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89 Cards in this Set

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Culture
A pattern of assumptions, beliefs, and practices that unconsciously frames or guides the outlook and decisions of a group of people
Social Roles
Culturally prescribed patterns of behavior for persons in a variety of social positions
Social group consists of a system of roles carried out in primary and secondary groups
Primary Group
Intimate, continued, face-to-face contact
Mutual support of members
Ability to order or constrain behavior
Example: family and peer groups
Secondary Group
Groups have limited, intermittent contact
Generally less concern for members’ behavior
Offer little support or pressure to conform
Example: professional associations
Communities 4 external assets
1. Support
2. Empowerment
3. Boundaries and expectations
4. Constructive use of time
Internal assets that are nurtured in the community
1. commitment to learning
2. Positive values
3. social competencies
4. positive identity
acculturation
when minority groups immigrate to another country, a certain degree of cultural and ethic blending occurs through this involuntary process.
Gradual changes produced in a culture by another culture that cause one or both cultures to become more similar.
assimilation
process of developing a new cultural identity.
Cultural relativism
provides for understanding of behaviors in their cultural context and sees other ways of doing things as different but equally valid. Concept that any behavior must be judged first in the context of the culture in which it occurs.
tone of voice
Asians--use a soft tone of voice to convey respect

Italian and middle Easter--typically use a loud tone of voice
eye contact
Americans--direct eye contact, lack of direct eye contact implies the person is lying or embarrassed

Middle Eastern--avoid making eye contact with nonrelated members of opposite gender

Asians--believe direct eye contact is seen as disrespectful, or a sign of hostility.

Native Americans--believe direct eye contact may lead to soul loss or soul theft. continued eye contact is thought as disrespectful.

Vietnamese-- avoid eye contact as a sign of respect
Tactile/Touch
Americans—use during conversation between intimate partners or family members

Italian/Latin American—view touch as a sign of concern, interest, and warmth
Use of space
Anglo American/North Europeans—keep distance during communication

Italian, French, Spanish, Russian, Latin American, Middle Eastern—like closer, personal contact, less distance during communication
Coining
Asian- produce weltlike lesions on the child’s back when a coin, held on edge, is repeatedly rubbed lengthwise on the oiled skin to ride the body of a disease
Cupping
Asia, Latin American, part of Europe- placing a container containing steam against the skin surface to “draw out the poison” or other evil element. Create bruise like blemish on the skin
Burning
South Asia- Small areas of skin are burned to treat enuresis and temper tantrums
Female genital multilation
Parts of Africa- Removal of any part of the female genital organ
Forced kneeling
Caribbean groups- Discipline measure, in which a child is forced to kneel for a long time
Topical garlic application
Yemenite Jews- Crushed garlic is applied to the wrists to treat infectious disease. It can results in blisters or garlic burns
traditional remedies that contain lead
Mexico- Greta and azarcon- used for digestive problems

