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Health Assessment test 2 (ch. 5 ethnic, cultural, and spiritual situations)
Terms in this set (92)
recognizes contributions of chaplains, ministers, rabbis, priests, or other spiritual leaders in helping patients and families express and meet their spiritual needs.
Patient Centered Care:
describe how diverse ethic, cultural, spiritual, and social backgrounds function as sources of patient, family, and community values.
Culturally competent care is delivered when....
nurses value health or illness experiences through patient's eyes.
Nurses working together from ________ and may practice in different ways.
Native Americans emphasize spirituality in their nursing process such as:
Touching someone has spiritual power.
Honor is a characteristic that includes components of appreciation and respect.
They feel honored to be present at a birth and at a death.
______ is a characteristic that includes components of appreciation and respect.
The United States has been called a _________ because many cultures and religions are represented and live in the US.
About ____ of people in the United States speak a language other than English at home. On this continuum are people with---
20%; varying cultural and spiritual behaviors and beliefs
refers to differences in gender, age, culture, race, ethnicity, religion, sexual orientation, physical or mental disabilities, and social and economic status.
Belief systems act as ...
lenses through which people filter everything they view.
Diversity can create challenges such as:
When cultures and languages and religions are different.
When caring for individuals by not forcing compliance, by working with beliefs and value systems.
Responsibilities and goals as a nurse when dealing with individuals who may not have the same skin color, language, health practices, beliefs, religion practices, and values of your own--
is to not force patients and their families to comply with your beliefs, values, and practices, but instead to meet patients where they are and to work with their belief and value system.
Nurses can improve cultural awareness by asking about--
unique beliefs, practices, and values.
There are many definitions of culture, and they all overlap with ______ and ______
ethnicity and religion.
A nurse is not responsible for knowing--
However, they are responsible for asking about--
health beliefs, practices, and values of all groups.
beliefs—this is essential for individualized care.
How the nurse interacts with the patient depends on what?
partly on the nurses own heritage and culture and partly on the nurses knowledge of and attitude towards other cultures and other health beliefs and practices.
"the thoughts, communications, actions, customs, beliefs, values, and institutions of racial, ethic, religious, and social groups."
Culture is all of the socially transmitted behavior patterns such as:
life ways Characteristics that
influence a worldview.
refers to characteristics that a group may share in some combination such as common geographic origin
Ethnicity consists of a cultural and social that shares a common group with cultural and social heritage which includes:
2. language and dialect
3. religious beliefs
4. shared tradition and symbols
5. literature, folklore, and music
6. food preferences
7. settlement and employment patterns
8. internal sense of distractiveness.
Race is genetic in origin and includes physical characteristics such as:
1. Skin color
2. bone structure
3. eye color
4. hair color.
The human genome product shows that all humans share --
a genetic code greater than 99% identical.
Although less than 1% difference exists in genetic code, the differences are evident when performing _________
Individuals from the same racial group are not necessarily from the same _____
refers to an organized system of beliefs, rituals, and practices in which an individual participates.
_____ is a broader concept than ______
Spirituality may include:
Walking in the woods
Listening to music
Intentional appreciation of beauty
Being present in the world with others
Spiritual and religious beliefs influence--
Relationship with god, a spiritual being, a higher being, or reality greater than the self.
existential, not of the material world; meaning and purpose in life; and life force or integrating aspect of the person.
Religion may or may not be part of ones _______
There are 14 national standards to ensure ____________
equitable and effective treatment
The 14 National Standards are organized around which 3 themes:
1. Culturally competent care.
2. Language access services.
3. Organizational supports for cultural competence.
Health care team members are affected by the first standard, which states that...
Heath care organizations should ensure that patients/consumers receive from all staff members effective, understandable, and respectful care that is provided in a manner compatible with the cultural health beliefs and practices and preferred language.
Improving cultural awareness and meeting Standard 1 of CLAS require that nurse to take several steps including:
1. Become culturally competent through sensitivity to differences between their own culture and that of the patient.
2. Avoid stereotyping and assuming the meaning of others behavior.
3. Develop a template that may have been used for cultural and spiritual assessment of patients and the families.
______ directly affects nurses.
Healthcare organizations should ensure that patients receive:
-Effective, understandable, and respectful care.
