312 exam 2

leukoedema

- a grayish-white benign lesion occurring on the buccal mucosa - is present in 68% to 90% of Blacks and 43% of Whites.

African American / black folk healers

-- "old lady" = usually, an older woman who has successfully raised her own family; knowledgeable in childcare and folk remedies --- spirtualist = called by god to help others; no formal training; usually associated with christian church. ---voodoo priest/priestesses: the daughter can be the priest if she is born with a veil (amniotic sac) over the face.

Amish folk healers

-- braucher = men or women who use a combination of modalities including physical manipulation, herbs, teas, etc. -- lay midwives = care for women before, during, and after childbirth.

chinese folk healers

-- herbalist = knowledgeable in diagnosis of illness and herbal remedies. -- acupuncturist = 3.5-4.5 years of courses on acupuncturist.

Greek folk healers

--- Magissa "magician" = woman who cures matiasma or evil eye; may referred to as doctor. ---Bonesetter = specialize in treating uncomplicated fractures. --- priest (orthodox) = may be called on for advice, blessing, exorcisms, or direct healing.

cyanosis

-A severe condition indicating a lack of oxygen in the blood. -can be harder to tell on dark people. -Only severe cyanosis is apparent in skin. It is best to check the conjunctivae, oral mucosa, and nail beds rather than to rely on the assessment of the skin, which will appear dull and lifeless in darkly pigmented people.

cultural assessments

-also known as culturologic assessment. -refers to a systematic, comprehensive examination of individuals, families, groups, and communities regarding their health-related cultural beliefs, values, and practices.

Addison's disease

-cortisol deficiency characteristic -causes an increase in melanin production, which turns the skin a bronze color that resembles suntan. -The nipples, areola, genitalia, perineum, and pressure points such as the axillae, elbow, inner thighs, and buttocks look bronze. -Harder to recognize in darker people.

Complementary and integrative health care

-defined as a comprehensive, often interdisciplinary, approach to treatment, prevention, and health promotion that brings together complementary and professional care therapies. -discover through rigorous scientific investigation the usefulness and safety of complementary and integrative health approaches and their roles in improving health and health care

Cultural belief systems

-develop from the shared experiences by members of a social group and are expressed symbolically. -embraced by people worldwide are magico-religious, scientific/biomedical, and holistic health paradigms or worldviews.

culture-bound syndromes

-disorders or patterns of behavior created by personal, social, and cultural reactions to malfunctioning biological or psychological processes and can be understood only within defined contexts of meaning and social relationships. -it is important for the nurse to find out what the client, family, and other concerned individuals believe is happening, what prior efforts for help or cure have been tried, and what the results or outcomes from the treatment were.

petechiae

-found in clusters and consist of small, pinpoint spots that vary in color from red, brown, or purple

Holistic paradigm

-in this the forces of nature must be kept in natural balance or harmony -Everything in the universe has its place with a role to perform according to the natural laws that maintain order. Disturbing these laws creates imbalance, chaos, and disease.

copy-number-variants

-larger blocks of DNA sequence that vary. -one of the two most important components of human genetic variation.

biocultural variations

-nurses may encounter when conducting the physical examination of clients from different cultural backgrounds. -Accurate assessment and evaluation of clients require knowledge of normal biocultural variations among healthy members of selected populations, as well as variations that occur in illness.

jaundice

-observed in the sclera of any race. -When examining culturally diverse individuals, exercise caution to avoid confusing other forms of pigmentation with jaundice. -darker skin people may have higher levels of fat deposits in the subconjuctival area that can mimic jaundice. -Light- or clay-colored stools and dark golden urine often accompany jaundice in both light- and dark-skinned clients.

Albinism

-refers to a group of inherited conditions -People with albinism have little or no pigment in their eyes, skin, or hair. -They have inherited altered genes that do not make the usual amounts of the pigment melanin. -affects people from all races. -People with this always have impaired vision (not correctable with eyeglasses) and many have low vision.

oral hyperpigmentation

-shows variation by race. -Usually absent at birth, hyperpigmentation increases with age.

single nucleotide polymorphism (SNP)

-single DNA base pairs that differ among individual DNA sequences. -Most common SNPs are shared among populations from different continents, which reflect continued migration and gene flow among humans through history.

