|
Examples of Common Labs
|
|
|
Red: (blood bank, type and cross, discard tube)
|
Lavender: (hematology, CBC, ABC,
H&H,
platelet counts,)
|
|
Red marble-top or gold: (chemistry,
Ca, BUN,
creatinine)
|
Gray: (chemistry,
glucose determinations)
|
|
Light blue: (coagulation studies,
PT, PTT, INR,
fibrinogen)
|
Green: (chemistry, ionized Ca,
plasma
determinations)
|
7/7/14
Examples of Common Labs
1/14/14
Russian Nurse Heritage
Communication:
Primary
language is Russian. Greetings should be formal. Direct eye contact and
touching are acceptable, independent of age and gender. Until trust is
established, Pts may be standoffish toward health-care workers.
Health-care Practices:
News of a
critical or terminal illness is believed to make the condition worse. Cupping
is a form of suction cup–like therapy used to treat a multitude of respiratory
illnesses.
It produces bruising on the back, which may be misinterpreted as a sign of
abuse. Many have an elevated fear of contracting HIV/AIDS from blood donation
and transfusion.
Diet and Nutrition:
Bread is
a staple in every meal. Diets are high in fat and sodium. Pts generally do not
prefer cold drinks.
Pain Management:
More
stoic by Western standards and are not likely to ask for pain medication.
Health-care workers may need to encourage pain medication and explain that it
will enhance healing.
Death and Dying:
Expression
of grief is variable. Families prefer to be told of impending death before
telling the patient. It is appropriate to discuss do-not-resuscitate (DNR)
orders with the family and Pt. Most prefer hospice care.
Taboos and Disrespect:
No
significant cultural taboos noted.
Puerto Rican Nurse Heritage
Communication:
Primary
languages are Spanish and English. Speech is fast by Western standards.
Greetings should be formal. Older generations may regard direct eye contact as disrespectful,
but most younger generations encourage it. Shaking hands is encouraged. Women
of older generations may require a larger personal space when interacting with
men. Many enjoy sharing personal information and expect the same in return from
health-care workers while developing a professional relationship.
Health-care Practices:
Women may
need to consult their husband prior to signing a consent. Many are reluctant to
receive or donate blood. Same-gender health-care provider may
be
requested. Many combine traditional, folk, and Western medicine.
Diet and Nutrition:
Rice and
beans are a staple. Being overweight is a sign of health and wealth.
Pain Management:
Many tend
to be loud and outspoken when expressing pain. Pain medication is openly
accepted. Older generations may not understand the concept of a pain scale.
Death and Dying:
Seek out
the head of the family (usually the eldest son or daughter) for notification of
a deceased Pt. Grieving may be loud and expressive by Western standards.
Cremation
is rarely practiced and autopsy is considered a violation of the body. Organ
donation is regarded as highly positive.
Taboos and Disrespect:
Open
communication about physical ailments and sexuality is taboo. Addressing Pt or
family with terms such as “honey” or “sweetheart” may be considered
disrespectful.
Refusing food from family members may be regarded as personal rejection.
Mexican Nurse Heritage
Communication:
Primary
language is Spanish. Emphasis is placed on verbal communication. Greetings
should be formal. Older generations may regard direct eye contact as
disrespectful, but
most
younger generations do not. Shaking hands is okay, but physical contact during
an assessment may need to be explained.
Health-care Practices:
Assumption
of the sick role is highly tolerated and family members readily take on the Pt’s
responsibilities. Blood transfusion is acceptable.
Diet and Nutrition:
Rice,
beans, and tortillas are staples. Being overweight is seen as positive.
Pain Management:
Explaining
that pain medication promotes healing will help Pts to accept pain medication
more easily.
Death and Dying:
Expect to
have many visitors when death is imminent. Electric candles may be used when
family wants lighted candles near the Pt. Organ donation and transplantation, cremation,
and autopsy are generally not acceptable.
