Week 5 Health promotion & disease Prevention, Self Concept & Sexuality, Cultural & Spiritual nursing care Flashcards
What are Risk factors for disease?
Genetics:
Sex:
Physiologic factors:
Environmental factors:
Lifestyle‑risk behaviors:
Age:
How can sex impact disease
women at greater risk for autoimmune
males at greater risk of suicide
what are physiologic factors
states place clients at an increased risk for health problems (body mass index [BMI] above 25, pregnancy
how do environmental factors impact health
Toxic substances and chemicals can affect health where clients live and work (water quality, pesticide exposure, air pollution
examples of life-style risk
. Risk behaviors to screen for include stress, substance use disorders, tobacco use, diet deficiencies, lack of exercise, and sun exposure.
age risk considerations
Ages vary with individual practices (for example, a woman who is sexually active before the age of 20 should start screenings when sexual activity begins).
Routine physical examination screening
1 to 3 years for females
every 5 years for males from age 20 to 40,
more often after age 40.
Dental assessment every
Every 6 months.
Tuberculosis screen every
Tuberculosis (TB) skin test every 2 years
health care workers are tested annually
Blood pressure every
if previously elevated?
At least every 2 years;
annually if previously elevated.
Body mass index:
At each routine health care visit.
Blood cholesterol screening start at? every?
Starting at age 20, a minimum of every 5 years.
Visual acuity screenings for different age groups?
Age 40 and under: every 3 to 5 years.
Every 2 years ages 40 to 64.
Every year 65 and older.
Visual acuity:
Age 40 and under: every 3 to 5 years.
Every 2 years ages 40 to 64. Every year 65 and older.
Hearing acuity:
Periodic hearing checks as needed; more frequently if hearing loss is noted.
Skin assessment:
Every 3 years by a skin specialist for age 20 to 40; annually over age 40 years and abnorrmaliites
Digital rectal exam:
During routine physical examination
Annually if have at least a 10‑year life expectancy.
Consult with the provider if screen should continue after age 76.
-prostate check
Colorectal screening:
Every year between the age of 50 and 75 for high‑sensitivity fecal occult blood testing,
or flexible sigmoidoscopy every 5 years,
or colonoscopy every 10 years.
Consult with the provider if screen should continue after age 76.
Cervical cancer screening:
Ages 21 to 65
Papanicolaou test (Pap smear) every 3 years;
at age 30, can decrease Pap screening to every 5 years if HPV screening performed as well.
65, no testing is needed if previous testing was normal
Breast cancer screening:
Ages 20 to 39: clinical breast examination every 3 years,
40 and up is annually.
mammogram screening
ages 40 to 54: annual mammogram;
ages 55 and older should have the choice to have a mammogram every 1 to 2 years
Clinical testicular examination:
At each routine health care visit starting at puberty
Prostate‑specific antigen test, digital rectal examination:
with provider discussion starting at age 50 years,
and again whether to continue after age 76.
Primary-health promotion
Immunization programs
Child car seat education
Nutrition, fitness activities
Health education in schools
Secondary-screenings
Communicable disease screening, case finding
Early detection, treatment of diabetes mellitus
Tertiary-treatment/diagnoses
Begins after an injury or illness
Prevention of pressure ulcers after spinal cord injury
Promoting independence after traumatic brain injury
Referrals to support groups
Rehabilitation center
Healthy People 2030
Updated every 10 years
Improve health priorities/prevent disease
at the local, state, and national level
for research, evaluation, and data collection of health disparities
Improve awareness and understanding
Nursing Interventions for prevention
- Examine risk factors to identify modifications, adopt mutually agreeable goals, and identify support systems.
- Use behavior‑change strategies
*Promote health lifestyle behaviors
Self-Concept is
what people think of themselves
-is subjective and includes self‑identity, body image, attitudes, role performance, and self‑esteem.
how can self esteem impact stress
Individuals who have high self‑esteem are better equipped to cope successfully with life’s stressors.
Stressors that affect self‑concept include unrealistic expectations, surgery, chronic illness, and changes in role performance
what effects self-concept
Physical, spiritual, emotional, media, puberty, race, sexual, familial, and sociocultural
Body Image changes because of
cognitive growth and physical development
-hormonal changes
-aging
-amputation, mastectomy, hysterectomy; loss of body function due to arthritis, spinal cord injury, or stroke; and an unattainable body ideal
what external factors impact body image
External influences (media, others’ perceptions and responses, cultural standards, societal attitudes) can affect body image
Poor body image increases the risk of
suicide
Identity-individuality
The person’s uniqueness, and how it compares to others
-faith, education, skills
Sexuality and nursing
- vital components of general health and part of a nursing assessment.
- integral part of identity.
- changes during various stages of the lifespan.
Sexual health is physical, mental, emotional, and social well-being regarding sexuality and sexual activity.
how can medications impact sexuality
Some medications affect sexual functioning.
