Chapter 8 & 12

Norms

"rules" for behavior in a group

Karma

(Hinduism and Buddhism) the effects of a person's actions that determine his destiny in his next incarnation

Imam

(Islam) the man who leads prayers in a mosque they follow prescribed procedures for washing and shrouding the body in death

Arab health

-Do not use the left hand for any other reason than to clean after elimination. Rude to offer medication to the left hand. -Bed must face the mesa

Native American Health Beliefs

-Illness occurs when the harmony of nature (Mother Nature) is disturbed -uses a Shaman -heavy use of herbs and psychological treatments ceremony

Hispanic health/medicine beliefs:

-avoid direct eye contact -use therapeutic touch -use face, hand, and body gestures -respect them wanting to use traditional therapies

asian health beliefs:

-steam removes toxins from body -heated blankets (yin yang) -Do not look women in the eye (look at the head of the house)

What are the challenges likely to be faced by a divorced adult ?

A divorced adult may face the challenges of dating and financial instability, as well as redefining the relationship with the ex-spouse.

stereotype

A generalized belief about a group of people

race

A group of human beings distinguished by physical traits, blood types, genetic code patterns or genetically inherited characteristics.

Presbyopia

A visual disorder associated with aging due to the loss of flexibility of the lens, making it difficult to see close objects.

What are the racial categories according to the federal government standards ?

According to federal government standards, the five racial categories are American Indian or Alaskan Native (origins in North and South America, including Central America); Asian (origins in the Far East, Southeast Asia, or the Indian Subcontinent); Native Hawaiian and other Pacific Islander (origins in Hawaii, Guam, Samoa, or other Pacific Island); Black or African American (origins in any of the Black racial groups of Africa); and White (origins in Europe, the Middle East, or North Africa).

What are the changes that take place in the lives of adults in their 30s ?

Adults in their 30s may find themselves without a job as companies are taken over by bigger conglomerates, headquarters move to another city, and plants close. Some adults decide to embark on a new career path or to return to school. Changes in career status, either voluntary or because of economic needs, can place stress on couples and families. Individuals must engage the support and assistance of the entire family.

Who are the individuals who perform rituals as part of the healing process in various ethnic and religious groups ?

Among Native Americans, rituals are usually performed by shamans (medicine men). Curanderos (work with herbs and counseling) perform rituals for Latinos/Hispanics/Mexicans. Mullahs perform rituals for Muslims. Ministers or priests perform rituals for Christians. Among Jews, rituals are performed by rabbis.

A nurse caring for a client recognizes the client's need for spiritual support. Which intervention should the nurse perform ?

Answer: Ask the client to contact a spiritual leader RATIONALE: The nurse should instruct the client to contact a spiritual leader. It would not be appropriate for the nurse to instruct the client to visit religious places or listen to spiritual discourses. Nor would it be appropriate for the nurse to recite spiritual stories to the client.

A Buddhist client with depression visits the healthcare center. Which principle of Buddhism can the nurse use to help the client overcome depression ?

Answer: Attain pain-free existence RATIONALE: The nurse can use the Buddhist principle of attaining an existence free of desire and pain when helping the client to overcome depression. Taoists believe in living a natural life. Confucians favor a high appreciation of life and an emphasis on public health.

How does cultural sensitivity help a nurse provide better care ?

Answer: By understanding and accepting other's behaviors RATIONALE: Cultural sensitivity helps the nurse to understand and accept the behaviors of others. It is crucial in the delivery of competent nursing care.

A client tells the nurse about several choices confronting life. What is a common choice in life that occurs during middle adulthood ?

Answer: Developing the intellectual self by continuing education RATIONALE: Developing the intellectual self by continuing education occurs during middle adulthood. Entering a serious relationship, choosing to work in a people-oriented occupation, and establishing adult identification occur during early adulthood.

A nurse is caring for a Muslim-Arab female client. Which is the most expected reaction of the client when the nurse is conducting an assessment ?

Answer: Exhibits no facial expressions RATIONALE: A Muslim-Arab woman would not exhibit any facial expressions when the nurse is conducting an assessment. Most Muslim-Arab women are uncomfortable with eye-to-eye or direct eye contact with another person, especially if the person is male. The client would not be very comfortable when the nurse touches her as part of the assessment.

