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Question 1

Some diseases seem to effect people from some cultural background than others. Other people are spared by diseases due to the biocultural characteristics. A good example is the immunity conferred on Africans with sickle cell trait against Malaria. Blacks with the sickle cell and their children tend to survive Malaria attacks (Andres & Bolye, 2016). Another biocultural aspects is the emergence of childhood disorders due to intermarriage among certain groups of people. For example, ventricular septal defects among the Amish is related to intermarriage. Also, amyloidosis is common among Maryland/ German and Indian/Swiss families. According to Mahmoudian, D., & Amin, D. (2018) mental retardation among British children is also related to intermarriages.

There is also a link between race and childhood disorders. For example, sickle cell anaemia is common among blacks and people of Mediterranean origin. Cystic fibrosis is also common among white children than other races. Congenital hypothyroidism and phenylketonuria are common among Chinese and Asian children (Tiwari, Bandyopadhyay & Saha, 2019). Among black children, there is a high risk of G-6-PD deficiency and haemoglobin C disease. Ethnicity also seem to influence the chances of children developing diseases. Ethnicity is related with tuberculosis in North America with some groups being affected more than the rest. A good example is Tay-Sachs disease. According to Echeverri et al. (2018), Tay-Sachs disease that is likely to affect Ashkenazi Jews children.

Question 2

There are significant ethnic, racial and gender differences in the growth of children among different cultures. Since the development process takes place in a context of culture, the development of the infant, child and adolescent is influenced. A good example is the difference in language development between aboriginal people in Canada compare to the general population. Another observable characteristic is in terms of body size and stature. For example, African American children have been noted to be three-fourth inch shorter than white children in most stages of development (Andres & Bolye, 2016). Also, children of higher social-economic status are taller than poor children in most cultures.

Question 3

Most cultures see illnesses as a form of punishment with children suffering from chronic illnesses and their families often being seen as cursed. Chronic illnesses are often seen to come from supreme beings such as gods to children and families where there is seen or violation of a taboo. A family with where a child suffers chronic illness is often discussed in the community. The most type of chronic illnesses that are related with supernatural causes are inherited disorders (Andres & Bolye, 2016). A family curse that is passed from one generation to the next is often seen as the cause of inherited diseases.

Religious and philosophical beliefs often affect how genetic diseases are interpreted in most cultures. Among some communities such as the Latinos, chronic diseases are believed to be caused by imbalance between hot and cold within a child. As such the cause and cure of the disease is within the child and they must seek to establish an equilibrium by regaining balance. If the disability is permanent and cannot be healed are perceived as unclean and impure. According to Andres & Bolye (2016), even when an explanation of genetic transmission is explained, families still believe in supernatural causes such as curses and bad blood. When disabilities are seen as divine punishment, a result of personal state of impunity or inherited evil, the child become a shame to a family.

While most cultural explanations of causes of chronic diseases are negative, a few are positive. For example, among Mexican Americans, there is a believe that a certain number of disabled children would be born in the world. Also, Mexican Catholics believe that God singled them for the role of taking care of disabled or diseased child after observing their kindness. As such, these will received quality care to fulfill God’s will.

Question 4

1. In Hispanic cultures, Pujos (grunting) is a disease whose symptoms include grunting sounds and protrusion of the umbilicus. Hispanics believe that Pujos (grunting) is caused by contact with a woman undergoing menstruation. It can also come when the infant comes to contact with the mother if she menstruates less than 60 days after delivery.
2. For a child with Mal de ojo (evil eye) dehydration is a common symptom and a serious threat. Often a nurse will need to plan for immediate fluid and electrolyte replacement (Andres & Bolye, 2016). Other symptoms of the problem among the Hispanics include the child becoming listless, crying, experiencing fever, vomiting and diarrhea.
3. Caida de la mollera (fallen fontanel) among Hispanics comes with such signs as fever, crying, vomiting and diarrhea. It is common for nurses to see these condition together with dehydration due to the loss of water from vomiting and diarrhea (Andres & Bolye, 2016). As such, rehydration to raise the fontanel is a common treatment among parents.
4. Empacho (a digestive disorder) is a gastrointestinal sickness that cause internal fever that may not be observed. Excessive thirst, and abdominal swelling hence children with the condition tend to take excessive amounts of water. The disease is linked to supernatural causes among the Hispanics.

References

Andres, A.M. & Bolye, J.S. (2016).  Transcultural Concepts in Nursing Care (7th ed.).  ISBN 978-1-4511-9397-8

Echeverri, N., Terhaar, C., Bardos, J. D., & Longman, R. (2018). Tay-Sachs: An Ashkenazi Jewish Disease or Not?[26E]. Obstetrics & Gynecology, 131, 59S.

Mahmoudian, D., & Amin, D. (2018). Successful Treatment of Severe Mentally Retarded Child by Homeopathy. Asian Journal of Traditional, Complementary and Alternative Medicines, 1(1-2), 22-26.

Tiwari, A. K., Bandyopadhyay, D., & Saha, B. (2019). A preliminary report on newborn screening of inborn metabolic disorders. Indian Journal of Child Health, 39-41.

 INSTRUCTION BELOW:

PLEASE SEE THE ATTACHED RUBRIC DETAILS FOR THE ASSIGNMENT.

ZERO (0) PLAGIARISM, AT LEAST FIVE (5) REFERENCES NO MORE THAN 5 YEARS, FOLLOW THE APA WRITING FORMAT 

An understanding of cells and cell behavior is a critically important component of disease diagnosis and treatment. But some diseases can be complex in nature, with a variety of factors and circumstances impacting their emergence and severity.

Effective disease analysis often requires an understanding that goes beyond isolated cell behavior. Genes, the environments in which cell processes operate, the impact of patient characteristics, and racial and ethnic variables all can have an important impact.