Southeast Asia- paylooah- used for rash or fever

India- surma- used as a cosmetic to improve eyesight
BELIEF framework to integrate culture and spirituality into the nursing assessment
B- belief system
E- ethics or values
L- lifestyle (diet, clothing, medication, culture, etc.
I- involvement in spiritual community
E- education
F- future events
ASKED, explores your cultural competence
A- awareness
S- skill
K- knowledge
E- encounters
D- desire
African
* Believe illness are caused by:
Natural: forces of nature without adequate protection or
Unnatural: God’s punishment
* Use self-care and folk medicine, prayer common used for prevention/tx.
* Strong kinship bonds in extended family
* Alert to any evidence of discrimination
* Place importance on nonverbal behavior
* Affection shown by touching and hugging
* Initial eye contact shows respect
* Best to use direct but caring approach
Chinese
* Health seen as results of balance between the forces of yin(cold) and yang (hot)
* Illness caused by imbalance
* Goal of therapy is to restore balance
* Some health practice:
--Tai chi
--acupuncture
--moxibustion (apply heat)
--use herbs
* Respect for elders
* Family and individual honor and “face” important
* Open expression of emotions unacceptable
* Eye contact avoided as sign of respect
- often smile when they do not understand
Japanese
* Energy restored by means of acupuncture, acupressure, massage, and moxibustion
-Kampo medicine- natural herbs
* Believe in removal of diseased parts
* Trend is to use both western and Asian healing methods
* Care for disabled viewed as family’s responsibility
* Tend to suppress emotions
* Will often wait silently
-take pride in child's health
1. Issei is
2. Nisei is
3. Sansei is
4. Yonsei is
Japenese for
1. 1st generation
2. 2nd
3. 3rd
4. 4th
concept of haji is
Japanese
= shame, imposes control, unacceptable behavior of children reflects on family.
Mexican-American
* Health controlled by environment, fate, and will of God
- seeks help from CURANDERO = by birth, apprenticeship, or calling via a dream or vision
* Certain illnesses considered “hot and cold” states and are treated with food that complements those states
* Treatments include herbs, rituals, and religious artifacts
* Strong kinship includes compadres (godparents)
* May shake hands
* Prolonged eye contact as disrespectful
* Relaxed concept of time-may be late to appointments
Native American
* Believe health is state of harmony with nature and universe
* Participation in religious ceremonies and prayer to promote health
* Extended family structure
* Elder members assume leadership roles
* Respect indicated by Avoid eye contract
Vietnamese
* Good health considered to be balance between yi n and yang
* Health as family responsibility
* Use herbal medicine, spiritual practices, and acupuncture
* Avoid touching head after feet
* May use cupping, coin rubbing, or pinching skin
* May inhale aromatic oils, take herbal teas, or wear strings tied on body
* Father is main decision maker
* Parents expect respect and obedience from children
* May hesitate to ask question
* May avoid eye contact to show respect
Importance of Culture and Religion to Nurses
-Need to raise cultural competence of nursing practice
-Being a part of the “nursing culture”
-Need to be aware of own cultural values and spiritual beliefs
the psychosexual stages of freud
infancy, birth to 1 yr = oral
toddler, 1 to 3 yr = anal
early childhood, 3 to 6 = phallic
middle childhood, 6 to 12 = latency
adolescence, 12- 18 = genital
the psychosocial stages of erikison
birth to 1 = trust vs. mistrust
1 to 3 = autonomy vs. shame and doubt
3 to 6 = initiative vs. guilt
6 to 12 = industry vs. inferiority
12 to 18 = identity vs. role confusion
the cognitive stages of piaget
birth to 2 = sensorimotor
2 to 4 = preoperational thought, preconceptual phase
4 to 7 = preopertional thought, intuitive phase
7 to 11 = concrete operations
11 to 15 = formal operations
the moral stages of kohlberg
1 to 3 = preconventional (premoral), punishment and obedience
3 to 6 = preconventional (premoral), naive instrumental
6 to 12 = conventional, good-boy, nice girl orientation, law and order orientation
12 to 18 = postconventional or principled level, social contract orientation.
permanence, in what stage?
piaget's sensorimotor stage, at what age?
stage is birth to 2
happens closer to 2
egocentrism, in what stage?
piaget's preoperational 2 to 7
1. intuitive
2. transductive
- happens when?
1. style of reasoning ex. stars have to go bed, just as they do.
2. style of reasoning that if two events happen together, they cause eachother, ex. all women with big bellies are pregnant.

- Happens during preoperational stage piaget.
conservation happens when?
physical factors such as weight, height, and number remain the same even though outward appearances are different.
- happens during the concrete operations stage piaget
inductive reasoning happens when?
their reasoning progresses from perceptual thinking to making judgments based on what they reason.

