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Pharm Ch 6
Transcultural and Genetic Considerations
| Question | Answer |
|---|---|
| Define ethnopharmacology. | a domain that integrates pharmacodynamics (drug conc. and its effect on body) and pharmacokinetics (drug movement through body) with genetic and ethnic variations |
| What has a profound effect on the way clients metabolize drugs as well as tolerate and experience side effects? | racial, heriditary, and genetic influences |
| List some specific pharmacodynamic variations linked to ethnic diversity. | ethanol, isoniazid, phenylthiocarbamide, and succinylcholine |
| List some factors affecting the efficacy and compliance with drug therapy. | environment and culture |
| Define ethnocultural. | combination of ethnic and cultural variables |
| What plays an important role in the client's acceptance and adherence to prescriptive therapy and understanding of medical treatment? | ethnocultural perceptions and beliefs of illness |
| What factors affect drug metabolism, efficacy, and client adherence to prescriptive therapy? | gender, age, diurnal rhythms, dietary practices, living conditions, and high-risk behaviors |
| What is the Purnell Model for Cultural Competence? | a circle with an outlying rim that represents global society, a second rim that represents community, a third rim that represents family, and an inner rim that represents the person; these are the macroaspects of the model |
| List the domains of culture. | (1) overview/heritage; (2) communication; (3) family organization; (4) Biocultural ecology; (5) high-risk behaviors; (6) nutrition; (7) spirituality; (8) health care practices; (9) health care practitioners |
| List the concepts included in overview/heritage domain of culture. | origins, topography, economics, education |
| What does racial origin affect? | responses to some drugs |
| It is important for students to understand that racial categories and labels are more ___________ applied than _________________. | (1) socially-culturally(2) concise genetic markers |
| Which ethnic groups have an increased incidence of diabetes? | African Americans, Hispanics, and those living in all Western countries |
| What drugs do Asians have an increased sensitivity to? | beta-blockers |
| What ethnic group responds better to monotherapy for hypertension than their European American cohort groups? | African Americans |
| Define topography. How does it affect clients? | the landscape and surface configuration of terrain; may affect clients physiologically |
| How are people from high-altitude mountainous climates physiologically different from people from lower-altitude climates? | they usually have increased red blood cell counts because of lowered oxygen tension in the high-altitude climate |
| How do clients coming from low-lying swampy terrain different from people from higher-altitiude climates? | they are at an increased risk for dengue fever, malaria, and sickle cell anemia |
| What is a cultural characteristic that crosses all racial and ethnic groups? | poverty |
| Why must nurses assess the socioeconomic status of their clients? | to help them access necessary drugs if they lack resources to pay for them |
| What concepts are included in the communication domain of culture? | language, dialect, contextual use of the language, volume, and tone |
| Define spatial distancing. | the physical proximity between people conversing |
| Define temporality. | the perspective of time; determines whether the client stresses a past, present, or future orientation, and needs to be considered when the nurse cares for clients from diverse cultures |
| What concepts are included in the family organization domain of culture? | head of household, gender roles |
| What concepts are included in the biocultural ecology domain of culture? | biologic variation, heredity, genetics, endemics, and drug metabolism |
| Why do African Americans with hypertension respond better to monotherapy? | because their hypertension is usually related to volume expansion, decreased renin, and increased intracellular concentration of sodium and calcium |
| What drugs should be avoided for people of Greek and Chinese Heritage with glucose-6-phosphate dehydrogenase deficiency? Why? | quinine and chloramphenicol, because life-threatening hemolytic crises may occur if these oxidizing drugs are used |
| What do many Asians/Pacific Islanders experience increased side effects of? | alcohol with facial flushing, tachycardia, and palpitations |
| What should perioperative nurses be aware of in regards to the enzyme pseudocholinesterase? | that it inactivates succinylcholine, a commonly used muscle relaxant used in surgery |
| biochemical variations with isoniazid | (drug to treat TB) can be inactivated rapidly or slowly depending on a specific phenotype; slow inactivation occurs in approx. 60% of European and African Americans, 10-40% of Native Americans, and 10-20% of Asians |
| What ethnic group is at an increased risk for having an atypical form of pseudocholinesterase? What does this mean? | Alaskan Eskimos; they will suffer from prolonged muscular paralysis and inability to spontaneously breathe after receiving this drug |
| What does the high-risk behavior domain of culture include? | use of tobacco, alcohol, sex practices, and recreational drugs |
| How does tobacco affect medications? | it often causes more rapid elimination of medicines from the body; thus the prescribed drug does not have its full therapeutic effect |
| What drugs does alcohol interfere with? | some psychotropic medicines and enhances the effects of analgesics |
| What does the recreational use of drugs do to medications? | (e.g., marijuana, antihistamine combos, cocaine) may potentiate the effects of medications, resulting in increased side effects, an enhanced therapeutic response, or an overdose |
| What concepts does the nutrition domain of culture include? | common foods, enzyme deficiencies, limitations in obtaining nutritious foods, eating rituals, how food are used for health promotion and wellness |
| What does the proportion of fats, carbohydrates, and proteins have an affect on? | how some drugs are absorbed or metabolized |
| What ethnic groups have higher incidences of lactose intolerance, resulting in maldigestion and bloating? | Asian/Pacific Islanders, Hispanics, and African Americans |
| Among Jews, what does a Kosher diet demand? | that dairy and meat should not be eaten at the same meal |
| What ethnic groups consider foods as "hot" or "cold" and these foods must be balanced? | Haitians, Hispanics/Latinos, Vietnamese, Greeks and Greek Cypriots, and Iranians |
| What concepts does the spirituality domain of culture include? | religious preference, meaning of life, and individual sources of strength |
| religious holidays and fasting | nurse can improve medication usage by working with the client to determine acceptable medication schedule during religious holidays |
| What can empty or full stomachs influence in regards to drugs? | can influence drug absorption and gastric irritation |
| What may holistic health beliefs do in regards to taking medication? | may inhibit a person from taking meds that could be perceived as "artificial" or altering a higher order's life plan |
| What ethnic groups may believe family is the most important aspect of their lives and gives meaning to life? What can the nurse do to facilitate this belief? | Mexican, Guatemalan, and Panamanian ancestry; include the family in teaching strategies |
| What concepts does the health care practices domain of culture include? | focus of health care, traditional medical practices, self-medicating practices, barries to accessing health care, the sick role, and perceptions of mental illness |
| In what cultures can clients enter a sick role without feelings of guilt or attached stigma? | Hispanic and Arabic cultures |
| How do some Asian/Pacific Islanders express pain? | they may be reluctant to express pain because they believe it is God's will or a punishment for past sins |
| How do some Arablic people express pain? | expected to express their pain openly and expect immediately relief, preferably through injectable or IV medication |
| What may the differences in disease processes and gender be related to? | hormones, differing amounts of body fat, and comorbidity problems |
| What concepts does the health care practitioners domain of culture include? | status of health care providers, folk practitioners, gender, and the health care system |
| For some Arabs and Arab-Americans, what is the most respected health care provider? | an experienced middle-aged to elderly male physician with several degrees |
| Why may some foreign-educated physicians have difficulty being accepted by some Appalachian people? | because they are considered outsiders |
| Why is nursing not seen as a desirable profession to many Arab countries? | because it requires contact between the genders |
| Why may folk practitioners be preferred over allopathic educated physicians? | because treatments are less invasive; folk practitioners usually do not treat the symptoms of illness, they remove the cause of the illness |
Created by:
thehealthynurse
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