Week Thirteen Flashcards
Acculturation
Involuntary process that occurs when people adapt or borrow traits from another culture
Cultural assimilation
The process by which an individual develops a new cultural identity
Culture
The nonphysical traits, values, beliefs, attitudes and customs that are shared by a group of people and passed from one generation to the next.
Subculture
Composed of people who have a distinct identity, yet are related to a larger cultural group
Culture shock
Disorder that occurs in response to transition from one cultural setting to another
Ethnicity
Group within the social system that claims to possess variable traits such as a common religion or language
Ethnocentrism
Belief that one’s own culture or way of life is better than that of others
Folk medicine
Those beliefs and practices relating to illness prevention and healing that derive from cultural traditions rather than from modern medicine
Race
The classification of people according to shared biologic characteristics, genetic markers or features
Stereotyping
Assuming that all members of a culture or ethnic group are alike
Transcultural care
Describes the provision of nursing care across cultural boundaries that takes into account the difference and similarities of the beliefs, values, and patterns of culture
Magico-religious Health views
Health and illness are controlled by supernatural forces
Biomedical Health Views
Life and life processes are controlled by physical and biochemical forces that can be manipulated by humans
Holistic Health views
Balance or harmony must be maintained in forces of nature
Body
Physical
Mind
Cognitive Process
Spiritual
Positive and negative learned spiritual practices and teachings, dreams, symbols, stories, metaphysical forces
How does communication influence health care?
Verbal: vocabulary, voice speed, silence, use of interpreters. Non-Verbal: touch, eye contact, facial expressions, posture
How does space influence health care?
intimate, personal, social, public space
Intimate Space
touching- 1.5 ft
Personal Space
1.5ft-4 ft
Social Space
4 to 12 feet
Public Space
12 ft or greater
How does time influence health care?
significance placed on past, present, future
How do nutritional patterns influence health care?
staple foods, food preparation, remedies for illness
How does family pattern influence health care?
who is the authority figure, how are they treated, are they the keepers of wisdom, can the wife be involved, whom is involved, how to properly address individual
How does the nurse develop cultural sensitivity?
proactive, consider diversity an asset, identify and control personal beliefs & attitudes, include cultural assessment as part of your overall nursing assessment/history, acknowledge the patient/family right to make health care choices, convey respect and cooperate with traditional healers and caregivers, seven steps to cultural competence, self assessment, education, listen, observe, share what you learn, be alert to discomfort
What are specific strategies for interacting with clients of differing culture of heritage?
- Give your full name, title, and how you would like to be addressed
- Address patients and others by their last names until given permission to do otherwise
- Be authentic and honest
- Convey respect for practices, support persons
- Explore patient’s thoughts, feelings about health problems, treatments
- You Statements
What information should be collected during a nursing history when assessing culturally diverse clients?
- Birthplace of immediate and close extended family
- Location of family now and when growing up
- Contact with extended family and geographic proximity
- Change in family name or spelling
- Ethnic/Religious background of spourse
- neighborhood affiliation with same religious or ethnic background
- Preparation of foods based on tradition or heritage
- Paticipation in ethnic activities or holidays
- Native and primary language
Faith
To believe in or be committed to something or someone, gives life meaning, provides strength and hope, includes beliefs, values, language, and rituals
Religion
Sense of community cound by common beliefs, organized system of beliefs and practices, guidance for responding to life, includes rituals, disciplines and rules of conduct
Spirituality
part of being human that seeks meaning through intra-, inter- and transpersonal connection, reflection of an inner experience that is expressed individually, a sense of balance and purpose
What spiritual needs underlie all religion?
meaning and purpose, trust, respect, value, meaning to the fullness of life, creativity, belonging to a community, preperation for and acceptance of death, hope, forgiveness, dignity, values, connection with a God of higher power or being who is greater than oneself, vision
What are characterisitics of spirituality in an individual?
meaning, values, transcendence, connection, becoming
Meaning
Having a purpose, can make sense of life
Values
Having cherished beliefs and standards
Transcendence
Appreciating a dimension that is beyond self (like music)
Becoming
Reflection, allowing life to unfold and knowing who you are
What factors affect spirituality?
past experience, culture, perceived importance/value, lifestyle, family, availability, environment, society, family
Information to be collected during a nursing histry when assessing a client’s spirituality?
- Are any particular religious practices important to you?
- How will being sick interfere with your religious practices?
- How is your faith helpful to you?
- How might I support your spirit?
- Visit from spiritual counselor or chaplain?
- What are your hopes and sources of strength?
What are normal findings of a spiritual assessment?