-Care provided in a manner compatible with cultural health beliefs and practices and preferred language.
The Joint Commission requires that a spiritual history be taken from every patient admitted to _______, _____, or ______.
home health agency
TJC expects health care organizations to define the _____ and _____ of spiritual assessment and the qualifications of the person(s) performing the assessment
content and scope
Barriers to Assessing Spiritual Needs--
-personal and individual barriers
Personal and Individual Barriers to assessing spiritual needs include--
-Nurses view assessing patients spiritual needs as private or family matters or pastoral responsibilities, not their responsibility.
-Nurses may experience person embarrassment, discomfort, or uncertainty without their own spirituality.
-Nurses may be uncomfortable dealing with conditions and situations that frequently result in spiritual distress (suffering and grief)
Knowledge Barriers to assessing spiritual needs include--
-Nurse s lack knowledge about spirituality and the religion beliefs of others.
-Nurses have minimal, if any, education related to spiritual assessment.
-Nurses make spiritual needs for psychosocial needs
Culturally competent nurses respect patient as unique person by assessing the individual's to assess their/determine their:
When assessing a patient from a different culture, race, preference, needs, values, and religion needs to beware of--
your own biases
It is important for nurses to know questions to ask in order to--
learn about unique cultures of patients
5 Interrelated Attributes of Cultural Competence include--
Gain information about cultural differences and values that can be acquired through training and education and by talking with people from different cultures about their beliefs and practices.
Is acquired when the nurse uses knowledge patients and others languages, practices, and customs when providing care.
Involves thoughtful consideration of the effects and importance of another's values and experiences.
Is communicated when nurses show appreciation and regard for cultural differences for patients and nurses with whom they work with.
Is adapting interactions based on cultural practices and beliefs of others.
Although knowledge of and respect for cultural beliefs and practices for different cultures are valued, familiarity with all cultural perspectives that a nurse might encounter is _____
Ways to Develop Cultural Competence:
Acknowledge that cultural diversity exists
Recognize the uniqueness of and demonstrate respect for individuals and families of other cultures other than your own. Each person's cultural values are ingrained and are a part of who that person is.
Demonstrate knowledge and understanding of the patients culture, health-related needs, and meanings of health and illness. When patients culture is unfamiliar, ask the patient about his or her culture using the template for assessment. Recognize that some cultural groups have definitions and health and illness that may differ from yours and thus use health and healing practices that may be different from yours.
Respect the unfamiliar and learn more about it is no longer unfamiliar. Be open to cultural encounters. Identify and explore your own cultural beliefs as you learn about those of others.
Be willing to modify health care delivery to be more congruent with the patients cultural background.
A nurse should recognize the uniqueness of each individual regardless of--
Cultural heritage equals _____
Cultural Heritage helps explain--
There are differences that exist within ____ and ____.
cultures and groups.
Beliefs and attitudes in the United States have been shaped/influenced by stereotypical images and misinformation that is presented through such as---
educational and political institutions
ALL individuals/patients are unique, deserving of a _________ of their beliefs, values, and traditions.
Common misbeliefs and stereotyped images—
-All African Americans have large families
-All welfare recipients are minorities
-All Asians excel in mathematics and science
-All native Americans live on reservations
-All Hispanics speak Spanish
Each major cultural group is composed of unique individuals and families who may not have the same values and attitudes as the cultural norm—therefore, nurses should not assume that:
just because an individuals or families are Asian or pacific islanders that they all share culturally same beliefs.
Likewise, people who identify themselves are being one religion does not mean that they have all the same beliefs or practices as another individual who identifies themself with the same religion. Even people who share the same culture and background are not necessarily the same.
When assessing a patient, during a direct assessment of a patient, a nurse should ask about --
health beliefs and practices that may reflect his or her cultural heritage as well as spiritual beliefs and any practices that are important to them.
Focused interview provides information about patient's--
personal beliefs, values, and attitudes.
A person may be from one of the major racial and cultural groups such as--- or one of the often unrecognized cultural groups such as----
(Native American, African American, Asian, white, non Hispanic or Hispanic)
(homeless, migrant workers, gay men, or lesbians)
To improve cultural awareness and senility, nurses notice patients _______ during the initial interview for clues about preferred communication practices.