Concerns for a 30-year-old are commonly very different from younger populations. What concern for a 30-year-old married woman with two children needs to be addressed first at this time ?

Answer: Financial ability to pay for costs of healthcare of children RATIONALE: Often an adult's concern is related to financial or physical ability to pay for costs of healthcare for children or for an aging parent.

A housewife in her 30s complains of regular headaches and tells the nurse that she is contemplating divorce. How should the nurse react ?

Answer: Inform the client about the risk of financial instability after divorce RATIONALE: The nurse should inform the client about the risk of financial insecurity after divorce. The nurse should not advise the client to seek advice from her in-laws or to compromise with her spouse; these actions may not help resolve the client's problem.

A nurse is taking a health history and is aware that the client believes in a health belief system dominated by supernatural forces. Which health belief system is dominated by supernatural forces ?

Answer: Magico- religious RATIONALE: The magico-religious health belief system is dominated by supernatural forces. The belief that physical and biomedical processes can be studied and manipulated to control life is called scientific/biomedical belief. The belief that the forces of nature must be kept balanced is called holistic medicine. The belief that illness develops when life forces are out of balance is called hot-cold theories or yin-yang.

A client wants to know the reason for the higher percentage of non-whites diagnosed with mental illness in the United States. What should be included in the nurse's response ?

Answer: Poverty RATIONALE: Poverty is one of the reasons for the higher percentage of nonwhites diagnosed with mental illness in the U. S. Family conflicts, genetic disorders, and stressful lifestyles are not the reasons for this situation.

A nurse is appointed to care for a Muslim client. What beliefs or practices should the nurse be aware of when dealing with this client ?

Answer: Prohibit pork and alcohol RATIONALE: The nurse should be aware that pork and alcohol are prohibited among Muslims. Jews observe kosher dietary laws and decline diagnostic tests on holy days. Hindus believe in faith healing.

A client has a health belief that the physical and biomedical processes control life. Which health belief are the physical and biomedical processes studied and manipulated to control life ?

Answer: Scientific RATIONALE: The scientific/biomedical health belief system involves the study of physical and biomedical processes. According to magico-religious belief, supernatural forces dominate health. Holistic medicine believes that forces of nature must be balanced. Yin-yang theory believes that illness is developed when life forces are out of balance.

A 25-year-old client who has recently graduated wants to know what he should focus on at this point in his life. Which is the best choice for this client ?

Answer: Selecting an occupation RATIONALE: Considering the client's age, the nurse should encourage the client to select an occupation that will help him move forward in life. This client can focus on marriage, self-identity, and intimate relationship during the middle adulthood period.

A 45-year-old client tells the nurse about struggling with several issues. The nurse knows that a client of this age is typically dealing with which period transition ?

Answer: Self identity RATIONALE: For age 40 to 45 years, self-identity is the appropriate period transition. Career choice occurs for 18- to 22-year-olds. Settling down occurs for 33- to 39-year-olds and change of career occurs for 28- to 33-year-olds.

The nurse is addressing a meeting in which college students are being informed about researchers' theories of development as it applies to young and middle adulthood. What information should be included about Erikson theory in the presentation ?

Answer: There are psychosocial challenges that individuals face in young and middle adulthood RATIONALE: Erikson states that there are psychosocial challenges that individuals face in young and middle adulthood. These challenges are not based on learned behaviors, ability to make successful transitions, or build a safe structure for the future and have commitment and security

An Asian couple visits the healthcare center with their 2-year-old child, who has a mild temperature. In relation to beliefs about personal space and touching, what approach should the nurse take when caring for this client ?

Answer: Touch the child on the arm RATIONALE: Because the client is of Asian origin, touching the child on the arm would be the safest approach. In some Asian cultures, touching the child on the head is considered a sign of disrespect and is believed to cause illness. Kissing the child on the cheeks or tightly hugging the child is not considered appropriate by Asians.

Ethnocentrism

Belief in the superiority of one's nation or ethnic group.

Culture

Beliefs, customs, and traditions of a specific group of people.

18-22 years

Career Choice

28-33 years

Change of career

For biologic reasons, women in their 30s must make specific decisions related to ____________________________.

Childbearing

Why do some couples in their 20s choose to postpone marriage ?

