Chapter 7 Cultural and Pharmacogenetic Consideration Study Guide

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Pharmacology
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1

___________ is the study of drug responses that may be unique to an individual due to social, cultural, and biologic phenomena. of drug movement in the body to achieve drug action and

Ethnopharmacology

2

Ethnopharmacology integrates ____________ (the process ultimately elimination), ___________ (drug concentrations and their effects on the body), and ____________ (the effect of a drug that varies from the predicted response due to genetic factors).

Pharmacokinetics; Pharmacodynamics; Pharmacogenetics

3

The nurse must integrate knowledge of __________ within clients’ cultural contexts.

Pharmacogenetics

4

____________ is defined as sets of learned behavior and ideas that human beings acquire as members of a community.

Culture

5

A ________ is a cluster of individuals who function as a group to attain cultural universals.

Community

6

__________ __________are designed to meet the community's survival needs and common goals such as the obtainment of food and the continuance of practices that serve to maintain the group.

Cultural universals

7

The term ___________ implies that groups are connected to a particular place, but many groups are mobile. For example, consider migrant farm workers in the western United States, such as those in California.

Community

8

Anthropologists define ____________ according to shared languages, shared religions, shared customs, and shared histories.

ethnic groups

9

_______________ is defined as the widespread human tendency to perceive the ways of doing things in one's own culture as normal and natural and the ways of other cultures as strange, inferior, or possibly even unnatural or inhuman. All cultures practice some degree of this and the views of powerful and dominant cultural groups tend to have the greatest impact on societal norms.

Ethnocentrism

10

The concept of transcultural nursing was formalized by _______ ________, a nurse anthropologist who founded the Transcultural Nursing Society in 1974. A challenge for nurses worldwide is the degree of cultural diversity owing to migration and global movement.

Madeleine Leininger

11

Numerous and large cultural groups engage in the use of ______ _______ _______that may be considered folk medicine. The practices include the use of teas, herbs, spices, and special foods as well as homeopathic remedies, poultices, and ointments.

Traditional health practices

12

__________ play a large role in traditional health practices in about 80% of the population worldwide. They usually have some practical knowledge of human anatomy and physiology, pharmacology, and pharmaceutic substances.

Healers

13

Cultural groups undergo varying degrees of __________. This occurs when a less powerful group changes its ways to blend in with the dominant cultural group. Members of a group who have immigrated into a new region during adulthood usually need a longer period of time than group's who are younger members.

Assimilation

14

It is essential to not make generalizations about an individual's beliefs or behaviors based upon apparent ethnicity; at the same time, nurses must be sensitive to possible differences within cultural groups. It is also important to keep in mind that apparently well-assimilated individuals may be influenced by traditional beliefs and practices. This sets the stage for __________ __________ practices that combine traditional beliefs and mainstream health practices.

Complementary Health Practices

15

The Transcultural Assessment Model, developed by Giger and Davidhizar in 2008, postulates that all cultures have six cultural phenomena. These cultural phenomena flow from a culturally unique individual. The six phenomena are? (Figure 7-3).

(1) communication, (2) space, (3) social organization, (4) time, (5) environmental control, and (6) biologic variations

16

_______________ occurs verbally and nonverbally. It is necessary for sustaining human life. Nurses must be alert to the different types of communication styles among clients to provide culturally competent care.

Communication

17

The use of languages other than English among clients poses a challenge to many nurses working in the United States. Nonverbal communication becomes pivotal in these encounters. What should be used whenever possible, but they may not be readily available?

Translators

18

Adding to the challenge of communication is the pervasive use of words and terms that are popular in particular social or cultural groups. For example, the term "________ ________ ________ ________" has been used to describe a style of English speaking that is used among some African Americans.

“African American Vernacular English”

19

Nurses must keep in mind that client-nurse interactions in health care settings are considered _______ and that ________ styles of communication should be used only after careful consideration.

Formal; Informal

20

The amount of ________ that surrounds a person's body is an important psychological consideration. Americans often desire a great deal of this. In some other cultures, population density may dictate limited amount. It is important that the nurse have frequent contact with these clients and allow significant members of the social group to remain with the client as much as possible.

Space

21

Groups are organized according to a social order that is perceived to facilitate the functioning of the group. Families are basic social units. The definition of family and the criteria for inclusion varies among individuals and among cultures.

Social Organization

22

The perception of _________ is largely shaped by culture. Some cultures are primarily present-time oriented. Others are more concerned with the future. Clients with a future-oriented perception of time are more likely to be concerned with long-term health outcomes.

Time

23

A major aspect of culture is the desire to control nature to facilitate the needs of human beings. The concept of “nature” may include otherworldly forces or beings, such as deities and spirits. Illness may be attributed to cosmic forces and believed to be cured or ameliorated by persons who possess special abilities.

Environmental Control

24

Human migration around the world has been so vast over such a long period of time that most people have a variety of genetic markers. The study of pharmacogenetics can pave the way for pharmacotherapy that yields greater therapeutic benefits and causes fewer adverse reactions. A person who is dark-skinned and appears to be of African descent is likely to have some European genetic markers. This is Considered to be?

Biologic Variations

25

TABLE 7-1 SELECTED ETHNIC/CULTURAL GROUPS AND COMPONENTS OF THE GIGER AND DAVIDHIZAR TRANSCULTURAL ASSESSMENT MODEL

Read on Page 120

26

1. The nurse is performing a health assessment on a newly admitted client who is of Asian descent. The client looks at the floor whenever the nurse asks a question. Communication is enhanced when the nurse does which action?

a. Frequently touches the client

b. Asks questions that require only “yes” or “no” for answers

c. Discontinues the health assessment

d. Uses eye contact sparingly

2. The nurse has been measuring the blood pressure of an African-American client every 4 hours for the past 3 days in a hospital setting. The blood pressure is consistently above 140/90. The client has been compliant with the antihypertensive drug therapy while hospitalized. The nurse will initially perform which action?

a. Question the client about the types of food consumed in the last 3 to 4 days.

b. Inform the prescriber that the antihypertensive drug therapy is not working

c. Increase blood pressure measurements to every 2 hours.

d. Place the client on a restricted fluid intake.

3. A male nurse has been assigned to care for a young, married woman who practices Islam. It is important that the nurse perform which action?

a. Not touch any part of the client's body

b. Delegate nursing care that involves touching to a female member of the nursing team whenever appropriate

c. Touch the client only when her spouse is present

d. Communicate to the nurse manager that he cannot take care of female clients who practice Islam

4. A nurse is teaching a 16-year-old female client about a newly prescribed medication. The client is bilingual in Spanish and English. Which behavior best indicates the client's understanding of the instructions?

a. The client frequently nods her head while listening to the nurse's instructions.

b. The client states that she understands the instructions.

c. The client repeats the nurse's instructions to her mother who is present during the teaching.

d. The client does not ask the nurse for any clarification of the instructions.

5. An Asian client is being treated in the emergency department for a fractured right ankle. The physician has ordered codeine for complaints of pain. The client denies any allergies. The nurse would anticipate that after administration of the codeine, the client will experience what response?

a. Quick relief of the pain

b. Little relief of the pain

c. Idiosyncratic responses

d. Signs of anaphylaxis

6. A Native American client is newly diagnosed with diabetes mel

Answers: 1, d; 2, b; 3, b; 4, c; 5, b; 6, c.