((For example—if patients do not make eye contact, they may be demonstrating that this is a preferred way of communicating in their culture. If patients back up as nurses approach them, they may prefer more personal space.))
Nurses ask questions to gather information about the ______, _____, and _________ of patients.
and spiritual practices of individuals of other cultures and backgrounds
During assessment, ask one question at a time, allowing ________, ________, and __________ (this assessment performs part of the personal and psychosocial history)
ample time for response
use active voice
avoid medical jargon.
Personal and Psychosocial Introductory Questions include:
What cultural practices are important to you?
Where were you born?
With what particular cultural group (or groups) do you identify?
Personal and Psychosocial Primary Language and method of communication questions include:
What language is spoken in your home?
How well do you read, write, and speak English?
In what language do you think?
Do you have to translate in your mind when communicating in English?
Will you need service of a translator during the time you are in this health care facility?
Are there unique customs in your culture that influence verbal and nonverbal communication? Tell me about them.
What are some ways of indicating respect for others
What are appropriate ways to enter and leave situations?
Personal and Psychosocial Personal Beliefs about Health and Illness questions include:
What are some of the practices you believe will improve your health?
Do you believe in control of your own health? If not, who do you believe controls it?
Which practices or rituals that you believe will improve your health?
Whom do you consult when you are ill?
Who makes health decisions in your family?
What can health care team do to help you stay healthy?
Do you use alternative healing methods?
Personal and Psychosocial Beliefs about a current health problem questions include:
What are the most important results you hope to receive from this treatment?
What do you call this sickness?
What do you thick caused this sickness?
Why do you think it started when it did?
What do you think sickness does? How does it work?
How severe is your sickness?
What kind of treatment do you think you should receive?
What do you fear most about this sickness?
Personal and Psychosocial Religious and Spiritual influences questions include:
Do you have any spiritual needs or concerns related to your health?
Do you belong to a specific relgious or faith community?
What role does your spirituality play in your daily life?
Do particular rituals or religious practices help you deal with daily life and its obstacles? If so, describe them.
How do your beliefs affect your health practices?
Personal and Psychosocial Roles in the Family questions include:
Who makes decisions in your family?
What is the comparison of your family?
How many generations or family members live in your household?
What is the role of an attitude towards children in the family?
Do you or the members of your family have special beliefs and practices surrounding conception, pregnancy, childbirth, lactation, and childbearing?
Personal and Psychosocial Special Dietary Practice questions include:
Are there any special types of food that are forbidden by your culture?
What is the main type of diet eaten in your home?
Who in your family is responsible for food preparation?
How is the food in your culture prepared?
Personal and Psychosocial Strategies to Note the Patients Surrounding include:
When asking the patient questions, look around the immediate area for religious symbols. ((Notice: religious books (Bible, Koran, Torah, a cross, or rosary beads) if you notice any, you may be able to gather more data by commenting on it saying like: "I notice you have your rosary beads.?" In response the patient may comment on its meaning for her.
Notice if patient is wearing an amulet, which is an object with magical powers such as a charm worn on a string or chain around the neck, wrist, or waist to protect the patient from physical and psychological illness, harm, or misfortune. If you notice an amulet, you may be able to gather additional data by commenting on it. For example, you might would say: "I notice that you have something on a chain around your neck. Tell me more about it."
FICA stands for--
5 questions using the acronym FICA:
What is your faith tradition?
How important is your faith to you?
What is your church or community of faith?
How do your religious and spiritual beliefs apply to your health?
How might we address your spiritual needs?
The most important behaviors in cultural assessment are--
Gather specific information specific to the individual patient.
Do not stereotype.
Do not assume care for one individual of a culture is appropriate for another individual of same or similar culture.
Regardless of culture heritage or race, each patient is unique—before you become involved in a detailed task if a physical assessment, FIRST take time to know each patient and his or her family.
Staff development educators are responsible for assisting staff nurses in being adequately prepared to perform their duties as they care for patients from many different cultures and backgrounds. As the educator works with a new nurse from the Philippines, the educator will include:
A. Training on American food choices.
B. Assistance with competency in skin lesions on dark skin.
C. Practice in assessing patients' personal beliefs and practices.
D. Information on immigration and privacy laws.
Correct Answer: C
Rationale: Training on a specific population is of value. However, it is more important for a nurse to understand how to assess each individual patient related to cultural background and beliefs. The reason for this is twofold. First, Western society is becoming so heterogeneous that it is difficult for nurses to know about all cultures. Secondly, individual patients may experience their culture differently than other members of that social group.