Couples in their 20s who live together often prefer to postpone marriage until after completing college, establishing a career, and building up adequate financial resources. Others do not want to commit to a long-term relationship until later in life, if at all. Some adults live together for the same reasons others marry—for protection, to share expenses, or to escape the parental home.

According to Erikson and other theorists, developmental challenges depend on individual characteristics, support from society, and ___________________________________ influences.

Cultural

____________________________ sensitivity is the understanding and tolerance of all cultures and lifestyles

Cultural

___________________________ is the accumulated learning for generational groups of individuals within structured or nonstructured societies

Culture

What does culture consist of ?

Culture consists of language and communication, health beliefs and practices, customs and rituals, and religious beliefs and practices.

Hinduism health practices

Do not offer meats

During a routine checkup, a 36-year-old unmarried client reveals to the nurse that she is anxious to start a family and have a baby. What are the challenges this client is likely to face ?

During the age of 30 to 40 years, women realize that they wish to have children now or it may soon be too late. Career goals and motherhood can conflict. An unmarried woman in her 30s may feel pressured to find the right father for the baby because life is passing her by. Adoption and artificial insemination are options for single women. Women who choose to have babies outside a committed relationship face the responsibilities and challenges of single parenthood.

Intimacy

Establishing relationships with others.

_____________________________________ is the common heritage shared by a specific culture

Ethnicity

Caring for clients while taking into consideration their religious and sociocultural backgrounds is called ____________________________________

Ethnonursing

Rituals

Formal, ceremonial behaviors with a specific purpose and significance.

The tasks of ________________________ occur when middle adults decide to pass on learning and share skills with younger generations.

Generativity

22-28 years

Getting into the adult world

Presbycusis

Gradual hearing loss associated with aging, often starting in middle age and becoming noticeable by the mid 60s.

What are the various methods that can help older adults plan for retirement ?

In preparation for a productive and interesting retirement that may last for 25 years or longer, adults should develop interests and hobbies in midlife. Financial planning is an important component of retirement. The money available for pensions has declined, and many corporations offer no pension at all. Middle-aged adults need to plan their own retirement funds and investments. Large houses may be sold for simpler living arrangements. Individuals may look for part-time work and may consider relocating to warmer or more scenic environments. Many adults consider a return to school at this age, enrolling in colleges and universities.

Transcultural communication is facilitated through the use of a professional _______________________________

Interpreter

Rabbi

Jewish religious leader

The belief that supernatural forces dominate is called ________________________________

Magico-religious

Shaman

Native American doctor or healer

Buddhists believe that hard work and right living enables people to attain ____________________________

Nirvana

Jehovah's Witness

No blood products should be used

Generativity

Passing on and sharing skills with younger generations.

45-65 years

Payoff years

What is indicated by the term "sandwich generation "?

People in their middle years are caught between caring for aging parents and caring for their own growing children. Personal needs and goals are often shoved aside. Such adults have been referred to as the "sandwich generation."

Stagnation

Person focuses on personal pursuits and interests.

Racial mixing has blurred the _______________________ characteristics of individuals

Physical

_________________________ is a belief based on preconceived notions about certain groups of people

Prejudice

Many adults consider a return to school during their _____________________________ years, enrolling in colleges and universities in their free time without work.

Retirement

40-45 years

Self-Identity

midlife transition

Sense that arises in middle adulthood that others of the same age have achieved more and that one must contribute to society before it is too late.

Isolation

Separation from others; separation of people with infectious diseases from others.

33-39 years

Settling down

Give the significant aspect of the young adult period for starting and shaping a family.

Society still expects most adults to marry and to establish a family and home. Many adults postpone marriage or childbirth until their 30s, preferring to first establish careers and become financially secure.

Demographics

Study of population trends, including births, deaths, and diseases.

____________________________________ are groups within dominant cultures

Subcultures

What concepts identified by the American Nurses Association (ANA) for nursing care for clients from diverse cultures should the nurse be aware of ?

The concepts identified by the ANA for nursing care for clients from diverse cultures are knowledge of cultural diversity is vital at all levels of nursing practice; approaches to nursing practice that do not incorporate cultural sensitivity are ineffective; and knowledge about cultures and their impact on healthcare is essential for nurses.

A nurse is caring for clients of various cultures. What are the critical factors involved in nursing care for diverse cultures ?

The critical factors involved in nursing care for diverse cultures include approaching the clients with patience, empathy, concern, and competence and developing a high level of self-awareness among the clients.

