NSG 504 caring for diverse families

cultural competence

an ongoing process in which the health care provider continuously strives to achieve the ability to work with the cultural context of the patient

acculturation

integration into the mainstream culture, affected by the time of introduction and predominant culture (usually takes 3 generations)

cultural desire

professional who wants to be open, flexible, accepting of differences, willingness to learn

cultural awareness

related to one's own self-awareness, rather than knowledge of other cultures

cultural knowledge

seeking and obtaining a foundation of knowledge about diverse cultural and ethnic groups

cultural skill

collecting cultural data and conducting a culturally relevant physical examination

cultural encounters

direct encounters with people of various vultures to refine or alter preexisting beliefs

cultural competence and birth

• must focus on the interaction between the cultural meaning of childbirth and the biology of childbirth

• cultural barriers develop when the medical model and cultural norms differ

• cultural assessment means learning about a woman's beliefs and values, health related behaviors, and cultural rites and practices

1st rule of developing cultural competence (hunter's rule)

everybody is an individual

adoption

• to take by choice into a relationship

• especially, to take voluntarily (a child of other parents) as one's own child

voluntary termination

biological parents decide to relinquish their rights

involuntary termination

a court of law finds it is in the best interest of the child to terminate parental rights

3 types of adaption in the US

• private domestic

• foster care

• international

open adoption

• provides full disclosure of information

• ongoing relationship between birth parents and adoptive parents

• biological parents have some control over the environment

benefits

• promotes well being in the child

• children formulate realistic and positive identity

• resolve their feelings about adoption without fantasy

• adoptive parents are not faced with "search" anxiety

closed adoption

• provide confidentiality for all parties involved

• no identifying information was shared

• information limited to medical, social, and physical descriptions

benefits

• secrecy intended to prevent birth parents from interfering

• adoptive parents become insecure and impedes attachment

• secrecy gives closure to birth parents

transracial adoption

parent to do list

• commit to kid's extracurriculars where more families of color are involved (instead of you and your white friends)

• talk often about race and racism (with adults and children)

• consider moving to diversify lives

• get over discomfort at being in an unfamiliar cultural environment

• volunteer on kid's school's diversity committee

• walk into hair salon and admit you dont know about child's hair

treatment for opioid use in pregnancy

• methadone is the standard

• buprenorphine sometimes

neonatal abstinence syndrom (NAS)

• a group of problems that occur in a newborn who was exposed to addictive illegal or prescription drugs during pregnancy

• constellation of behavioral and physiological signs and symptoms that are remarkably similar despite marked differences in the properties of the causative agent

• prenatal opioid substance abuse

• postnatal treatment with narcotics

• babies of mothers who drink during pregnancy may have a similar condition

withdrawal in newborns

• wakefulness

• irritability

• tremors, temperature variation, tachypnea

• hyperactivity or high pitched, continuous cry

• diarrhea , diaphoresis

• rub marks, restless sleeping, respiratory difficulty

• apneic attacks

• weight loss or failure to gain weight

• alkalosis (respiratory)

• lacrimation (runny eye syndrome)

(its an acronym)

role of the nurse in maternal substance use

• appropriate screening and identification of women who abuse substances during pregnancy (empathetic and non-judgmental)

• attempt to determine readiness of change

• use supportive nursing interventions (avoid confrontation)

• use principles of motivational interviewing

• evaluate progress

nurses role in intimate partner violence

• assess safety

• routinely inquire about current and past violence

• ask direct questions

• acknowledge

• referrals

• assure

• document findings