Diuretics decrease vaginal lubrication, cause erectile dysfunction, and reduce sexual desire.
Antidepressant medications can cause erectile dysfunction and reduced libido.
What can impact sexuality
-impacted by genetics, hormones, culture*, religion. Decrease in sexual functions, age, meds
Assessment
Posture, Appearance, Demeanor, Eye contact, Grooming, Unusual behavior
Ask about sexual orientation and preferred pronouns or terminology related to sexual self-concept or identity
- blunt and respectful
- concerns about sexual function,
- ask about sexual activity
PLISST
P: Permission (obtaining permission to discuss this with the client)
LI: Limited information (related to sexual health patterns)
SS: Specific suggestions (using assessment data to make appropriate suggestions)
IT: Intensive therapy (more referral if needed)
What is culture?
Culture involves the similarities shared among members of a group.
These similarities include ways of thinking
Language and communication, and customs
Culture is generational
Cultural groups can be linked by
a common ethnicity, race, nationality, language, religion, location, sexual orientation, class, or gender
what is ethnicity
the shared identity, bond, or kinship people feel with their country of birth or place of ancestral origin
affects culture.
What is Race
has traditionally been linked to biological or genetic traits, or shared origin or background.
While genetic discoveries have shown that races cannot be identified scientifically,
race continues to be used as a way to identify groups of individuals (when individuals self-identify on the U. S. census).
Cultural awareness as a nurse
involves self-awareness for the nurse,
examining personal attitudes related to various aspects of culture, to identify possible bias.
what is culture sensitivity
Cultural sensitivity means that nurses are knowledgeable about the cultures prevalent in their area of practice
Cultural appropriateness
means that nurses apply their knowledge of a client’s culture to their care delivery
Culturally competence means
understand and address the entire cultural context of each client within the realm of the care they deliver.
Competence is developed over a lifetime as the nurse continues to attain knowledge
Cultural imposition is
similar to ethnocentrism
Occurs when a nurse imposes the rules of their culture onto another person.
-a cultural blindness
Culturally Responsive Nursing Care
Providing language assistance
Informing clients of language services verbally and in writing
Providing competent, trained interpreters
**Giving the client learning materials (videos, handouts) and having signs in all languages common among the population
Barriers to Culturally Responsive Nursing Care
- Language: and perception of time differences.
- Culturally inappropriate tests and tools that lead to misdiagnosis
- Different ethnicities metabolize drugs differently
- Ethnocentrism (belief in cultural superiority )
- Poor access to health care (financial)
Faith
is a belief in something or a relationship with a higher power. Faith can be defined by a culture or a religion.
Hope is a concept
that includes anticipation and optimism and provides comfort during times of crisis.
Transcendence
is the belief in a force outside the person and material world that is superior.
Self-transcendence
is an authentic connection with the inner self
Religion
is a system of beliefs practiced to express one’s spirituality, typically related to a particular form of worship, sect, or spiritual denomination.
Spirituality can include religious practices, but does not always
Buddism health beliefs
Health & Illness
-correlate with modern medical science.
Illness is nonhuman spirits invading the body
.
no euthanasia
Might not take time off from responsibilities when ill.
Good health through good deeds.
Medications can be seen as harmful
treatment by a health care worker of the same gender.
*Might decline bovine-derived medications (cow)
buddist dietary belief
Some clients are vegetarians.*
Some clients avoid alcohol and tobacco.
Clients might fast on holy days*
buddist death ritual
Brain death might not be death.
can advocate withdrawal of life sustaining measures.
Many prefer for dying at home.
*The body is prepared by a male.
Mourners are quiet and peaceful, and avoid touching the body but might touch the head and stand nearby, praying.
Many use cremation
Christianity Rituals
Health & Illness
can correlate with modern medical science.
Clients often use alternative or complementary practices.
There is a common belief in faith healing; can use “laying on of hands” during prayer.
anoint a client who is ill or near death (Catholicism; Sacrament of the Sick).
Organ donation is generally allowed.
Many believe in health maintenance.
Christian Dietary Rituals
Some avoid alcohol, tobacco, and caffeine.
Clients might fast during Lent.
Christain Death Rituals
Most believe in continuing hydration and nutrition therapies as long as possible.
Christain Religious Rituals
Some clients practice Holy Communion.
visits from spiritual leaders (clergy)
Sikhism Health and Rituals
Health care beliefs often correlate with modern medical science.
**Female clients often prefer to be examined by females.
Having to remove undergarments can be very distressing for some clients.
Rituals
Clients can use religious symbols or devotional prayer.
Clients might not permit cutting or shaving of the hair**
Navajo Health
Health & Illness
Health is a part of humanity and relate to the place of humans in the universe.
holistically.
Clients might adhere more to wellness interventions than disease prevention.
Clients can attempt to correct poor health using symbols, stories, songs, rituals, prayers, and paintings (a practice known as blessingway).
