Health and assessment chapter 11: Assessing culture.

A nursing instructor is teaching students about communication in different cultures. When discussing the meaning of hand gestures and body language in different cultures, the nurse realizes that further instruction is necessary when a student makes which statement?

"I can make a circle with my thumb and forefinger and people of all cultures know it means OK." Explanation: There are many different elements of body language and hand gestures among different cultures. Using the hand to indicate height is a common gesture of Americans and Latins. Making a circle with the thumb and forefinger can mean OK for Americans but can be a definite and serious insult in many cultures. Therefore, if any hand gesture is used, the nurse should always clarify if there seems to be a strange or unexpected outcome on the other person's part.

Asian traditions

-Chinese medical practitioners, herbalists -Prevent or rebalance yin/yang, hot/cold foods and conditions, wear amulets, acupuncture, cupping, moxibustion

western European traditions

-Homeopathic physicians, physicians, and other health professionals -Maintain physical and emotional well-being with proper science-based modern nutrition, exercise, cleanliness, belief in and faith in God

African traditions

-Magicoherbalist, hoodoo (also known as conjurers), or other traditional healers known as "Old Lady," "granny," or lay midwife - Magical and herbal mix of herbs, roots, and rituals, talismans, or amulets

Hispanic traditions

-traditional healer: folk healers -preventive and healing practices: hot/cold balance for diet, herbs, amulets, prayers to God and saints and spiritual reparations for sins, avoiding "evil eye" caused by jealousy and envy

Subculture

A group of people with a culture that differentiates them from the larger culture of which they are a part.

Enculturation

A natural conscious and unconscious conditioning process of learning accepted cultural norms, values, and roles in society and achieving competence in one's culture through socialization.

Taboo

A restriction on behavior imposed by social custom.

Ethnicity

A socially, culturally, and politically constructed group that holds in common a set of characteristics not shared by others with whom members of the group come into contact

Stereotyping

An oversimplified conception, opinion, or belief about an aspect of an individual or group.

ASKED

Awareness Skill Knowledge Encounters Desire

The client comes to the health care provider stating he has a sore throat and believes he needs an antibiotic. This is an example of what type of model for health?

Biomedical Explanation: The biomedical model views health as the absence of disease and health is restored through prompt diagnosis and elimination of pathology. Alternative treatments are used in instead of conventional. Complementary treatments includes alternative an conventional treatments. Spiritual is based upon one's belief system.

The nurse is caring for a married female client who defers to her husband to answer all assessment questions. The nurse understands that it is common in some cultures for the male to hold a dominant role in the relationship. What stage of cultural awareness does the nurse display?

Conscious competence Explanation: Conscious competence is consciously learning about the client's culture and providing culturally relevant interventions; aware of differences; able to have effective trans-cultural interactions.

The nurse is caring for a client who is from another country, and states to the charge nurse, "I just don't know if the client really understands what I am saying, and I am not understanding the client either, even though he speaks English." What stage of cultural awareness is the nurse experiencing?

Conscious incompetence Explanation: Conscious incompetence is the awareness that one lacks knowledge about another culture; aware that cultural differences exist but not knowing what they are or how to communicate effectively with clients from different cultures.

The nurse knows that she will be caring for a client from Southern Korea who has been visiting with a family member. The nurse obtains some information about the Korean culture so that she will be able to meet the clients needs. What is the nurse demonstrating?

Cultural knowledge Explanation: Cultural knowledge is the process of seeking and obtaining a sound educational foundation concerning the various world views of different cultures. The nurse has sought information in order to provide culturally competent care by seeking knowledge of the client's culture.

A nurse is performing an admission assessment of a client of Asian descent who participates in traditional cultural practices. During the assessment the nurse observes large, round, red marks on the client's back. What action should the nurse take?

Document findings. Explanation: Cupping is a traditional healing practice used in Asian societies, and it often leaves large, red marks. The nurse would document the findings. There is no reason to ask the client's spouse to leave the room or report abuse to the supervisor because these marks are normal in the client's culture. The nurse does not have to notify the health care provider, because these are not abnormal findings.

A client of African descent tells the nurse they communicate with the dead. How should the nurse respond?

Document the client's statement. Explanation: In African societies communicating with the dead is not considered pathologic. It is termed a "spell," in which a person communicates with dead relatives or spirits, often with distinct personality changes. Because this is considered normal in the client's culture, the nurse would not request a psychiatric consultation. The nurse may perform a comprehensive neurological exam, but it is not indicated in this situation. Documenting that the client is hearing voices is inaccurate. The nurse would document that the client stated, "I communicate with the dead."

A Navajo Native American client states having "bad dreams, and feelings of confusion and danger." The nurse notes the client's mother died one month ago. What would the nurse do next?

