, and feet are washed before prayer
  • right hand used for everything but elimination
  • no pork or alcohol
  • gender concordant care
  • modesty
    (give pills in right hand, left hand used for elimination,
    pork - bacon, sausage)
29
Q

judaism

A
  • kosher certified foods
  • sabbath is from sunset Friday to sunset Saturday
  • sabbath may not want to use call light
  • cremation is prohibited or highly discouraged
  • daily prayers are valued
  • circumcisions
    (not use call light - nothing no one is supposed to work on the sabbath (including you and the elevator),
    circumcisions - holy ceremony, done specific number of days after birth, done by Rabbi, not circumcised in hospital - make sure they are aware when and how things are happening when signing consent)
30
Q

buddhism

A
  • no belief in a personal creator/God
  • mindfulness and mental clarity
  • quiet and peaceful environment
  • may be vegetarian
  • prefer family to bathe, toileting, feed…
  • suffering is part of life
  • karma
31
Q

hinduism

A
  • reincarnation
  • personal hygiene important and must be daily
  • cremation common on day 2 after death
  • right hand for eating, left hand for toileting
  • many are vegetarians
  • accept death and illness as part of life
  • elders have a strong influence on decision making
32
Q

diversity

A

the unique variations between individuals informed by genetics and cultural background, refined by experience and personal choice

33
Q

variations

A
  • race
  • gender
  • sexual orientation
  • age
  • education
  • abilities/disabilities
  • life experiences
  • geographic
  • parental status
  • language
  • profession/occupation
34
Q

culture

A

learned and shared beliefs involving: knowledge, behaviors, ideas, attitudes, values, habits, work and lifestyle practices, traditions, languages, symbols, rituals, expression of thoughts and emotions, ceremonies, and practices that are unique to a particular group of people

35
Q

cultural care

A
  • Leninger defines transcultural nursing as a comparative study of cultures to understand similarities and differences across human groups
  • cultural sensitivity: being aware of cultural similarities and differences of others with out assigning them value based on similarities or differences
  • cultural competence: requires acquiring specific knowledge, skills, and attitudes to ensure delivery of culturally congruent care
  • cultural awareness: self exam of one’s own bias
  • cultural knowledge: sound education base about diversity
  • cultural skills: gathering information through a cultural assessment and being aware of physical findings that are based on race/ethnicity
  • cultural encounters: engage face to face
  • cultural desire: want to engage with diverse populations
36
Q

cultural congruent care - ANA standard 8

A

13 competencies
- demonstrates respect, equity, and empathy
- participates in (lifelong learning)* to understand cultural preferences
- creates an (inventory of one’s own values, beliefs and cultural heritage)*
- (applies knowledge of variation)* in health beliefs, practices and communication practices
- respects decisions based on age, tradition, belief, and family influence
- promotes equal access to services, tests, interventions, health promotion
- educates nurse colleagues and other professionals about cultural similarities and differences
- considers the effects and impact of discrimination

37
Q

barriers to culturally competent care

A
  • bias (unconscious and implicit): one sidedness, tendency to learn a certain way, lack of impartiality
  • prejudices: negative attitudes towards others based on race, gender, sexual orientation…
  • ethnocentrism: believing your way of living is superior to others, cause of biases and prejudices
  • cultural imposition: use their own values and lifestyles and the absolute guide in dealing with patients
  • cultural stereotype: all people of a certain racial or ethnic group are alike in certain aspects
  • discrimination: behavior manifestations of prejudices
38
Q

culture and life transitions

A
  • pregnancy
  • childbirth (what you do with the placenta)
  • newborn
  • grief and loss (how you handle the body post death)
39
Q

cultural and healthcare

A

how different cultures view the following variables affects health care in significant ways:
- what is the patient’s definition of health?
- health promotion and protection: how is health achieved and maintained?
- practitioners and remedies: who and what can heal a person?
(may believe someone, not something, made them sick)

40
Q

cultural assessment

A
  • family structure
  • communication patterns
  • foods with cultural significance
  • time orientation
  • space
  • control
    (food - lots of carbs, sugar, could be making them stressed,
    time may not be of importance to pt, “I’ll get to my medicine when I get there, not going to take at a specific time)
41
Q

cultural assessment continued

A
  • how do you prefer to be addressed? (may not prefer Ma’am or sir)
  • where were you born? your parents? your grandparents?
  • how long have you been in the US?
  • are you more comfortable reading materials in your native language if other than English?
  • how are important healthcare decisions made in your family?
  • are there certain healthcare procedures and tests that your culture prohibits?
42
Q

ethnicity

A

a cultural group’s shared identity such as values, language, geographical space, racial characteristics

43
Q

race

A

the grouping of people based on biological similarities and attributes
(biological)

