Developmental Transitions I: Chapter 2 Diversity and Maternal Child Nursing

A nurse is advising a pregnant woman on the importance of calcium intake during her pregnancy. Which would be the most appropriate suggestion for the nurse to make?

• "Your body needs plenty of calcium during pregnancy. Here is a list of foods that are high in calcium."

After reading a journal article about culture and cultural diversity, a nurse demonstrates understanding of the information when the nurse identifies which situation as an example of cultural assimilation?

• An American living in France celebrating French National Day

A nurse is providing care to a woman who speaks little English. The nurse enlists the aid of an interpreter. Which method would the nurse include when working with the interpreter when teaching this patient? Select all that apply.

• Ask an interpreter to translate material into the family's primary language. • Be certain that rooms in your health care agency, such as bathrooms, are labeled with international symbols. • Assess each client's reading level and rewrite information at an easier reading level if necessary. • Use hand gestures or draw a figure, if need be, to communicate better.

A client who immigrated from China and has undergone labor induction with Pitocin has an elevated temperature and dry mucous membranes. She is refusing sips of water and ice. Which is the most appropriate nursing action at this time?

• Ask the client what she would like to drink.

A clinical nurse specialist is conducting a review class for a group of nurses about cultural compentence and cultural diversity. The nurse determines that teh teaching was successful when the group identifies which term as reflecting the view of the world and set of traditions of a specific social group passed down through generations? You Selected:

• Culture

A lesbian woman is in labor, and she has just arrived with her partner to the labor and delivery unit. The nurse who is up next for an assignment refuses to take care of this couple because to do so conflicts with her religious beliefs. This an example of:

• Discrimination

Which concept characterizes transcultural nursing?

• Planning care compatible with the client's health belief system

What are examples of culturally sensitive care? Select all that apply.

• Providing discharge instructions in Spanish to a Hispanic patient who speaks in broken English. • Nodding hello instead of shaking hands with an Orthodox Jewish male. • Providing a Middle Eastern woman an extra gown for covering up.

An Islamic woman is in active labor and informs the nurses that she is fasting during the day since it is Ramadan. What would the nurses be assessing for in this woman related to her cultural ritual?

• Respect this woman's faith, but also assess for dehydration and hypoglycemia.

Which intervention best demonstrates the L & D nurse is respectful of a client who is deaf and in early labor?

• Seek assistance from another health care professional who can converse in sign language.

Which are considered universal cultural taboos? Select all that apply.

• murder • incest • cannibalism

cultural awareness

Being aware that we all live and function within a culture of our own and that our identity is shaped by it

cultural blindness

Do not see or believe they are cultural differences among people. Everyone is the same

prejudice

a negative attitude towards members of a group or is an intellectual act

pain

a person's response to ____ is both individually and culturally determined

culture

a view of the world and a set of traditions a specific social group uses and transmits to the next generation.

lesbian

female identified individuals who are sexually attracted to female partners

FTM

female to male transition usually prefers male pronouns

homosexual

someone who finds sexual fulfillment with a member of his or her own sex. This term is often disparaged in the LGB community. Same-sex partner and gay (for men or women) can be an umbrella term to use instead of homosexual.

heterosexual

someone who finds sexual fulfillment with a member of the opposite gender. Straight is often used in place of heterosexual

hormone replacement therapy

use of estrogen and antiandrogens for MTF individuals and testosterone for FTM individuals to gain characteristics of their gender identity

Personal space and distance is a cultural perspective that can impact nurse-client interactions. What is the best way for the nurse to interact with a client who has a different cultural perspective on space and distance?

• Allow the client to adopt a position that is comfortable for him or her.

A Hispanic woman in active labor begins to recite a Hispanic lullaby to "call the baby outside." Which action by the nurse caring for this woman is most appropriate at this time?

• Allow the client to perform a ritual.

The nurse is reviewing the medical record of a female patient. The history reveals that the patient believes that her gender identity and sex match. The nurse would identify the patient's gender identity by which term?

• Cisgender

A young African-American woman has just been admitted to the hospital's birth center because her water broke. The client has just moved to the area and has a strong southern accent. The client explains that she lost a baby in childbirth several years earlier. Her husband has not arrived yet. The client seems nervous when responding to the nurse's questions. Which problem would the nurse identify pertaining to cultural diversity would best explain the client's nervousness?

• Embarrassment about her regional accent

A cultural group that one is born into is called:

• Ethnicity

A client who just learned she is pregnant says, "I can no longer eat strawberries, even though they are my favorite." What best explains this statement?

• It is related to culture.

The primary care provider has ordered a biophysical profile (BPP) test for a pregnant woman. The nurse quickly discovers that the client and her husband do not read or write English. Which is the best way for the nurse to obtain their consent for the test?

