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MED SURG NURSING CH 4 &. 15


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Ashley Heacock


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8 Cultural Phenomena: Death & Dying and End-of-Life Issues
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Become knowledgable in other cultures rituals surrounding death and bereavement.

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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.
Worldview
Way a person perceives the world.