MED SURG NURSING CH 4 &. 15 - Detalles

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8 Cultural Phenomena: Death & Dying and End-of-Life Issues

Become knowledgable in other cultures rituals surrounding death and bereavement.

8 Cultural Phenomena: Communication Styles

- Variations in grammer, word meaning, pronunciation of a spoken language. - Non-verbal communication: use and degree of eye contact, perception of time, and physical closeness with peers and superiors.

8 Cultural Phenomena: Space

Personal space, comfort zones (differs across all cultures).

8 Cultural Phenomena: Time Orientation

Perception of time has two dimensions. Clock time vs. social time & Past, present, future.

8 Cultural Phenomena: Social Organization

Perceived head of household, gender roles, and roles of older and extended family members.

8 Cultural Phenomena: Health Beliefs

May believe that their illness is due to a spiritual cause and not bacteria.

8 Cultural Phenomena: Environmental Control

May not turn to Western medicine. Alternative healthcare and therapies.

8 Cultural Phenomena: Choice of Health Care Providers (HCPs)

Some cultures may prefer a highly educated HCP. Others may prefer traditional healers because they are known to the patient, family, and community.

8 Cultural Phenomena: Biological Variations

- Body, build and structure - Skin color - Vital signs - Laboratory values - Susceptibility to disease - Nutrition

Nursing care that exhibits cultural awareness, sensitivity, and competence:

- Have specific knowledge of ur patients care. - Have an awareness of your own culture and not let it influence patient care. - Accept & respect cultural differences. - Adapt your nursing care to your patient's culture.

Review the use of an interpreter (Refrain - Why?)

- Family members may not be proficient in medical terminology. - May unintentionally omit or alter important information. - Using family to interpret may violate HIPAA. - If children are used, they may not be emotionally mature enough to handle the information being conveyed.

Key Changes and Implications: Muscular System

Changes: - Decreased muscle mass - Decreased muscle tone - Slower muscle responses - Decreased elasticity of tendons/ligaments Implications: - Longer time for movement - Risk for injury

Key Changes and Implications: Skeletal

Changes: - Exaggerated bony prominences - Eroding cartilage - Joint stiffness - Osteoporosis Implications: - Limited range of motion - Self-care deficits - Falls & fractures

Key Changes and Implications: Integumentary

Changes: - Thinning skin/hair - Decreased subcutaneous fat - Increased dryness of skin/nails - Increased pigmentation - Decreased melanin (gray hair) Implications: - Pressure injurise - Longer healing time - Dryness - Foot care - Altered temp regulation

Key Changes and Implications: Cardiovascular

Changes: - Cardiac output decreases - Classic symptoms of cardiac emergencies - Arrhythmias - Leg vein valves less efficient Implications: - Fluid overload - Edema - Orthostatic hypotension - Atypical cardiac symptoms

Key Changes and Implications: Respiratory

Changes: - Emptying of lungs less complete - Lung capacity decreased - Tone of lung tissue reduced Implications: - Activity tolerance - Respiratory infections - Weaker cough or gag reflex - Vaccines & flu shots

Key Changes and Implications: Gastrointestinal

Changes: - Gastric emptying delayed - Liver enzymes decline - Peristalsis decreases - Taste, smell, saliva decreases - Tooth loss Implications: - Aspiration - Constipation - Drug toxicity - Malnutrition - Oral care

How to communicate with a patient who is hard of hearing:

- Moderate volume & low tone - Stand face-to-face with patients - Speak slowly & clearly - Provide written instructions

Culture Shock

When values, beliefs, and practices sanctioned by the new culture are very different from the ones of native cultures.

Cultural Sensitivity

Using culturally appropriate language and not offending another person's cultural beliefs.

Belief

Things that a person accepts as true.

Acculturation

Learning to accept ones own beliefs as well as those of the new country. Occurs. through socialization process of those who are learning to become a member of the society or group.

Assimulation

When a new member takes on the dominant culture's values, beliefs, and practices, sometimes at the cost of losing some of his or her cultural heritage.

Cultural Awareness

Having an appreciation for and attention to arts, music, crafts, celebrations, foods, and traditional cooking.

Cultural Competence

Having the skills and knowledge required to provide effective nursing care.

Cultural Conflict

When one's own culture conflicts with a new culture.

Cultural Diversity

Nationality, race, skin color, gender, age, spirituality, and religious affiliation.

Culture

The socially transmitted behavior patterns, beliefs, values, customs, arts, and all other characteristics of people that guide their view of the world.

Ethnic

Belonging to a subgroup of a larger cultural group.

Ethnocentrism

Tendency to think that your way of thinking, acting, and believing are the only right, proper, and natural ways.

Spirituality

Essence of being and gives purpose to existence.

Stereotype

Opinion or belief about a group of people that is ascribed to an individual.

Traditions

The transmission of customs of beliefs from generation to generation.

Values

Principles or standards that has meaning or worth to an individual.