 

An understanding of the signals and symptoms of alterations in cellular processes is a critical step in the diagnosis and treatment of many diseases. For APRNs, this understanding can also help educate patients and guide them through their treatment plans.

In this Assignment, you examine a case study and analyze the symptoms presented. You identify cell, gene, and/or process elements that may be factors in the diagnosis, and you explain the implications to patient health.

To prepare:

By Day 1 of this week, you will be assigned to a specific case study for this Case Study Assignment. Pleas see case study scenario below:

  Scenario 2: A 42-year-old man comes to clinic with chief complaint of pain, redness, and swelling of his right calf. He states that he had been working in his yard using a string trimmer when the trimmer slipped and cut his leg. He cleaned the wound with water from the garden hose and covered the wound with a large Band-Aid. Several days later, he developed fever to 100.6˚ F and chills and noticed that his leg was swollen and red. He comes to the emergency department for definitive care. 

 

The Assignment (1- to 2-page case study analysis)

Develop a 1- to 2-page case study analysis in which you:

• Explain why you think the patient presented the symptoms described.
• Identify the genes that may be associated with the development of the disease.
• Explain the process of immunosuppression and the effect it has on body systems.

Respond using one or more of the following approaches:

Ask a probing question, substantiated with additional background information, and evidence.

Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

Validate an idea with your own experience and additional sources.

Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

Expand on your colleagues’ postings by providing additional strategies for addressing barriers to EBP based on readings and evidence.

                                                        Main Post

                                         Introduction/PICOT Question

Pain is the most common complaint of people who present to the emergency department (ED).  It is estimated that 75% of all patients use the ED for pain related complaints (Bergman, 2012).  Patient satisfaction survey results emphasize the importance of adequate pain management (Bergman, 2012). With this in mind, nurses have a responsibility to evaluate, assess, and be advocates for a patient’s pain control.  Studies have shown when an ED department has pain management protocols and delegates these to the nurses there is a reduction in patient’s pain (Hadorn, Comte, Foucault, Morin, & Hugli, 2016).  Discovering patient expectations for pain management allows healthcare workers and patients to understand each other.  Once understanding has taken place, we can evaluate essential questions related to the patient’s pain management.  As healthcare workers are we expected to base pain management protocols solely on self-reported pain by the patient?  If so then an important question to answer is: When patients present with pain in the ED, how does a nurses’ perception of the pain influence the level of pain management the patient receives? 

Evidence-Based Practice

              Currently, in the ED I work in pain guidelines and protocols are in place for the nurse to initiate as needed.  Hadorn et al. (2016) state, “guidelines or protocols are generally used to facilitate the transfer of compelling evidence into clinical practice” (p. 81).  This evidence-based pain management protocol is available for the nurse to initiate based on the patient’s self-reported pain, nursing assessment, and observational data.  At times, nurses evaluate pain based on vital signs, facial expressions such as grimacing, restlessness, self-report, and chief complaint (Hazelett, Powell, & Androulakakis, 2002).  In our organization, the policies and procedures for pain management support the adoption of evidence-based practices.  By using the set protocol for pain, nurses are better able to treat pain promptly.  Nurses have a crucial role in delivering evidence-based healthcare in order to have the best outcomes and treatments for their patients (Majid et al., 2011).

Barriers

       Studies noted a barrier to effective pain management is the nurses’ perception of the individual.  Some patients frequent the ED over exaggerating or making up complaints to seek pain medications (Hazelett et al., 2002).  This repetitive drug seeking over time creates a barrier to compassionate care.  The ED is a vulnerable place for drug abuse, especially by patients attempting to get narcotics or other pain medications (Bergman, 2012). 

Emergency department nurses and staff have a culture within their units that influence everyday practices.  There is often a vast age range in the nursing staff which highlights differences in work ethic, attitudes, and professionalism.  The culture of our ED hinders the initiation of evidence-based practices due to stressed out, overworked, and underappreciated nurses.  With this in mind, it is vital that as an organization we provide opportunities for nurses to have adequate rest and find ways to show appreciation for all their hard work.

             Proper access and initiation of the pain management protocol increases the likelihood of adequate pain control for patients.  By discovering the expectations of patients and barriers to providing appropriate care we can eliminate miscommunication regarding pain control. 

References

Bergman, C. (2012). Emergency nurses’ perceived barriers to demonstrating caring when managing adult patients’ pain. Journal of Emergency Nursing, 38(3), 218-225. http://dx.doi.org/10.1016/j.jen.2010.09.017 

Hadorn, F., Comte, P., Foucault, E., Morin, D., & Hugli, O. (2016). Task-shifting using a pain management protocol in an emergency care service: Nurses’ perception through the eye of the roger’s diffusion of innovation theory. Pain Management Nursing, 17(1), 80-87. http://dx.doi.org/10.1016/j.pmn.2015.08.002

Hazelett, S., Powell, C., & Androulakakis, V. (2002). Patients’ behavior at the time of injury: Effect on nurses’ perception of pain level and subsequent treatment. Pain Management Nursing, 3(1), 28-35. http://dx.doi.org/10.1053/jpmn.2002.29012

Majid, S., Foo, S., Luyt, B., Zhang, X., Thong, Y., Chang, Y., & Mokhtar, I. (2011). Adopting evidence-based practice in clinical decision making: Nurses’ perceptions, knowledge, and barriers. Journal of the Medical Library Association, 99(3), 229-236. http://dx.doi.org/10.3163/1536-5050.99.3.010

 Compare the physical assessment of a child to that of an adult. In addition to describing the similar/different aspects of the physical assessment, explain how the nurse would offer instruction during the assessment, how communication would be adapted to offer explanations, and what strategies the nurse would use to encourage engagement.