Health belief systems

Generally, theories of health and disease or illness causation are based on a group's prevailing worldview. three major health belief systems or worldviews: 1. Magico-religious 2. Scientific/biomedical 3. Holistic

Health literacy

Health literacy is the ability to obtain, read, understand, and use healthcare information in order to make appropriate health decisions and follow instructions for treatment. Individual health literacy becomes compromised under situations of duress such as illness, pain, stress, high emotion, altered cognitive states, and with aging.

Dietary supplements

Dietary supplements such as herbs, vitamins, minerals, oils, topical agents, and other substances are very popular and used extensively across all cultures and social strata in the United States.

Self-care

For common minor illnesses and injuries, most people initially try self-care with over-the-counter medicines, megavitamins, herbs, exercise, and/or foods that they believe have healing powers. Many self-care practices have been handed down from generation to generation, frequently by oral tradition

Taboos

Many cultures have food taboos that expand during pregnancy and the postpartum period. One cultural practice is that a mother should eat what she craves because "the baby must need this." Unfortunately, food taboos can contribute to unhealthy nutritional practices in pregnancy.

genomics

addresses all genes and their interrelationship to identify their combined influence on the growth and development of the organism.

Naturopathy

an alternative medical system based on the premise that there is a healing power in the body that establishes, maintains, and restores health.

Birthing plan

an individualized list of preferred actions to facilitate a desired childbirth. the optimal outcome will include finding common ground between maternal expectations and the hospital's rules and culture.

genome

an organism's complete set of DNA, including all of its genes.

Sick role behavior

any activity undertaken by a person who considers himself or herself ill to get well or to deal with the illness.

Mongolian spots

are irregular areas of deep blue pigmentation usually located in the sacral and gluteal areas but sometimes occurring on the abdomen, thighs, shoulders, or arms. most common in black and asian people.

Unintended pregnancy

as any pregnancy that is mistimed, unplanned, or unwanted at the time of conception.

pallor

assessing in darkly pigmented clients can be difficult because the underlying red tones are absent. The brown-skinned individual will manifest pallor with a more yellowish brown color, and the black-skinned person will appear ashen or gray. Generalized pallor can be observed in the mucous membranes, lips, and nail beds

Postpartum depression

associated with adverse infant and maternal outcomes such as less breastfeeding and poor maternal-infant bonding.

Which Eurocentric value is at the core of the dominant Western value system? a. spirituality b. self-determination c. cooperation d. dominance

b

Which cultural care value is characteristic of Western culture? a. The culture relies on folklore medicine and practices. b. The culture is placing increasingly more emphasis on the quality of pregnancy. c. The older woman of the family is the head of the household. d. They may treat the illness with the use of medals, prayers, and amulets.

b

Which of the following is not a cultural care value of the dominant Hispanic culture? a. The emphasis is on the use of medals and prayers to prevent illness. b. An older woman referred to as the "Old lady" is consulted about common ailments. c. A yerbero is consulted about the use of curative herbs. d. The ability to treat illnesses is considered a "gift from God."

b

Which of these cultural and social structure influences would you be likely to find in someone highly influenced by the dominant European American culture? a. In greeting a European American person, it is usually preferred that you address the person by their title and surname (e.g., Mr. Smith, Mrs. Jones, Dr. Cunningham) to establish trust. b. Present day actions highly influence future possibilities. c. Respect for elders is paramount, to the point that elders are sought out before major health decisions are made. d. Group members often use informal greetings among themselves and may refer to each other by titles such as aunt, cousin, sister, or brother.

b

Traditional Chinese medicine

is the current name for an ancient system of health care from China. TCM is based on a concept of balanced qi, or vital energy, which is believed to flow throughout the body. Qi regulates a person's spiritual, emotional, mental, and physical balance and is influenced by the opposing forces of yin (negative energy) and yang (positive energy).

presbycusis

is the slow loss of hearing that occurs as people get older and the cilia (tiny hair cells) in the inner ear become damaged or die.

epigentics

is the study of how genes are influenced by forces such as the environment, obesity, or medication.