• Locate a bilingual staff member or an interpreter to translate before the couple signs the consent.

A nurse would be extra understanding and aware of modesty issues when working with clients from which culture?

• Middle East

cultural competence

The capacity to work effectively and with people, integrating elements of their culture- vocabulary, values, attitudes, rules, and norms. Translation of knowledge into action

taboos

actions not acceptable to a culture. Three universal taboos are murder, incest, and cannibalism

cultural values

: preferred ways of acting based on cultural traditions. They often arise from environmental conditions (scare water= not bathing daily, scare meat= ethnic recipes with little meat). They form early in life and strongly influence the manner in which people plan for childbearing and childrearing as well as the way they respond to health and illness. May cause conflict between children and parents because children learn opposing views from friends and school peers.

cultural destructiveness

Making everyone fit the same cultural pattern And excluding of those who don't fit - forced assimilation. Emphasis on differences as barriers

cultural humility

The lifelong process of self-reflection and self-critique that begins, not with an assessment of a client's beliefs but rather an assessment of your own

cultural sensitivity

Understanding and accepting different cultural values, attitudes, and behaviors

race

a social construct, refers to a category of people who share a socially recognized physical characteristic, often skin color or facial features. It can also refer to a group of people who share the same ancestry.

public space

any distance beyond business space such as shouting across a parking lot. Use of the internet or telephone can vary from private space (I have a secret to tell you) to public space (conversation in a chat room).

culture specific values

are norms and patterns of behavior unique to one particular culture

gender expression

behavior a person exhibits which may or may not be the same as the person's gender identity or sex assigned at birth

business space

beyond 4 feet as this amount of distance allows for room for a desk between parties

transcultural nursing

care guided by aspects and respects individual differences

minority

disadvantaged groups, groups not necessarily fewer in number but who holds less power and wealth

diversity

in a population means there is a mixture or variety of sociodemographic groups, experiences, and beliefs in the population.

gender identity

inner sense a person has of being male or female, which may be different from the sex assigned at birth

cultural humility

is a lifelong process of self-reflection and self-critique that begins, not with an assessment of a patient's beliefs, but rather with an assessment of your own

cultural awareness

is being aware cultural differences exist

stereotyping

is expecting a person to act in a characteristic way without regard to his or her individual traits; usually derogatory in nature. Usually occurs because of lack of exposure to people in a particular group leading to a lack of understanding.

cultural competence

is respecting cultural differences or diversity

ethnocentrism

is the belief one's own culture is superior to all others

intimate space

is the space closely surrounding a person. Physical examinations are conducted in this very tight space because palpation and auscultation are parts of the examination

gay

male identified individuals who are sexually attracted to male partners. This term is also sometimes used to refer to both men and women who have same sex partners

MTF

male to female transition, usually prefers female pronouns

assimilation

means people blend into the general population or adopt the values of the dominant culture.

bisexual

people are bisexual if they achieve sexual satisfaction from both same sex and heterosexual relationships. *Both men who have sex with men (MSM) and women who have sex with women (WSW) include individuals who may not self-identify as gay or homosexual but who may have sex with people of the same gender. They are also terms used in medical or public health publications instead of the terms homosexual, gay or lesbian

gender dysphoria

realization one's physical sex and gender are mismatched, which can cause a lot of stress and anxiety

ethnicity

refers to the cultural group into which a person was born, although the term is sometimes used in a narrower context to mean only race.

acculturation

refers to the loss of ethnic traditions because of disuse.

culture universal values

refers to values, norms, and patterns shared across almost all cultures

gender affirmation surgery

surgical procedures to change body characteristics to match an individual's gender identity

discrimination

the action of treating people differently based on their physical or cultural traits or is a doing act.

threshold sensation

the amount of stimulus that results in pain

pain tolerance

the point at which an individual withdraws from a stimulus

pain threshold

the point at which the individual reports a stimulus is painful

mores/ norms

the usual values of a group

conversational space

usually 18 inches to 4 feet away

sex assigned at birth

usually based on a person's chromosomal sex male (XY) or female (XX). There have been cases of individuals born intersex, with ambiguous genitalia where sex was assigned based on a providers assessment of the genitalia alone.

transgender

when an individual feels that their gender and sex do not match

cisgender

when an individual feels their gender and their sex match

After an initial cultural assessment, the nurse has determined that a family's time orientation is focused on the present and the past. Which is the best feeding goal to focus on for this family?

• After this hour with the lactation consultant, the baby will demonstrate a good latch.

An expectant mother from a South Asian culture arrives 20 minutes late for her appointment. Which response by the nurse would be the best way for the nurse to address the client's tardiness?

