NUR2115: Final Exam Study Guide.

NUR2115: Final Exam Study Guide. Know the different types of wellness:  Wellness: an active state of being healthy, including living a lifestyle that promotes good physical, mental, and emotional health.  Physical Dimension: The physical dimension includes genetic inheritance, age, developmental level, race, and gender. These components strongly influence the person’s health status and health practices.  Emotional Dimension: How the mind affects body functions and responds to body conditions also influences health. Long-term stress affects body systems, and anxiety affects health habits; conversely, calm acceptance and relaxation can actually change the body’s responses to illness.  Intellectual Dimension: The intellectual dimension encompasses cognitive abilities, educational background, and past experiences. These influence the person’s responses to teaching about health and reactions to nursing care during illness.  Environmental Dimension: The environment has many influences on health and ill- ness. Housing, sanitation, climate, and pollution of air, food, and water are elements in the environmental dimension.  Sociocultural Dimension: Health practices and beliefs are strongly influenced by a per- son’s economic level, lifestyle, family, and culture. In general, low-income groups, racial and ethnic minorities, and other underserved populations are less likely to seek medical care to prevent illness and have fewer treatment options, while high-income groups are more prone to stress-related habits and illness.  Spiritual Dimension: Spiritual beliefs and values are important components of a person’s health and illness behaviors (see Chapter 45). It is important that nurses respect these values and understand their importance for the individual patient. o Three spiritual needs underlie all religious traditions and are common to all people: 1. Need for meaning and purpose 2. Need for love and relatedness 3. Need for forgiveness Know the definition of culture and what it means in healthcare:  Culture: a shared system of beliefs, values, and behavioral expectations that provides social structure for daily living. Culture influences roles and interactions with others as well as within families and communities, and is apparent in the attitudes and institutions unique to particular groups.  Culture in Healthcare: Nurses must be aware of, and sensitive to, the needs of a diverse patient population.  Physiological variation: Studies have shown that certain racial and ethnic groups are more prone to certain diseases and conditions.  Reactions to pain: Health care researchers have discovered that many of the expressions and behaviors exhibited by people in pain are culturally prescribed. Some cultures allow or even encourage the open expression of emotions related to pain, whereas other cultures encourage suppression of such emotions.  Mental Health: Most mental health norms originate in research and observations made of White, middle-class people. But many ethnic groups have their own norms and acceptable patterns of behavior for psychological well-being, as well as different normal psychological reactions to certain situations.  Gender roles: In many cultures, the man is the dominant figure and generally makes decisions for all family members. Knowing who is dominant in the family is important when planning nursing care.  Language and Communication: Linguistic competence refers to the ability of caregivers and organizations to understand and effectively respond to the linguistic needs of patients and their families in a health care encounter. o Nurses who work in a geographic area with a high popu- lation of residents who speak a language other than English should learn pertinent words and phrases in that language. o To avoid misinterpretation of questions and answers, it is important to use an interpreter who understands the health care system; friends and family members often discouraged. o One of the most culturally variable forms of nonverbal communication is eye contact.  American dominant culture emphasizes eye contact while speaking,  Direct eye contact may be considered impolite or aggressive by many Asians, Native Americans, Indochinese, Arabs, and Appalachians.  Hispanics may look downward in deference to age, gender, social position, economic status, or authority.  Muslim–Arab women often indicate modesty by avoiding eye contact with men, and Hasidic Jewish men may avoid direct eye contact with women  Orientation to Space and Time: Personal space is the area around a person regarded as part of the person. When providing nursing care that involves physical contact, you should know the patient’s cultural personal space preferences.  Food and Nutrition: Food preferences and preparation methods often are culturally influenced. Certain food groups serve as staples of the diet based on culture and remain so even when members of that culture are living in a different country. o Dietary teaching must be individualized according to cultural values about the social significance and sharing of food.  Family Support: In many cultural and ethnic groups, people have large, extended families and consider the needs of any family member to be equal to or greater than their own. Including the family in planning care for any patient is a major component in nursing care to meet individualized needs.  Socioeconomic Factors: The amount of money a person or family has affects how they meet their basic needs and maintain their health. o At highest risk are children, older people, families headed by single mothers, and the future generations of those now living in poverty. o Poverty has long been a barrier to adequate health care. It prevents many people from consistently meeting their basic human needs.  Health Disparities: Health disparities refer to health differences between groups of people; they can affect how frequently a disease affects a group, how many people get sick, or how often the disease causes death. Know Asian/African American cultural preferences for health and who makes decisions:  African American  Family: o Close and supportive extended-family relationships o Strong kinship ties with nonblood relatives from church or organizational and social groups o Family unity, loyalty, and cooperation are important. o Usually matriarchal  Folk and Traditional Healthcare: o Varies extensively and may include spiritualists, herb doc- tors, root doctors, conjurers, skilled elder family members, voodoo, faith healing.  