Scientific paradigm

life is controlled by a series of physical and biochemical processes that humans can study and manipulate.

lactose intolerance

means that the body cannot easily digest lactose, a type of natural sugar found in milk and dairy products.

Intimate partner violence

refers to behavior by an intimate partner or ex-partner that causes physical, sexual, or psychological harm, including physical aggression, sexual coercion, psychological abuse, and controlling behaviors.

Cultural care repatterning or restructuring

refers to professional actions and decisions that help clients reorder, change, or greatly modify their lifeways for new, different, and beneficial health care patterns while respecting the clients' cultural values and beliefs and yet providing more beneficial or healthier lifeways than before the changes were coestablished with the clients

cultural care accommodation or negotiation

refers to professional actions and decisions that help people of a designated culture to adapt to or to negotiate with others for beneficial or satisfying health outcomes with professional care providers

Genotyping

refers to the process of identifying differences in genetic makeup using biological testing rather than assuming their population affiliation as a surrogate.

Cultural care preservation or maintenance

refers to those professional actions and decisions that help people of a particular culture to retain and/or preserve relevant care values so that they can maintain their well-being, recover from illness, or face handicaps and/or death

Worldview

reflects the total configuration of beliefs and practices and permeates every lifeway within a group culture.

Cafe au lait spots

tan to light brown irregularly shaped oval patches with well-defined borders, are caused by increased melanin pigment in the basal cell layer of the skin.

ethnohistory

the branch of anthropology concerned with the history of peoples and cultures, especially non-Western ones. -Knowledge of the client's ethnohistory is important in determining risk factors for genetic and acquired diseases and in understanding the client's cultural heritage.

uremia

the illness accompanying kidney failure characterized by unexplained changes in extracellular volume, inorganic ion concentrations, or lack of known renal synthetic products.

Bed sharing

the practice of a child sleeping with another person on the same sleeping surface for all or part of the night.

Cosleeping

the practice of parents and children sleeping together in the same bed for all or part of the night—is common in families with young children, there are marked cultural differences in the proportion that regularly implement this practice.

Infant attachment

the relationship that exists between a child and its primary caregiver, which provides "a secure base from which to explore and, when necessary, as a haven of safety and a source of comfort"

Pharmacogenomics

the study of the role of inherited and acquired genetic variation in drug response, is an evolving field that facilitates the identification of biomarkers that can help health providers optimize drug selection, dose, and treatment duration as well as eliminate adverse drug reactions.

Magico-religious paradigm

the world is an arena dominated by supernatural forces. The fate of the world and those in it, including humans, depends on the actions of God, the gods, or other supernatural forces of good or evil. In some cases, the human individual is at the mercy of such forces regardless of behavior. In other cases, the gods punish humans for their transgressions.

Conjugal family

those with two married biologic parents and one or more children.

Curandero

traditional healer.

cultural norms

unconscious behavior patterns that are typical of specific groups.

Illness behavior

is any activity undertaken by a person who feels ill to define the state of his or her health and discover a suitable remedy.

Alternative health care

"instead of this" health care

erythema

(redness) can also be difficult to assess in darkly pigmented clients because the contrast between white and red is more pronounced than it is when the skin color is darker.

Folk healers

(sometimes referred to as traditional, lay, indigenous, or generic healers) -sometimes make house calls, usually speak the native tongue of the client, and often charge significantly less than professional/nontraditional health care providers

Determinants of illness behavior

10 facets of illness behavior important to understanding the help-seeking process

Blended families

Often, parents from two cultures join together to raise a family, with each parent's cultural norms merging to define the family norms

In the dominant European American culture, the predominant worldview is shaped by identification with the collective community. a. false b. true

a

genetics

a branch of biology that studies heredity and the variations of inherited characteristics.

vitiligo

a condition in which the melanocytes become nonfunctional in some areas of the skin, is characterized by unpigmented, patchy, milky white skin patches that are often symmetric bilaterally. People with this also have a statistically higher-than-normal risk for pernicious anemia, diabetes mellitus, and hyperthyroidism. These factors are believed to reflect an underlying genetic abnormality.

Female genital mutilation/cutting

a dangerous ancient cultural practice that can affect pregnancy. also known as female excision, is a violation of girls and women's human rights.