Document this as ghost sickness. Explanation: Ghost sickness is a Native-American culture-bound syndrome that involves feelings of danger, confusion, futility, suffocation, bad dreams, fainting, dizziness, hallucinations, and loss of consciousness. The possible causes are a preoccupation with death or someone who died. The nurse would recognize this syndrome and discuss with the client before referring to counseling. The client does not exhibit signs of depression at this time. The nurse should ask how the client has been sleeping over a larger span than one night for adequate data.

Perception that one's worldview is the only acceptable truth and that one's beliefs, values, and sanctioned behaviors are superior to all others.​

Ethnocentrism

All members of a particular culture expecting group members to hold the same beliefs and behave in the same way.​

Stereotyping

Cultural diversity

The coexistence of a difference in behavior, traditions, and customs—in short, a diversity of cultures, often resulting from cross-border population flows; perhaps better referred to as cultural pluralism (United Nations Educational, Scientific, and Cultural Organization, 2016).

Cultural imposition

The intrusive application of the majority group's cultural view upon individuals and families (citing the United Nations, 1948, Universal Declaration of Human Rights).

What must occur before a client will be willing to teach the nurse about her culture?

The nurse needs to establish rapport and trust Explanation: If the nurse has established rapport and trust, clients will be willing to teach about their cultures.

Ethnocentrism

The universal tendency of humans to think their ways of thinking, acting, and believing are the only right, proper, and natural ways.

Worldview

The way individuals or groups of people look at the universe to form basic assumptions and values about their lives and the world around them; includes cosmology, relationships with nature, moral and ethical reasoning, social relationships, magicoreligious beliefs, and aesthetics.

the acculturation process.

affects values, behaviors, beliefs, attitudes, language, and much more.

Four humors of the body

blood, phlegm, black bile, yellow bile - regulate basic bodily functions, described in terms of temperature, dryness, and moisture

learned behaviors that are perceived to be appropriate and inappropriate.

norms

The nurse and a client are developing a transcultural nursing care plan related to hypertension. The nurse will include in the plan

nutritional information specifically for the client's culture. Explanation: Compare the nutrients of foods not usual in the United States with nutrition charts to understand how healthy a diet is, especially with regard to diseases such as hypertension. It is very difficult to get a client to change usual dietary habits drastically, even with knowledge of the interaction of diet and disease.

Native Americans/Alaska native Americans

medicine men or shamans

often refers to a group that has less power or prestige within the society, but actually means a group with smaller population number

minority

A nurse is caring for a female client. The client tells the nurse that in their culture, the husband makes all the decisions. The nurse understands that this is common in some societies that believe in which of the following family structures?

paternalistic Explanation: In paternalistic or patriarchal societies, the father of the family is expected to be informed of diagnoses and to make decisions about treatment. In generational cultures older family members have more say in health care and treatment than clients themselves, even if the client is an adult. The Western-style family structure is a biomedical one and believes clients should make their own decisions (also know as autonomous).

in humans, is not a physical characteristic but a socially constructed concept that has meaning to a larger group.

race

A nursing student realizes that which of the following is an important variation of communication?

silence Explanation: Silence is a very important variation of nonverbal communication. Beliefs, spirituality, and death rituals are considerations when doing cultural assessments but are not forms of communication.

cultural relativism

the belief that the behaviors and practices of people should be judged only from the context of their cultural system

Acculturation

the circumstance when a person gives up the traits of their culture of origin as a result of context with another culture, to variable degrees.

cultural diversity

the coexistence of a difference in behavior, traditions, and customs -in short, a diversity of cultures, often resulting from cross border population flows; perhaps better referred to as cultural pluralism.

assimilation

the gradual adoption and incorporation of characteristics of the prevailing culture

cultural imposition

the intrusive application of the majority group's cultural view upon individuals and families

A nurse understands that culture heavily influences diet and nutrition. Which of the following can seriously affect a client's appetite?

time the meal is served Explanation: When a meal is served can seriously affect appetite. For those who usually eat a midday meal at 2 or 3P M, it is unappetizing to see lunch served at 11 AM or 12 PM, and a 5 or 6 PM dinner is considered a late lunch rather than an evening meal. Food preferences that are nutritional are good choices for the client. If a client requests a specific diet, then the client will be inclined to eat it. For some people food serves as a comfort or as closeness to ethnic roots, which is a positive factor in regards to a client's appetite.

Learned beliefs about what is held to be good or bad

values

What aspects of culture are relevant when conducting a health assessment on a foreign-born client admitted for surgery? Select all that apply.

whether there are any existing language barriers nutritional or dietary considerations alternative medicine practices Explanation: Aspects of culture relevance to a health assessment include communication and language, nutrition, and health care beliefs and practices. The remaining questions relate to the social aspects of a cultural assessment.