-happens in the concrete operations stage piaget
social- effective play
how infants take pleasure with people, and learn to evoke emotions and responses from people/parents by smiling, cooing, etc.
sense pleasure play
non-social stimulation from light, color, textures, odors, food, water, bouncing, rocking that attract the child's attention, stimulate senses and give pleasure.
skill play
infants with the ability to grasp demonstrate there skill by repeating an action over and over again.
Unoccupied behavior
are not playful but focusing their attention momentarily on anything that strikes their interest, Children daydream, fiddle, with clothes, or other objects, or walk aimlessly.
Dramatic or pretend play
begins in late infancy (11 to 13 months and is predominate form of play in the preschooler)
- Using toys that are replicas of the tools in society provide a medium for learning.
- moves from the simple toddler using pretending to use the telephone to more complex preschooler acting as a storekeeper, nurse, policemen, etc.
imitative games
ex, pat a cake, peek a boo
formal games
for preschool children, beginning with ritualistic, self- sustaining such as ring-around the rosy and London bridge.
competitive games
-Not for preschoolers b/c they hate to lose, try to cheat, want to change rules, demand exceptions
- for school-age and adolescents enjoy these games
-ex. cards, chess, baseball.
onlooker play
children watch what other children are doing but make no attempt to enter into the play activity.
ex. watching an older sibling bounce a ball.
solitary play
children play alone with toys different from those used by other children in the same area. They enjoy the presence of others, but make no attempt to get close or speak to them.
parallel play
-c/a of toddlers
-plays alongside, not with, other children with similar toys.
associative play
-children play together in similar or identical activity, but there is no organization, division of labor, leadership, or mutual goal.
-each child acts according to his own wishes with no group goal.
cooperative play
play is organized and children play in group with other children. They discuss and plan activities for the purposes of accomplishing an end, to make something, to attain a goal, to dramatize adult situation, to play formal game. Loosely formed, but leader and followers are established.
Infancy (birth to 1 year)
-Trust vs. Mistrust
-Feeding "getting and taking in"
-Children develop a sense of trust when caregivers provide reliabilty, care, and affection. A lack of this will lead to mistrust.
-result is faith and optimism
toddlerhood in erikison's stage
-1 to 3 yrs
- toilet training, anal
-autonomy vs. shame and doubt
-"holding on and letting go"
-Children need to develop a sense of personal control over physical skills and a sense of independence.
-result in self-control and willpower
early childhood in erikson's stage
-3 to 6 yrs
-exploration, phallic
-initiative vs. guilt
-want to explore with all their senses, develop a conscience, inner voice that is sometimes in conflict with parents.
-results in direction and purpose.
middle childhood in erikson's stages
- 6 to 12 yrs
- school
- industry vs. inferiority
- desire achievement
-learn to compete and cooperate with others
- if too much is expected of them or cannot live up to others expectations, inferiority
-ego sense of industry = competence
adolescence in erikson's stage
-12 to 18 yrs
-identity vs. role confusion
-social relationships
-Teens needs to develop a sense of self and personal identity. Success leads to an ability to stay true to yourself, while failure leads to role confusion and a weak sense of self.
-results in devotion and fidelity.
Oral Stage
-Birth to 1 year
-An infant's primary interaction with the world is through the mouth. The mouth is vital for eating, and the infant derives pleasure from oral stimulation through gratifying activities such as tasting and sucking. If this need is not met, the child may develop an oral fixation later in life, examples of which include thumb-sucking, smoking, fingernail biting and overeating.
Anal Stage
1 to 3 years
-Freud believed that the primary focus of the libido was on controlling bladder and bowel movements. Toilet training is a primary issue with children and parents. Too much pressure can result in an excessive need for order or cleanliness later in life, while too little pressure from parents can lead to messy or destructive behavior later in life.
Phallic Stage
3 to 6 years
Freud suggested that the primary focus of the id's energy is on the genitals. According to Freud, boy's experience an Oedipal Complex and girl's experience and Electra Complex, or an attraction to the opposite sex parent. To cope with this conflict, children adopt the values and characteristics of the same-sex parent, thus forming the superego.
Latent Stage
6 to 12 years
During this stage, the superego continues to develop while the id's energies are suppressed. Children develop social skills, values and relationships with peers and adults outside of the family.
Genital Stage
-12 to 18 years
The onset of puberty causes the libido to become active once again. During this stage, people develop a strong interest in the opposite. If development has been successful to this point, the individual will continue to develop into a well-balanced person.
define growth
An increase in number and size of cells as they divide and synthesize new proteins
Results in increased size and weight of the whole or any of its parts
Percentiles of growth:
Percentile of growth is a statistical representation of 100 children and placement within the 100 members of comparison group
define Development:
A gradual change and expansion
Advancement from a lower to a more advanced stage of complexity
Increased capacity through growth, maturation, and learning
define Maturation:
An increase in competence and adaptability
A qualitative change
Functioning at a higher level
define Differentiation:
Process of early cells and structures are systematically modifying and altering to achieve specific and c/a physical and chemical properties.
Trends are from simple to more complex
Principles of Growth
Complex
Quantitative
Qualitative
Rates vary:
Among individuals
Over time in same individual
developmental age periods
-infancy= birth to 1 yr

