Transcript culture and addiction

culture and addiction
"I hate to advocate drugs,
alcohol, violence, or insanity
to anyone, but they've always
worked for me”
--- Hunter S Thompson
Culture vs Ethnicity vs Race
vs subculture
• The dynamic network of knowledge, beliefs,
patterns of behavior, ideas, attitudes, values, and
norms that are unique to a particular group of
people
• An individual’s identification of self as a part of an
ethnic group
• A group of people based on biological similarities
(hair, skin, eyes, etc).
• A group with characteristic patterns of behavior
that distinguish the group from the larger culture
or society
Cultural _________
… assimilation
… competence
… diversity
… imposition
And then there’s acculturation
assimilation vs acculturation
• Process in which individuals from a minority
group are absorbed by the dominant culture
and take on the characteristics of the
dominant culture
• Process of learning norms, beliefs, and
behavioral expectations of a group other than
one’s own group
competence vs diversity
• Acquisition of knowledge, understanding, and
appreciation of a culture that facilitates the
provision of culturally appropriate health care
• Differences among a group of people that
result from ethnic, racial and cultural variables
imposition
• Tendency to assert one’s own beliefs, values,
and patterns of behavior on individuals from
another culture
Belief vs value
• Something accepted as true by a culture
• Priniciples and standards that have meaning
and worth to an individual, family, group,
community or culture
practice questions
1.) a nurse in an ambulatory care clinic is
performing an admission assessment for an AA pt
scheduled for a cataract removal w/ an
intraocular lens impact. Which question would
be innapropriate for the RN to ask on an initial
assessment?
a.) do you ever experience CP?
b.) do you have any difficulty breathing?
c.) do you have a close family relationship?
d.) do you frequently have HA’s?
Question 2
2.) RN is preparing a POC for a pt who is a
Jehovah’s Witness. The pt has been told that
surgery is necessary. The RN considers the
client’s religious preferences in developing the
plan of care and documents that:
a.) faith healing is practiced primarily
b.) med administration is not allowed
c.) surgery is prohibited
d.) administration of blood and blood
products is forbidden
Question 3
An anti HTN med has been prescribed for a pt. The client
tells the RN that she would like to take an herbal
substance to help lower her BP. The RN should …
a.) tell the client that herbal substances are not safe and
should never be used
b.) advise the client to discuss the use of an herbal
substance with the MD
c.) teach the client how to take her BP so that it can be
monitored closely
d.) tell the client that if she takes the herbal substance
she will need to have her BP checked freqently
question 4
a nurse educator is providing in-service education to the
nursing staff regarding transcultural nursing care when a
staff member asks the nurse educator to describe the
concept of acculturation. The appropriate response is…
a.) it is a subjective perspective of the person’s heritage and a
sense of belonging to a group
b.) it is a group of individuals in a society who are culturally
distinct and have a unique identity
c.) it is a process of learning a different culture to adapt to a
new or changing environment
d.) it is a group that shares some of the characteristics of the
larger population group of which it is a part
Question 5
Which of the following are low-risk therapies?
(select all that apply)
Herbs
Prayer
Touch
Massage
Relaxation
Acupuncture
Question 6
A nursing student is discussing cultural diversity
issues in a clinical conference when a nursing
instructor asks the student indicates a lack of
understanding of the issue of enthnocentrism?
a.) it is a tendency to view one’s own ways as best
b.) it is acting in a manner that is superior to other
cultures
c.) it is imposing one’s beliefs on individuals from
another culture
d.) it is believing that one’s own way is the only
acceptable way
Case Studies
• Report from the previous shift: Ms R is an 84 y/o
AA pt admitted for advanced ALS. She is trached
but can communicate through writing. She has a
DNR/DNI, so there’s no IV acess. She also has a
boyfriend who visits every evening, and often
during the day. She is suctioned about 4x per
shift and frequently requests RT. She is seen by
the chaplain every day. Otherwise, aside from a
foley, systems are normal, regular diet. She isn’t
to be attended by any male nurses.
Case Studies
30 y/o male patient admitted s/p motorcycle
accident. He has only recently regained baseline
mental status. Upon entering his room you
notice he has multiple facial piercings, a shaved
head, and tattoos on his extremities. His face
sheet shows his address as Salt Lake City Utah.
He has TPN hanging, IV access is an 18g LFA. He
has multiple abrasions and a R femur fracture.
