Chapter 3:
Cultural Competence in the Health History and Physical Examination
Copyright © 2016 Wolters Kluwer • All Rights Reserved
1
Cultural Assessment #1
Customized or tailored to the client’s unique background.
Health history and physical exam interrelated.
With growing diversity comes the need for nurses to develop knowledge and skills in cultural assessment.
Copyright © 2016 Wolters Kluwer • All Rights Reserved
2
Cultural Assessment #2
Assessments form the foundation for the plan of care.
Tend to be broad and comprehensive.
Cultural assessment usually integrated into the overall assessment.
Copyright © 2016 Wolters Kluwer • All Rights Reserved
Health History #1
The purpose of the health history is to collect subjective data.
This is combined with the objective data from the physical exam for both well and ill clients.
Copyright © 2016 Wolters Kluwer • All Rights Reserved
4
Question #1
Is the following statement true or false?
Subjective data refers to things that people say or relate about themselves, whereas objective data result from the physical examination and the laboratory findings.
Copyright © 2016 Wolters Kluwer • All Rights Reserved
5
Answer to Question #1
True
Rationale: Subjective data come from the client and is information only they can give and confirm; objective data are observable and confirmed through sources other than the client.
Copyright © 2016 Wolters Kluwer • All Rights Reserved
6
Health History #2
Major data categories to be considered when conducting a culturally competent health history:
1. Biographic data and history
2. Genetic data
3. Review of medications and allergies
4. Reason for seeking care
Copyright © 2016 Wolters Kluwer • All Rights Reserved
7
Health History #3
Major data categories to be considered when conducting a culturally competent health history (cont.):
5. Present health and history of present illness
(culture-bound syndromes)
6. Past health
7. Family and social history
8. Review of systems
Copyright © 2016 Wolters Kluwer • All Rights Reserved
8
Question #2
Is the following statement true or false?
Most cultures recognize the difference between prescribed medications and over-the-counter medications including herbs.
Copyright © 2016 Wolters Kluwer • All Rights Reserved
9
Answer to Question #2
False
Rationale: It is important to note all prescription and over-the-counter medications, including herbs, that clients might purchase or grow in home gardens. Because of cultural differences in peoples’ perceptions of which substances are considered medicines, it is important to ask about specific items by name.
Copyright © 2016 Wolters Kluwer • All Rights Reserved
10
Physical Examination #1
Accurate assessment and evaluation of clients require:
Knowledge of normal biocultural variations among healthy members of selected populations
Assessment skills that will enable you to recognize variations that .