Hinduism Health
Health care beliefs often correlate with modern medical science.
Illness = sins.
Decisions might be made by the community, especially by senior family.
Females defer to a spouse or family to make decisions.
Life-prolonging therapies might be discouraged.
Clients might decline porcine-derived medications****
Dietary Rituals
vegetarians due to an adherence to the concept of ahimsa (nonviolence as applicable to food).
Hindiusm rituals and death
Death Rituals
Clients might want to lie on the floor while dying, or the body might be placed on the floor following death with the head facing north.
Clients prepare for death, when possible, with prayer and meditations.
Care of the body should be by those of the same gender.
Cremation can be used as a way to purify the body following death.
Religious Rituals
Clients can use rituals for purity and prayer.
Clients can use amulets or other symbols
Islam Health
Clients’ view of health can be fatalistic, at times.
Clients often have a belief in faith healing.
Clients can avoid discussing death, (death is predetermined)
Clients might permit withdrawal of life-support measures but continue hydration and nutrition therapies.
Avoid euthanasia and organ transplantation.
Spirituality = health.
Clients often make decisions within families, and might prefer for new information to be discussed in this manner.
Pain = Cleansing.
NO porcine-derived medications** (pig)
Dietary Rituals
NO alcohol and pork.
FAST during Ramadan.
Islam Death and Religious Rituals
Death Rituals
The face turned towards Mecca.
The body can be washed and wrapped in a CLOTH by someone of the SAME gender. ()OR from the MOSQUE
Prayer
NO Autopsy
Burial > cremation.
Clients often value having loved ones close by.
Religious Rituals
Clients might practice Five Pillars of Islam.
Clients often find strength in group prayer.
Many clients pray FIVE times a day facing Mecca
Jehovah’s Witness
Health & Illness
May REFUSE blood transfusions, even in life‑threatening situations.
Dietary Rituals
Avoid foods having or prepared with blood.
Death Rituals
Clients can choose burial or cremation.
Judaism Health
Health & Illness
Balance God and medicine.
Obligation to avoid substance use and stay healthy.
Clients might refuse treatment on the Sabbath.
Clients can feel an obligation to visit the ill.
Euthanasia is often not permitted.
Life support measures can be discouraged. Views vary regarding hydration and nutrition at the end of life.
Birth Rituals & Health Care Decisions
On the eighth day after birth, males are usually circumcised.
Observing Sabbath
Judaism Diet and Death
Dietary Rituals
Kosher diet.
Death Rituals
Someone often stays with the body.
Orthodox clients often have the body prepared by the Jewish Burial Society and do not typically permit autopsy.
Burial often occurs within 24 hr, unless this is during the Sabbath.
Cremation and embalming are generally not permitted
Mormonism
Health & Illness/ Diet
NO alcohol, tobacco use, and caffeine.
Birth Rituals & Health Care Decisions
Children are usually baptized at age 8
Death Rituals
Clients might recite a confessional or affirmation near death (the Shema).**
The dying client is usually not left alone.
Last rites can include wearing temple clothes for burial.
Rituals
Clients often have visit from spiritual leaders (local elders) for blessing.
Clients might prefer to wear temple undergarments
Christian Science
Clients often rely on Christian Science practitioners, avoiding Western medicine and interventions.
Assessment of culture
Cultural background and acculturation
Health and wellness beliefs/practices
Family patterns
Verbal and nonverbal communication
Space and time orientation
Nutritional patterns
Meaning of pain
Death rituals
Care of ill family members
Health literacy
FICA ASSESSMENT
FICA
* Faith or beliefs
-what guides their life/sense of purpose
- Implications, importance and influence
-how it impact their life/decision
Community
-group that they meet/interact and share their belief
Address
-how their belief will affect their treatment.
LEARN assessment for culturally competent care
Listen
Actively, empathy and try to understand the client’s perception.
Explain
The health care professional’s perception of the problem, which can be cultural, psychological, spiritual, or physiological.
Acknowledge
Differences and similarities between the professional’s and client’s perceptions.
Recommend
Treatments, including the client’s choices.
Negotiate
With the client to involve medical recommendations and client preference
Interpreters
The Joint Commission requires that an interpreter be available in health care facilities in the client’s language
Use only a facility‑approved medical interpreter.
Do not use the client’s family or friends, or a nondesignated employee to interpret.
Inform the interpreter about the reason for and the type of questions that will be asked, the expected response (brief or detailed), and with whom to converse.
*Allow time for the interpreter and the family to be introduced and become acquainted before starting the interview.
Speak clearly and slowly; avoid using metaphors.
Direct the questions to the client, not to the interpreter.
Observe the client’s verbal and nonverbal behaviors during the conversation.**
Get feedback from the client throughout the conversation.
Do not interrupt the interpreter, the client, or the family as they talk.
If the conversation doesn’t seem to go well, stop the conversation and address it with the interpreter.