- sense of inner peace
- compassion for others
- reverence for life
- generosity
- capacity for unconditional love
- gratitude
- humor
- wisdom
- ability to transcend self
- sppreciation of both unity and diversity
What assessment findings that are deviations from normal spiritual wellness?
- expressions of lack of hope, meaning, or purpose in life
- refuses interaction with family/friends
- sudden changes in spiritual practices
- expressed feelings of abandonment by or having anger toward God
- requests visit from religious leader
- no interest in reading spiritual literature if there was an interest before
Define Spiritual Distress
An inability to experience and integrate meaning and purpose in life through connectedness with self, others, or other meaningful pursuits
Defining Characteristics for Spiritual Distress
anger, lack of courage, lack of acceptance, lack of hope, lack of love, lack of serenity, lack of purpose of meaning in life, guilt, poor coping
Define Spiritual Well-being, Readiness for Enhanced
Ability to experience and integrate meaning and purpose in life
Defining characteristics of Spiritual Well-being, Readiness for Enhanced
connectedness with self, others, art, music, literature, nature, and/or a power greater than oneself
TNIS for Spiritual Diagnoses
Provide presence, support religious practices, assist clients with prayer/meditation, discussion, referral for spiritual counseling
What health promotion techniques assist in meeting a patient’s spiritual beliefs and religious practices?
- Develp a trusting relationship
- Query how you can help
- Allow privacy and time as needed
- Respect religious articles and practices
- Implement dietary preferences as needed
- Self Education (become aware of different values/practices)
Shoulder Flexion
Raise arm in front of body up over head. NR 0-180
Where is 0 degrees when referring to the ROM of an extremity?
south pole in an inferior direction
Shoulder Extension
raise arms behind body, NR 0-180 degree
Shoulder Abduction
raise arm at side of body up over head, NR 0-180
Consciouness
an ongoing process of awareness of the self and the environment which may change from moment to moment. Alert, letharic, stuperous, comatose
Alert
fully awake, oriented X 3 and responds spontaneously to verbal stimuli
Lethargic
drowsy, sleepy but respond appropriately when aroused
Stuporous
no spontaneous movement and arouse only to vigorous stimuli in a nonverbal manner
Comatose
does not arouse even to painful stimuli
Orientation
person, place, time. oriented X 3= normal
Dementia
chronic illness characterized by a slow insidious process that results in progressive loss of several essential cognitive and physical functions. the patient exhibits a dcline in memory, judgment, language, abstract reasoning and problem solving. impulse behavior, stupor, confusion, and disorientation may also be observed. the RN may observe traces of joy or sorrow and a tendency to return to the same complaints frequently. Alzheimer’s disease is a acommon type of dementia.
Temperature
testing of this sensation is not usually performed if pain sensation is within normal limits
Light Touch
This sensation is tested at the same spot on both sides of the body
Three purposes of abdominal assessment
presence of abdence and quality of bowel sounds, determine the presence or absence of a distended bladder, investigate client’s complaints of abdominal pain
Red Flags of Abdominal Assessment
involuntary rigidity (contracted, hard, unable to relieve), intense pain experienced with any movement, pain shifts from umbilicus to lower right quadrant (appendicitis), N, V, decreased BP, elevated T
Inguinal hernias
may be seen or felt as a bulge in the groin, near where you would feel the pulsation of the femoral artery
Ventral hernia
seen or felt as a bulge between layers of muscles that come together at the midline or near any abdominal scar
Heart/Lungs order of assessment techniques
inspection, palpation, percussion, auscultation
order of assessment techinques for abdomen
inspection, auscultation, percussion, palpation
Distention
may indicate ascites, measure abdominal girth, look elsewhere for edema in the body
old scars
may be clue to previous operations
Hernias or bulges
ask client to raise head from supine position to emphasize the mass,location may provide clues to client’s symtoms
Visible pulsations or peristalsis
assess further during auscultation and palpation poritons of the exam
Hyperactive bowel sounds
every three seconds-continuous. may indicate early intestinal or bowel obtruction or intestinal ischemia which can be medical emergencies. ask about diarrhea and passage of blood.
Hypoactive bowel sounds
fewer than 3 per minute, increasing from none may indicate return of bowel function after surgery, if decreasing may indicate later stages of progressive bowel obstruction
Absent bowel sounds
5 minutes. may indicate parlytic ileus or may indicate complete bowel obstruction which is a medical emergency
Tenderness or Pain
may indicate infection
Bulges/Massess
may indicate hernias or lipomas or enlarged organs
Involuntary rigidity of muscles
may indicate peritoneal irriatation r/t a life threatening process
Tenderness abdomen
may indicate pathology of underlying structures