Values and Beliefs: o Present oriented o Members of the African American clergy are highly respected o Frequently highly religious  Nursing Considerations: o Many African American families may still use various folk healing practices and home remedies for treating particular illnesses. o Special care may be necessary for the hair and skin. o Special consideration should be given to the sometimes extensive and frequently informal support networks of patients (e.g., religious and community group members who offer assistance in a time of need).  Asian American  Family: o Welfare of the family is valued above the person. o Extended families are common. o A person’s lineage (ancestors) is respected. o Sharing among family members is expected. o Patriarchal  Folk and Traditional Healthcare: o Theoretical basis is in Taoism, which seeks a balance in all things. o Good health is achieved through the proper balance of yin (feminine, negative, dark, cold) and yang (masculine, positive, light, warm). o An imbalance in energy is caused by an improper diet or strong emotions. o Diseases and foods are classified as hot or cold, and a proper balance between them will promote wellness (e.g., treat a cold disease with hot foods). o Many Asian health care systems use herbs, diet, and the application of hot or cold therapy. Also, many Asians believe that there are points on the body that are located on the meridians or energy pathways. If the energy flow is out of balance, treatment of the pathways may be necessary to restore the energy equilibrium.  Values and Beliefs: o Strong sense of self-respect and self-control o High respect for age o Respect for authority o Respect for hard work o Praise of self or others is considered poor manners o Strong emphasis on harmony and the avoidance of conflict  Nursing Considerations: o Some members of Asian cultures may be upset by the drawing of blood for laboratory tests. They consider blood to be the body’s life force, and some do not believe that it can be regenerated. o Some members believe that it is best to die with the body intact, so they may refuse surgery except in dire circumstances. o Members of many Asian cultures seldom complain about what is bothering them. Therefore, the nurse must carefully assess the patient for pain or discomfort by observing for nonverbal signs of discomfort, such as facial grimacing or wincing and holding of the painful area. o Some Asians consider it polite to give a person the responses the person is expecting. Therefore, the client may transmit misinformation to the questioner in an effort to be respectful. o Some Asians may refuse diagnostic studies because they believe that a skilled and competent physician can diagnose an illness solely through a physical examination. o Some members may have a difficult time understanding the importance of a medication regimen because many folk treatments involve the ingestion of just one dose of herbal mixtures. o Dietary counseling may be necessary if the patient is on a salt-restricted diet because many Asian food contains soy cause. Food Preferences for different Religions:  Muslims  Offer a halal diet free of alcohol and pork or pork products; make sure medications are alcohol- and pork-free.  During Ramadan, Muslims must fast from sunrise to sunset. Fasting includes abstaining from all substances, including pharmaceuticals and IV drips. However, illness is an exception.  Jewish  The word kosher is usually translated as "proper." Certain foods, notably pork and shellfish, are forbidden; meat and dairy may not be combined, and meat must be ritually slaughtered and salted to remove all traces of blood. Know the difference between the following cultural definitions:  Stereotype: The assumption that all members of a culture or ethnic group act alike. This may be positive or negative. Negative stereotyping includes racism, ageism, and sexism.  Bias: the negative evaluation of one group and its members relative to another.  Ethnic Slur: an ethnic slur is a term designed to insult others on the basis of race, ethnicity, or nationality.  Stigma: a mark of disgrace associated with a particular circumstance, quality, or person. World Health Organization (WHO) of health:  Health: A state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity. Maslow’s Hierarchy of Needs:  Abraham Maslow (1968) developed a hierarchy of basic human needs that describes which needs of a person are the most important at any given time. The hierarchy is based on the theory that something is a basic need if it has the following characteristics:  Its lack of fulfillment results in illness.  Its fulfillment helps prevent illness or signals health.  Meeting it restores health.  It takes priority over other satisfactions when unmet.  The person feels something is missing when the need is unmet.  The person feels satisfaction when the need is met.  Level 1 – Physiological: for oxygen, water, food, elimination, temperature, sexuality, physical activity, and rest—must be met at least minimally to maintain life. These needs are the most basic in the hierarchy of needs, are the most essential to life and, therefore, have the highest priority.  Level 2 – Safety and Security: Physical safety and security means being protected from potential or actual harm. Emotional safety and security involves trusting others and being free of fear, anxiety, and apprehension.  Level 3 – Love and Belonging: Love and belonging needs include the understanding and acceptance of others in both giving and receiving love, and the feeling of belonging to groups such as families, peers, friends, a neighborhood, and a community.  Level 4 – Self Esteem: The need for a person to feel good about oneself, to feel pride and a sense of accomplishment, and to believe that others also respect and appreciate those accomplishments. Positive self-esteem facilitates the per- son’s confidence and independence.  Level 5 – Self Actualization: The need for individuals to reach their full potential through development of their unique capabilities. In general, each lower level of need must be met to some degree before this need can be satisfied. The process of self-actualization continues throughout life. Understand Evidence-Based Practice (EBP), its’ barriers, and how it is applied:  Evidence-based practice (EBP) in nursing is a problem-solving approach to making clinical decisions, using the best evidence available.  EBP blends both the science and the art of nursing so that the best patient outcomes are achieved. The information that is collected is analyzed and used to answer questions (the science of nursing), taking into consideration patient preferences and values, as well as the clinical experiences of the nurse (the art of nursing).  How EBP is applied:  Step 1: Ask a question about a clinical area of interest or an intervention.  Step 2: Collect the most relevant and best evidence.  Step 3: Critically appraise the evidence. o What were the results of the study?