• "I understand that Americans have a different understanding of time than other cultures; but it is important to be on time so that the provider can be available to see you."

While reviewing a woman's compliance with prenatal care, a nurse notes that which comment made by the woman may be a result of poverty rather than a cultural difference?

• "I wish I could afford fresh fruits for vitamin C because I just don't remember to take those prenatal vitamins."

Southeast Asian women have gained a reputation on the unit as having a low threshold for pain. A Southeast Asian woman arrives to the unit. The woman is 38 weeks' pregnant with her first baby and reports that her contractions began 1 hour ago. She is 1 cm dilated, rates her pain as 10/10 on the pain scale, and screams for pain medication. What is the best action from the nurse?

• "Let me start your IV so we can get you an epidural as soon as possible."

A couple had decided not to circumcise their newborn for nonreligious reasons. What is the appropriate response from the nurse?

• "OK, great. I will let the physician know."

A nurse is uncomfortable caring for a pregnant client who is married to her female life partner. The best advice another nurse can give her would include which statement

• "Spend some time self-reflecting why this family difference might be bothering you."

A nurse is uncomfortable caring for a pregnant client who is married to her female life partner. The best advice another nurse can give her would include which statement?

• "Spend some time self-reflecting why this family difference might be bothering you."

A nurse is discussing nutrition with a Chinese-American primigravida. The client states that she knows that calcium is important during pregnancy but that she and her family don't consume many milk or dairy products. What advice should the nurse give?

• "You should consume other non-dairy foods that are high in calcium."

The mother of an infant is staying on the unit. The pediatric nurse notes that the infant has not received the recommended vaccinations for his age, so the nurse provides information on immunizations to the mother. The mother informs the nurse that immunizations are against her cultural and religious beliefs, and she does not want her child to receive immunizations. In this scenario, what do immunizations represent?

• A cultural taboo

Which is an example of culturally competent care?

• A nurse who arranges for a family's espiritualisto to visit a Hispanic pediatric client

A gay couple asks their health care provider about how they can begin a family. Which methods should be discussed to accomplish their goal of a family? Select all that apply.

• One or both partners can donate sperm to a surrogate gestational carrier. • The couple can find a female surrogate and then donate sperm to allow for artificial insemination. • The nurse can give the couple a list of area adoption agencies that might be helpful to use to grow their family.

The nurse caring for a woman in active labor notices a strange odor coming from some tea the family has brought. When questioned, the woman informs the nurse of herbs they have brewed in the tea to help lower the pain. Which intervention would be considered the most appropriate for the nurse to take?

• Research the herbs in the tea and report the findings to the provider.

A male student nurse is interested in working in pediatric care. An instructor remarks to a colleague, "Children relate better to women--they are used to their mothers and want nurses like them." What term reflects the instructor's attitude?

• Stereotype

Which is the consequence of a nurse equating the client's skin color and other physical features with culture?

• Stereotyping

A female attending physician and three male resident physicians are working on the current shift. When a Muslim American woman is in labor, her husband asks that she be examined by a female provider. What action should the nurse take?

• Tell the couple that the male resident is available now, but to see the female attending they may have to wait.

A school-aged child from Japanese background expresses concern to the school nurse about feeling embarrassed over the parents' speaking broken English. After counseling the child, the nurse understands that which evaluation reflects a positive outcome for this child?

• The child no longer feels isolated because of the family's differences.

A woman who is from the Philippines becomes upset when the nurse brings in an interpreter, rather than using her cousin as the translator. Which would be the best reason for using an official interpreter in this case?

• There may be cultural limitations that change how the information is being interpreted by the family.

A nurse is caring for a client who has recently moved from her native Mexico. The nurse senses that the client misses her native country and asks her if she would like some burritos for lunch and perhaps watch the Mexican channel on television. The nurse is practicing:-

• cultural competence

A laboring client, 2 cm dilated and 50% effaced, is screaming in pain. The nurse caring for this client recognizes this woman's response to pain should be documented using which label?

• low pain threshold

When a labor and delivery nurse tells a coworker that an Asian client probably did not want any pain medication because "Asian women typically are stoic," the nurse is expressing a belief known as:

• stereotype.

When caring for woman who speaks a different language than one's own, the nurse must ask for an interpreter before having the client sign which forms to ensure clarity can be confirmed? Select all that apply.

• surgical permit • end-of-life care • consent to blood transfusions

A nurse encourages both partners in a lesbian family to come into the examining room with the newborn during a well-baby check. What type of nursing is the nurse practicing?

• transcultural nursing

A laboring woman has brought her partner as her support person who is dressed in feminine attire, but when she speaks, it is clear to the nurse that the support person has a male voice. When documenting about the client's support person, which term would be most appropriate?

• transgender