Chapter 4 Cultural in Fluences on Nursing Care

Answers CHAPTER 4 CULTURAL INFLUENCES ON NURSING CARE AUDIO CASE STUDY Dan and Cultural Assessment 1. Mrs. Basiouny did not want a male caregiver to bathe her or provide her personal care. She wanted her husband to be present during the health history. She did not like touch but did respond to eye contact. She preferred her own traditional foods. 2. Patients can appear noncompliant when in reality they are not receiving culturally appropriate care. 3. Assess and learn from each patient and avoid stereotyping. VOCABULARY 1. (2) 2. (10) 3. (3) 4. (11) 5. (4) 6. (1) 7. (8) 8. (5) 9. (7) 10. (6) 11. (12) 12. (9) CULTURAL CHARACTERISTICS 1. Primary characteristics of culture include nationality, race, skin color, gender, age, spirituality, and religious affiliation. 2. Secondary characteristics of culture include socioeconomic status, education, occupation, military status, political beliefs, length of time away from one’s country of origin, urban versus rural residence, marital status, parental status, physical characteristics, sexual orientation, and gender issues. 3. Traditional practitioners are health care providers from a patient’s native culture. They are typically native to another country, although they may practice in the United States. 4. Present-oriented people accept the day as it comes with little regard for the past and see the future as unpredictable. Past-oriented people may worship ancestors. Future-oriented people anticipate a better future and place a high value on change. Some individuals balance all three views; they respect the past, enjoy living in the present, and plan for the future. CRITICAL THINKING: IMMIGRANTS AND PERSONAL INSIGHTS There are no correct or incorrect answers for these sections because these are exercises requiring personal responses. CRITICAL THINKING: BATHING 1. In some cultures, it is improper for someone of the opposite sex to help with bathing. It is important to assess whether this is the case with this gentleman. 2. Find a male nurse’s aide, ask a family member to help, or skip the bath again. 3. Having a male aide do the bath is the best solution. If no male aide is available, the family may be approached for help, although this is not the best solution. Because this is the fourth day without a bath, skipping the bath is not the best option. REVIEW QUESTIONS—CONTENT REVIEW The correct answers are in boldface. 1. (4) is correct. Tay-Sachs disease is an inherited disease most common among people of Eastern European Jewish (Ashkenazi) heritage. (1, 2, 3) are incorrect. 2. (3) is correct. Ethnocentrism is the tendency for human beings to think that their culture’s ways of thinking, acting, and believing are the only right, proper, and natural ways. (1, 2, 4) are incorrect. 3. (1) is correct. Hispanic Americans and American Indians generally have a higher glucose level than whites. They also have a higher than average risk of diabetes. (2) is incorrect. REVIEW QUESTION—TEST PREPARATION The correct answers are in boldface. 4. (3) is correct. Initially you must assess what the family’s food practices are before an eating plan can be set up. (1) is incorrect. Giving a patient who has just moved to 1 2 Chapter 4 Answers the United States an exchange list of foods does not ensure that the patient will change dietary practices. (2) is incorrect. Being able to calculate carbohydrates does not respect the family’s cultural preferences. (4) is incorrect. Although this is certainly an option for the future, the initial step is to obtain a dietary assessment. 5. (4) is correct. Patients can have religious counselors visit as long as the counselor does not do anything to interfere with treatment or cause a safety problem. (1) is incorrect. It is not necessary to get the supervisor’s permission. However, it is a good idea to let the supervisor know that a religious counselor is going to visit. (2) is incorrect. Religious counselors are allowed to visit. (3) is incorrect. The patient has the right to see a religious counselor. 6. (4) is correct. Extended family may be very important to members of some cultures, and it may help these patients to have them nearby. (1) is incorrect. Large numbers of family members in the cafeteria may cause further disruption in the cafeteria. (2) is incorrect. Large groups in the lobby may cause overcrowding for other families. (3) is incorrect. All family members should be allowed to visit. It may help to have them choose a spokesperson to control visiting for this patient. 7. (2) is correct. Reducing portion size decreases the overall calorie and fat consumption but will still allow the patient to cook and enjoy traditional foods in her culture. (1) is incorrect. Telling a patient to not purchase lard does not mean she will comply. (3) is incorrect. Rarely does a person bake two separate pies. The goal is to reduce overall fat and calorie consumption. (4) is incorrect. It is inconsistent with the goal of reducing fat and calories. 8. (2) is correct. The patient must make her own decision, but she should be fully aware of the consequences. (1) is incorrect. Scare tactics are not appropriate; she may live whether or not she receives radiation therapy. (3) is incorrect. It borders on harassment by the staff. (4) is incorrect. Radiation therapy may be the best choice for this type of cancer. 9. (2) is correct. Changing the schedule slightly is preferable to omitting the medication. (1) is incorrect. Blood levels can be maintained on a different schedule, as long as the doses are reasonably spread out. (3) is incorrect. Omitting the medication will alter blood levels. (4) is incorrect. It does not respect the patient’s religious beliefs. 10. (3) is correct. This response seeks to discover the patient’s past spiritual practices. (1) is incorrect. Questionnaires are not appropriate when assessing patient’s spirituality. (2) is incorrect. Although it is important to be self-aware of one’s own spirituality and beliefs, it is not appropriate to share those beliefs with patients when they can cause distress, as in this case. (4) is incorrect. “Why” questions tend to feel critical and attribute blame.