VSS, RA, A&O x 4, GCS 15, no resp. distress,
CMSTP, CR<2.
Alcohol
“Here’s to alcohol: the cause of…and answer to
all of life’s little problems.” – H.Simpson
Regardless of the logic or validity of this
statement, it might be true and factual.
Alcoholism
• This is a drinking pattern that interferes with
physical, social, familial, vocational, and
emotional functioning.
• Like the moon and stars, the sea and life itself,
there are patterns indicative of alcoholism.
• These patterns are:
Patterns:
• Episodic drinking, continuous drinking,
morning drinking, increase in family fighting
about drinking, blackouts, legal problems,
health problems, hiding drinking problems.
The Little Prince
“What are you doing there?” he asked the
drunkard, whom he found sunk in silence
before a collection of empty bottles and
a collection of full ones.
“Drinking,” replied the drunkard, with a
gloomy expression.
“Why are you drinking?” the little prince
asked.
“To forget,” replied the drunkard.
“To forget what?” inquired the little prince
who was already feeling sorry for him.
“To forget that I am ashamed,” confessed
the drunkard.
“What are you ashamed of?” inquired the
little prince, who wanted to help.
“Of drinking!” concluded the drunkard,
withdrawing into silence for good.
Questions:
1. What medications can the nurse expect to
administer to a pt withdrawing from etoh?
a. warm maple syrup
b. pineapple schnapps
c. antabuse
d. librium or ativan
2. Using aversion therapy, what can be
used in the treatment of alcoholism?
a. Radiation therapy
b. Ketamine (Special-K)
c. Gasoline (petrol)
d. Disulfiram (Atabuse)
3. In rehabilitation of an alcoholic patient,
what methods should not be used?
a. Scorn
b. Use of nonjudgmental, matter-of-fact
attitude.
c. Setting realistic goals.
d. Help increase self-esteem.
4. Chronic alcohol-related illnesses include
(pick those that apply):
a. Chronic gastritis.
b. Hepatitis
c. Peripheral neuropathy
d. Malnutrition and dehydration
e. Pancreatitis
5. Patterns or behaviors indicative of
alcoholism include all the following
except:
a. Morning drinking
b. Nursing school
c. Binge drinking
d. Worry free mornings and a life time
without regret.
6. Delirium tremens may appear 12 to 36
hours after the last drink and symptoms
may include the following except:
a. Paranoia
b. Hallucinations
c. Market tremors
d. A positive outlook and a totally normal
take on the world and all that exists
Drugs!
• Marijuana leads to homosexuality ... and therefore to
AIDS.
White House Drug Czar Carlton Turner, 1986
• "Woe to you my Princess, when I come, I will kiss you
quite red and feed you till you are plump. And if you
are forward, you shall see who is the stronger, a
gentle little girl who doesn't eat enough or a big wild
man who has cocaine in his body."
Sigmund Freud addressing his wife, from 'On Coca'
Drug Abuse:
State of dependency produced by
repeated use of substance that
causes altered perception or mood,
or both.
1. Patients suffering from cocaine and
amphetamine withdrawal may exhibit all of the
following symptoms except
a.
b.
c.
d.
Depression
Fatigue
Priapism
Disturbed sleep
2. The following physical signs may indicate
intravenous drug abuse in a client:
a. Sudden and unexpected competency in the
German language
b. Priapism
c. Needle track marks, cellulitis at puncture
site, poor nutritional status
d. Rhinorrhea
3. Frequent reassessment of vital signs and level
of consciousness is especially important in
people undergoing valium withdrawal because
a. Priapism
b. Valium raises heart rate.
c. Rapid withdrawal from barbiturates,
antianxiety medications, and hypnotics may
be fatal.
d. The patient is depressed and lonely
4. When recommending therapy for chemically
dependent clients, the following therapy works
best
a.
b.
c.
d.
e.
Hypnotherapy
Priapism
Group therapy such as Narcotics Anonymous
Chemotherapy
Hydrotherapy
5. All of the following questions are part of
assessment for clients suffering from drug abuse
except
a. What drugs have you used and what is your
drug of choice?
b. How much have you taken and how long
have you been using this drug?
c. Priapism?
d. How often do you use this drug?
6. A client suffering from a cocaine overdose
may present with
a.
b.
c.
d.
Priapism
Jaundice
Pupillary dilation
Respiratory depression
• - LSD is known to induce psychosis, in people
who have never used it.
Timothy Leary