52B Exam III - Cultural Diversity/Ethnicity
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how are generalizations different from stereotypes?
generalizations are starting points to understanding the beliefs, practices, and physical characteristics of groups. Stereotypes predetermined conclusions
what factors increase suscepibility to health problems in ethnic groups?
- environmental factors
- general physical status
what ethnic groups are more likely to get TB?
Native Americans, Vietnamese, Mexical American
what population is most at risk for Cystic Fibrosis?
what population is most at risk for Sickel Cell Anemia
what is G6PD Deficiency?
- (Glucose-6-Phosphate Dehydrogenase deficiency)
- the deficiency of the enzyme G6PD
- it is an x-linked recessive chromosome defect
- causes hemolysis of RBCs and anemia
what ethnic populations have the highest rate of G6PD deficiency?
- African Americans (10%)
- people of Mediterranean origin
what drugs can precipitate hemolysis in G6PD deficiency?
- antimalarial agents (quinine derivatives)
- sulfonamides (antibiotic)
- high doses of vitamin C
- Thiazide Diuretics
what foods can precipitate hemolysis in G6PD deficiency?
horse/ broad beans (fava beans and their pollen)
what is lactose intolerance?
deficiency of the enzyme Lactase needed to metabolize lactose
what ethnic populations often have lactose intolerance?
southern europeans, jews, arabs, african americans, and native americans
what are some common S/S of lactose intolerance?
- abdominal pain
- abdominal distention
in what ethnic population do infants and children tend to be quieter, more adaptable, and coordinated sooner?
what ethnic population views slightly overweighs children as healthy?
in what ethnic population is iron deficiency prevalent?
what ethnic populations frequently have low birth weight babies?
African Americans and hispanics
what are prevalent health disorders in African Americans?
diabetes, iron deficiency, lactose intolerance, HTN, arthritis, G6PD deficiency, parasites, TB, hepatitis, STDs, and sickel cell anemia
the study of the effects of ethnicity on how drugs work
explain the ethnopharmacological effect on ACE inhibitors
they typically work better for HTN on euro-americans than african americans & other blacks
explain the ethnopharmacological effect on Thiazide diuretics
lower HTN better in african americans & other blacks than Euro Americans
what health disorders are more prevalent in Asians?
G6PD deficiency, TB, dermatitis, nasopharyngeal and liver cancer
what is another name for G6PD defiency?
what are some major health disorders for hispanics?
iron deficiency, lactose intolerance, exposure to pesticides, lead poisoning, diabetes, HTN, arthritis, parasites, TB, hepatitis
what can increase susceptibility of the lower-class to TB?
crowded living conditions
how does lead poisioning cause anemia?
lead interferes with heme synthesis
what are the general clinical manifestations of lead poisoning?
- acute cramping/abdominal pain
- short stature and decreased weight (long term)
what are the early clinical manifestations of lead poisoning? (CNS)
- decreased interest in play
- delay orreversal in verbal maturation
- lass of newly acquired motor skills
- deficits in sensory perception
- learning difficulties
- short attention span
what are the late clinical manifestations of lead poisoning? (CNS)
- mental retardation
what are the two main clinical manifestations of pulmonary TB?
Fever and weight loss
what are general clinical manifestations of pulmonary TB?
- (may be asymptomatic)
- caugh (may or may not be present)
- aching pain and tightness in chest
- hemoptysis (rare)
what clinical manifestations of pulmonary TB suggest worsening?
- increased respiratory rate
- poor expansion of lung on effected side
- diminished breath sounds and crackles
- dullness on percussion (lungs full of fluid)
- persistant fever
- pallor, anemia, weakness, and weight loss
in terms of health beliefs, explain natural, supernatural, and imbalances in foces (what ethnic populations believe this?)
- natural - cold entering the body can cause sickness
- supernatural - evil spirits, evil eye, or a curse could be responisble for sickness
- imbalances - hot/cold (yang and yin) balance not maintained could cause sickness so treat with hot or cold remedies
- (hispanic, filipino, chinese, and arab)
what is a curandera?
a hispanic folk healer
what could be one draw back to folk remedies?
if they do not help or harm, they may delay seeking professional medical help
what are some examples of folklore related to prenatal influences?
- the mother's thoughts can cause impressions on the fetus
- scratching can give your baby a birthmark in that area (a way to explain abnormalities and defects)
- eating clay to get needed minerals (can hurt mother and fetus)
what are some guidelines for using an interpreter?
- meet in advance to discuss what questions you will be asking
- avoid pulling the same staff member away from their job to act as interpreter
- introduce interpreter to family and allow them time to get acquainted
- maintain eye contact with client, don't focus on the interpreter
- discuss the interview with the interpreter after it is complete and ask for any impressions or feedback they can give
- try to use the same interpreter for a particular pt
what are some potential problems in communicating to people of a different culture?
- they may smileand nod when they actually don't understand what you are saying
- eye contact varies in appropriateness
- expression of emotions can vary
describe Roman Catholic beliefs in regards to birth, death, food, etc
- birth: baptism is mandatory (especially if prognosis is poor), and anyone can do it
- death: anointing of sick and last rites sacrament. organ donation deemed ok by vatican as an act of charity
- food: fasting during lent (children and the sick are exempt)
- etc: religous articles are very important
describe Jehovah Witness beliefs in regards to birth, death, food, etc
- birth: no baptism
- death: no official last rites
- food: can't ingest blood (this applies to blood transfusions or autolgous-self donated but some will take plasma expanders)
- etc: often need a court order to consent for child's transfusion
describe Muslim (Moslem) beliefs in regards to birth, death, food, etc
- birth: first words said in infant's right ear are "Allah-o-Akbar" (god is great), circumcision of male child
- death: spacific rituals required (bathing, and wrapping of body)
- food: no pork products, fasting during 9th month of Islamic year called Ramadan (children and the sick are exempt)
describe Judism beliefs in regards to birth, death, food, etc
- birth: no baptism, ritual circumcision on 8th day
- death: family/friends stay with deceased
- food: kosher
- etc: may refuse surgery on sabbath, no mutilations (refuse autopsies)
describe Buddhist beliefs in regards to birth, death, food, etc
- birth: no baptism
- death: last rite chanting at bedside
- food: discourage alcohol/drug use
- etc: optimistic outlook, teach ways to overcome fear, anxiety, and apprehension.
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