What are the culturally influenced components that are common to many members of a cultural group ?

The culturally influenced components are classified on the basis of values and beliefs, taboos and rituals, concepts of health and illness, language and communication, diet and nutrition practices, and attitudes toward death and dying.

Which are the four subcultures identified by the Centers for Disease Control and Prevention (CDC) ?

The four subcultures identified by the CDC are African Americans, Latinos/Hispanics/Mexicans, Asian Americans, and Native Americans.

A teenage client is discussing with the nurse her relationship with others. Which relationships should the nurse encourage ?

The nurse should encourage relationships that include coworkers, male and female housemates, intimate homosexual or heterosexual relationships, cohabitation, marriage, and religious orders. Some adults live with parents or other relatives for social support as well.

A nurse is addressing a meeting in which parents are being informed about the patterns of young adults leaving home. What information should the nurse include ?

The nurse should inform the parents about the important decisions that young adults make while leaving their home of origin. Some young people face financial problems that force them to return to their family homes temporarily. Leaving home can follow any of several patterns: •A person leaves home and does not move back. •A person stays at home until he or she is forced to leave by family members. •A person leaves, returns, leaves, returns, and continues a cycle of moving in and out. •A person leaves but remains within close proximity to the family of origin by moving next door.

A nurse is caring for clients belonging to various ethnic groups. What information should the nurse have regarding ethnic groups' retaining their cultural heritage ?

The nurse should understand that ethnic groups retain their cultural heritage by celebrating special occasions with traditional activities and food, have strong identification with their original culture, and pass on traditions to the next generation.

A couple with young children asks the nurse about the factors that contribute to a strong family unit. What instructions should the nurse provide to the parents ?

The nurse's instructions can include of sharing child care responsibilities, which enables both mother and father to develop close relationships with their children. Participation from both parents in household tasks and childrearing often contributes to a strong family unit.

Emerging adulthood

The period between the age of about 20 years to middle age, when an individual transitions from adolescent behaviors and choices to those of a mature adult. Choices during this period include adult lifestyle (e.g., single vs. married), occupation/career, and values.

minister

The person who administers or celebrates a sacrament (baptism, wedding, etc) examples: Christian Clergy person (Protestant) Pastor (Catholic/ Protestant)

Mullah

a Muslim healer (in some faiths) they are trained in Muslim religous law and doctrines

prejudice

a belief based on preconceived notions about certain groups of people example: "you're an Asian, that means you're smart"

Values

a person's or group's "rights" or "wrongs" or what is considered desirable or important

Ethniciy

a sense of identification of a collective cultural group, based on common heritage

Taboos

a social, religious, or cultural custom that forbids discussion or practice of a particular person, place, or thing example: adults avoid using profanity in front of children

Ethonursing

an approach to nursing that considers a client's religious and socio-culture backgrounds during treatment, also known as ethnic sensitive nursing

priest

an ordained minister of the Catholic, Orthodox, or Anglican Church having the authority to perform certain rites and administer certain sacraments.

curandero/curandera

folk healer, someone who uses prayers, herbs, and the laying on of hands to heal from Spanish word "curar", which means "to heal"

minority

group whose numbers are less than half the total amount of a total group. makes up approximately 36.3% of the current US population

Subculture

groups within dominant cultures they are formed because individuals share characteristics that belong to an identifiable group such as occupations (nurse, teacher), religions, and age

Jewish diet

no dairy and meat together no shellfish, pork, or rabbit. (kosher diet)

Beliefs

specific ideas that people hold to be true

cultural diversity

the existence of a variety of cultural or ethnic groups within a society.

transcultural nursing

the study of various cultures with the goal of providing care specific to each culture

Cultural Sensitivity

the understanding and tolerance of all cultures and lifestyles allows the nurse to understand more accurately and to accept the behavior of others

Yin and Yang

two forces in the universe, according to Chinese Theory: Yin is the passive, negative force, and Yang the active, positive force

Nirvana (Buddhism)

ultimate reality/goal, the end of suffering

What are the qualities that an interpreter should possess ?

•Knowledge and understanding of the nuances of medical language •Knowledge of the formal, slang, and conversational levels of the language that is being interpreted •Ability to communicate without implying judgment, bias, or personal opinions