The nurse is reviewing an entry made by the previous nurse in a newly

QUESTION

The nurse is reviewing an entry made by the previous nurse in a newly admitted patient’s medical record:

Admission Note: The patient is a 56-old-female whose father immigrated to the U.S. in 1938 and whose mother was born in the U.S. The patient explains that she didn’t learn English until entering grade school, which was appropriate since her father was learning the language at the same time. Her parents were hard workers, ran their own restaurant in which all family members were expected to work, and placed a high value on education. The patient states that “I might be female but I was raised as a boy.” She continued by explaining that her father didn’t want the females in the family to be dependent upon a man for an income or security through life. The patient attends church every Sunday and on Holy Days and follows abstinence of specific foods throughout the calendar year. Specific ethnic dishes are prepared for Christmas, Easter, and Saints Days. Her childhood home was filled with ethnic music, songs, and the expectation to play an instrument. Cigarette smoking was not condemned but wasn’t encouraged. Drinking alcohol such as wine and whiskey was an acceptable practice from an early age since this was the acceptable behavior from her father’s home country.
Which of Purnell’s cultural domains are represented in this chart entry? (Select all that apply.)
1. Heritage
2. Pregnancy
3. Communication
4. Workforce issues
5. High-risk behaviors

ANSWER:

Correct Answer: 1, 3, 4, 5

The cultural domain of heritage considers the characteristics related to the individual’s or the family’s country of origin, where the individual and family currently reside, the economics and politics of the country of origin and the country of current residence, reasons for emigration, and educational status and occupations of family members. The cultural domain of communication considers the individual’s dominant language and dialects, as well as the verbal and nonverbal characteristics of communication; such as volume, intonation, tone, and pace of speech, spatial distancing, eye contact, facial expression, touch, and the use of names. Also considered is orientation to time; past-, present-, and /or future-oriented, as well as clock versus social time. The cultural domain of workforce issues considers acculturation and assimilation within the dominant culture, gender roles, level of autonomy, beliefs about individualism, and language barriers. The cultural domain of high-risk behaviors considers health-risk behaviors such as the use of tobacco products, alcohol consumption, and the use of recreational drugs. The cultural domain of pregnancy considers beliefs and practices about birth control, pregnancy, birthing practices, and fertility practices.