Folk healing systems

a set of beliefs that has a shared social dimension and reflects what people typically do when they are ill versus what society says they should do according to a set of social standards

allopathic medicine

a system in which medical doctors and other healthcare professionals (such as nurses, pharmacists, and therapists) treat symptoms and diseases using drugs, radiation, or surgery.

Paradigm

a universal interpretation of the world and its phenomena and encompasses the assumptions, premises, and linkages that bind together a prevailing interpretation of reality.

When compared to Asian cultures, which term is often used to identify a member of Western culture? a. reserved b. dishonest c. introspective d. boisterous

d

From the options below, Which beliefs or generic care practices would a nurse likely find in patients highly influenced by the dominant European American culture? Select all that apply. a. Breast-feeding your baby will cause it to have a cleft palate. b. Using nutritional supplements can offset nutritional deficiencies in a poor diet. c. Maintaining a diet that corresponds to how ancient ancestors with your blood type ate will maximize how your body processes the food and keeps you thin and healthy. d. Surgical procedures for the sole purpose of enhancing one's attractiveness are ridiculed.

b, c

Which cultural beliefs associated with pregnancy are characteristics of the Hispanic culture? Select all that apply. a. Exposure to moonlight may cause the fetus to be born with a deformity. b. The baby's name is never spoken before the naming ceremony. c. A pregnant woman avoids reaching over her head in order to prevent the umbilical cord from wrapping around the fetus's neck. d. Pregnant women are encouraged to sleep lying on their backs.

c, d, a

Read this scenario and determine which statement regarding cultural or social structure is true for someone highly influenced by the dominant European American culture. Select all that apply. John has worked his third 10-hour day in a row. He is saving up for the newest model of his favorite sports car. John has been experiencing digestive upset and tightness in his chest and left arm for many days, but doesn't want to see a doctor for fear that he'll be told to stop working for a while. John does not want to be away from work because it would put him further away from his goal of a new car. Because of the long days, he hasn't been motivated to go to the grocery store for fresh fruits and vegetables. Instead, John opts for convenience by getting meals from fast food restaurants. a. There is distrust of the professional medical system. b. There is high comfort with technology. c. There is high value on the accumulation of material possessions. d. Economic factors prevent many people from seeking professional care. e. Eating a diet abundant in fresh fruits and vegetables is a high priority. f. There is high value for one's time.

c, f

ecchymoses

caused by systemic disorders are found in the same locations as petechiae, although their larger size makes them more apparent on dark-skinned individuals.

Premasticate

chew -Some cultures, the mother does thus for young children because of the belief that this will facilitate digestion.

De novo

creating ___ family requires a great deal of planning and preparation. lesbian couples

Integrative health care

defined as a comprehensive, often interdisciplinary, approach to treatment, prevention, and health promotion that brings together complementary and professional care therapies.

Pica

eating nonnutritious substances such as clay, red dirt, and starch—is seen often in the Southern United States and among African American populations.

Participatory women group

employs trained facilitators to hold scheduled community meetings where groups of local women are led through a cycle of problem identification, action planning, strategy implementation, and outcome evaluation.

steatorrhea

fatty, pale-colored, extremely smelly stools that float in the toilet and are difficult to flush away due to excess fat in the stool

Professional care systems

formally taught, learned, and transmitted knowledge and practice skills and approaches for treating acute and chronic illness and maintaining health and wellness that prevails in professional institutions and health care systems with multidisciplinary clinicians and staff.

appalachia folk healer

granny woman, herb doctor, "granny witchcraft" --Healer usually accessible, familiar with the culture, provides accepted cultural remedies and well known to family.

Extended family

in which parents and children coreside with other members of one parent's family. The most recent published estimates indicate that 16% of children live with extended family, including around 10% of children coresiding with a grandparent.

Ayurvedic medicine

includes diet and herbal remedies and emphasizes the use of body, mind, and spirit in disease prevention and treatment.

Osteopathic medicine

is a form of conventional medicine that, in part, emphasizes diseases arising in the musculoskeletal system. There is an underlying belief that all of the body's systems work together, and disturbances in one system may affect function elsewhere in the body.