A school nurse notices a boy with a bandage on his arm and black fluid under the edge of the bandage. She asks the teen what happened to his arm. He replies that his mother applied axle grease to a boil. What is the nurse's most appropriate response to this boy?
A. Tell the teen to remove the bandage and wash his arm
B. Ask the teen what the boil looks like, what it feels like, and if the axle grease is helping it get better
C. Advise the teen to tell his mother to use antibiotic cream rather than axle grease
D. Suggest that the teen see a health care provider because the axle grease will infect the boil.
The nurse caring for a woman who has just been pronounced dead. Her adult children are in the room What statement by the nurse indicates culturally competent care?
A. "which funeral home would you like notified of your mothers dealth"
B. "We will be moving her to the morgue in about 30 minutes"
C. "would you like some time alone with your mother for any specific ceremonies?
D. "Here are some of her personal belongings that were in the drawer."
A nurse is assessing a woman whose religious beliefs do not allow blood transfusions. She has severe anemia, is very weak and has altered mental status. What behavior by the nurse is needed to provide effective care to this woman?
A. Examine his or her own feelings about the improtance of religious beliefs in making decisions about life.
B. Recognize that he or she cannot provide care to patients whose religious beliefs endanger their lives.
C. Try to convince the patient to have the blood transfusion to save her own life.
D. Determine weather the patient is competent to make her own decisions about health care.
A nurse is teaching a family from Guatemala about the importance of exercise to reduce body weight. The husband asks "what exercises do we do?" Considering the time orientation of this family, which response by the nurse is most effective?
A. "In the past research has shown that walking 30 minutes most days of the week are best"
B. "is there an exercuse that you can do today for 30 minutes and make it part of your daily routine?"
C. "If you exercise 30 minutes most days of the week, you can lose weight by your next visit"
D. "I have always found that resistance weight training each day for 30 minutes is effective"
An older man who is near death has been admitted to the hospital, and family members are at his bedside. During the admission assessment, the nurse uses which question or statement to appropriately address spiritual needs?
A. What is your religion? Ill make the appropriate spiritual arrangements?
B. Tell me what death means to people from your culture?
C. Are there any special needs or rituals that you and your family request at the time?
D. Ill call the hospital priest so he can administer last rites.
A nurse understands that culture heavily influences diet and nutrition. Which of the following can seriously affect a patient's appetite?
time the meal is served
A mother brought a child in to the Emergency Department stating that she thinks her child's appendix has ruptured. Before any diagnostic tests can be done, the father comes in and says, "I don't want anything done, we will take the child to our church where prayer will heal him." What is an appropriate action by the nurse at this time?
Notify the ethics committee immediately.
A hospitalized patient is found on the floor of the room, kneeling on a small rug praying. The nurse understands that this ritualistic behavior is common in which religious practice?
Islam rituals include:
In the religion of Islam, prayer occurs five times a day. Prayers are done facing east toward the sacred place of Mecca and often occur on a prayer rug with ritual washing of hands, face, and feet prior to prayer
A Muslim teenager is in the hospital for surgical repair of a severe fracture in the leg during the month of Ramadan, which the client says he would like to observe during his stay. Which of the following interventions should the nurse be prepared for in caring for this client?
Withhold all food and drink between sunrise and sunset
A nurse assesses the spirituality of a client who is terminally ill with pancreatic cancer. Which of the following is the best rationale for this action, from the nurse's perspective?
Identifying possible coping mechanisms
A nurse begins an interview with a client who is a Native American. The nurse should recognize that this client will display what type of behavior when responding to questions or engaging in conversation with the nurse?
A patient reports wanting to practice yoga while hospitalized. The nurse understands that yoga is a form of spiritual practice proven to:
Encourage greater mental and physical health
A nurse recognizes that the belief that one's world view is the only acceptable truth and that one's beliefs, values, and sanctioned behaviors are superior to all others is called what?
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