44
Q

diversity attitude scale

A
  • celebration: we need each other
  • affirmation: I’ve got something to learn from you
  • civility: I respect your rights
  • tolerance: you have a right to be here
  • intolerance: I’ll work to keep you out
45
Q

improve your relationship with different kinds of people

A
  • honestly assess your attitudes
  • put yourself in perspective with others
  • respect differences but don’t overlook similarities
  • search for more knowledge
  • treat people as individuals rather than stereotyping them
    don’t forget we’re all in this together
46
Q

world view

A

set of assumptions which guides how people perceive the world around them. viewing the world through a lens which was created throughout our life.
- etic: outside perspective
- emic: insider perspective
(want to have emic perspective where learn around other cultures)

47
Q

health disparities

A

a health difference because of a social, economic, or environmental disadvantage or part of marginalized groups (people of color, gay, lesbian, bisexual, transgender, physically or mentally challenged and people not college educated)
- ex: black males have higher incidence of colorectal cancer than white males
- ex: American Indian and Alaskan natives have a higher incidence of Diabetes 2 than whites

48
Q

stressors and stress

A
  • physical, emotional, or psychological perceived demands that may lead to growth, personal development or a crisis
  • stress is the result of an exposure to a stressor
49
Q

overview of the stress process

A

cortisol: stress hormone, fight or flight
3 reactions:
- emotional response: annoyance, anger, anxiety, fear, dejection, grief
- physiological response: autonomic arousal, hormonal fluctuations, neurochemical changes, and so on
- behavioral response: coping efforts, such as lashing out at others, blaming oneself, seeking help, solving problems, and releasing emotions

50
Q

fight or flight response

A
  • arousal of the sympathetic nervous system
  • stress makes it harder to heal
  • parasympathetic and sympathetic chart
51
Q

Selye’s general adaptation syndrome

A

any event (stressor) that threatens an individual leads to a 3 stage response
- alarm: sensing stressor
- resistance: how you’re going to work through that, emotionally, behaviorally, physiologically
- exhaustion: exhausted bc have worked through that

52
Q

consequences of stress

A

highly variable
- type and number of stressors
- anticipated stressor
- perception of stressors
- length of time that stressor occurs
- type of coping mechanism implemented (exercise, breathing techniques, meditation, sleep)
- resilience of individual/feelings of competence
- previous experiences
- state of health
- available resources

53
Q

assessment

A
  • history
    – medical
    — general state of health
    — illnesses
    — surgeries
    — medications
    — treatments
    — use of alcohol, tobacco, and/or drugs
    — changes in sleep, eating, sexual patterns
  • perception of threat
  • past coping patterns
  • social
    – family dynamics/friends
    – work/recreation
    – living environment
    – financial
  • general examination (observable)
    – general description and appearance
    – behavior
    – communication/speech
    – mood, affect and feelings
    – judgement/insight
  • physical examination (head to toe assessment)
54
Q

signs and symptoms of stress

A
  • cognitive: decreased concentration, comprehension and memory
  • behavioral: irritability, withdrawal, violence
  • emotional: fear, anxiety, depression, fatigue
  • physiological:
    – increased BP, HR, respirations, etc.
    – somatic symptoms
    – decreased immune response
55
Q

coping

A

coping mechanisms are ways to which external or internal stress are managed, adapted or acted upon.
- Susan Folkman and Richard Lazarus define coping as “constantly changing cognitive and behavioral efforts to manage specific external and/or internal demands that are appraised as taxing.”

56
Q

intervention/implementation

A

teach coping skills
- regular exercise
- support systems
- time management
- guided imagery/visualization
- progressive muscle relaxation
- assertiveness training
- journal writing
- positive affirmations
- massage
- pets
- prayer/meditation
- music
- singing
- laughter
- aromatherapy
- sleep
- healthy eating
- decrease use of phone/internet
- organization
- 8 vitamins
- sex
- hugging

57
Q

key points of coping

A
  • coping can apply to an individual, a family, or an entire community
  • coping occurs along a spectrum from effective/adaptive responses to ineffective/maladaptive responses
  • coping may be problem focused or emotion focused
  • all individuals use coping mechanisms regardless of race, sex, or gender
  • outcomes of coping range from resolution to acceptance
58
Q

case study where someone who was physically abusive and incarcerated for child sexual abuse is dying from cancer. he asks how he is ever going to make amends bc god must be punishing him.

A
  • don’t say anything if you can’t say anything nice
  • maybe ask them why they feel that way, get them to talk about it
59
Q

what should the nurse focus on when caring for a terminally ill patient?

A
  • the nurse’s relationship with the patient allows for an understanding of patient priorities
  • allowing more ppl in room than typically allowed
  • caring for family

IM1 Exam 6 (3 decks)

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