-early childhood= 1. toddler = 1 to 3
2. preschool = 3 to 6

-middle childhood= 6 to 11 or 12

later childhood= 1. prepubertal = 10 to 13
2. adolescence = 13 to 18
Cephalocaudal:
"head to tail”
-infants have control of head before control of trunk and legs/arms.
Proximodistal:
“center to periphery”
- near to far
- infants control shoulders, then hands, then fingers.
Id:
the unconscious mind—“pleasure and gratification”
Ego:
conscious mind—“the reality principle”
Superego:
conscience or moral arbitrator—“the ideal”
linear growth or height occurs...
almost entirely as a result of skeletal growth
bone age and dentition are used as indicators of
-radiologic determination of osseous maturation.

- bone age and dentition are used as indicators of development
stages of ossification
1. diaphysis- the central portion of bone
2. epiphysis- end portions of the bone
3. metaphysis- columns of spongy tissue, which unites with the growth plate.
BMR- basal metabolic rate
rate of metabolism at rest
-highest in newborn
basal energy requirements (kcal/kg) and protein (g/day)
infants= c: 98-108 p: 9-11
1-3= 102 13
4-8= 90 19
M9-13= 55 34
F 9-13= 47 34
M14-18= 45 52
F 14-18= 40 46
the easy child
-40% of children
-even tempered, regular and predicable habits
-positive approach to stimuli
-typically positive
the difficult child
-10% of children
-highly active, irritable, and irregular in their habits
-typically mood is intense and negative
-adapt slowly to new routines
-violent tantrums
-may be prone to colic
the slow to warm up child
-15% of children
-typically react negatively with mild intensity to new stimuli and unless pressured adapt slowly.
-respond with only mild but passive resistance.
-moderate irregularity in functions.
degree of fit
the "fitness" btwn child and environment, specifically their parents, that determines the child's degree of vulnerability to developmental risks.
factors that influence the formation of a child's self esteem are: (4)
1. child's temperament and personality
2. abilities and opportunities to accomplish developmental tasks
3. how significant others interact with the child
4. social roles assumed and the expectations of these roles
emotional deprivation
lack of interpersonal relations and contact which can lead to FTT and developmental delays.
masked deprivation
children reared in homes in which there is a distorted parent-child relationship or home environment.
FTT b/c caregiver is hostile, afraid to handle to child, or indifferent to their needs.
recommended hours of TV viewing for children
under 2 yrs= no TV/day
2 or older= less than 2 hrs/day
Developmental Screening
Purpose: quickly and reliably identify at-risk children for further investigation
Screening vs. diagnostic tests
Denver II is most widely used developmental screening tool