Taboos and Disrespect:
Direct
eye contact with older generation.
Haitian Nurse Heritage
Communication:
Primary languages
are French and Creole. Greetings should be formal and shaking hands is okay.
Haitians are very expressive with their emotions, including loud animated
speech.
Do not misinterpret loud speech as anger. Eye contact with authority figures is
avoided, but otherwise acceptable. Casual touching is a common gesture and is
not considered inappropriate.
Health-care Practices:
It is
common for Haitians to use traditional and Western practitioners simultaneously.
Privacy is highly regarded; therefore, family should not be used for
interpretation.
Expect a
large number of visitors for Haitian Pts. Nursing homes for the elderly are not
acceptable to the family.
Diet and Nutrition:
Yogurt,
cottage cheese, and runny egg yolks are not eaten, and Pts may refuse non-Haitian
hospital food. Being overweight is normal compared to Western standards.
Pain Management:
Pain
manifests outwardly with moaning and facial expressions. Many Haitians have a
very low pain threshold.
Death and Dying:
Haitians
prefer to die at home. Mourning is highly emotional and expressive by Western
standards. Organ donation and transplantation are generally not acceptable.
Taboos and
Disrespect: Homosexuality
is taboo.
Filipino Nurse Heritage
Communication:
Primary
language is Pilipino, but starting in the third grade, all education is taught
in English. Adults should be greeted formally. Prolonged eye contact is avoided
with a figure of authority or a person who is older. Meanings are embedded in
nonverbal communication. Male health-care workers should avoid prolonged eye
contact with younger females, as it may be interpreted as flirting. Close,
personal space should be respected.
Health-care Practices:
High
value placed on personal cleanliness. May seek traditional, alternative
treatment first; otherwise, Western medicine openly accepted. Assumption of the
sick role is highly tolerated and family members readily care for the Pt.
Diet and Nutrition:
High
incidence of lactose intolerance. Cold drinks, fruit juice, and tomatoes are
avoided in the morning to prevent stomach upset.
Pain Management:
More stoic
by Western standards. Pain medication may need to be encouraged.
Death and Dying:
Many are
resistant to discussing advanced directives or living wills. Cremation is acceptable,
but organ donation is not.
Taboos and Disrespect:
Planning
one’s death is viewed as tempting fate.
Cuban Nurse Heritage
Communication:
Primary
language is Spanish. Speech tends to be loud and fast by western standards, and
direct eye contact is acceptable during conversation. Greetings should be
formal. Shaking hands and casual contact are okay, but necessity to touch
private areas during an assessment may need to be explained.
Health-care Practices:
Language
is the biggest barrier to health care and many may seek traditional,
alternative treatment first; otherwise, Western medicine openly accepted. Blood
transfusion is generally acceptable.
Diet and Nutrition:
Yams, yuca,
plantains, and grains are a staple. High incidence of lactose intolerance.
Being overweight is seen as positive, healthy, and sexually attractive.
Pain Management:
Pain is
expressed openly as verbal complaints, moaning, and crying. Explaining that
pain medication promotes healing will help Pts to accept pain medication more easily.
Death and Dying:
Bereavement
is expressed openly and mourning may be elaborate by Western standards. Organ donation
is generally acceptable.
Taboos and Disrespect:
Cutting
an infant’s hair or nails before the age of 3 months is believed to cause
blindness and deafness.
Bosnian Nurse Heritage
Communication:
Primary
language is Serbian. Older and traditional Pts expect formal greetings. Females
maintain eye contact with other women but not with men. Physical contact between
genders is not exhibited in public. Shaking hands (right hand only) is okay,
but males should not initiate a handshake with a female. Asking too many questions may cause
apprehension.
Health-care Practices:
High
value placed on cleanliness. Samegender health-care provider is strongly
preferred. Most consider it shameful to accept Medicaid.
Diet and Nutrition:
Pork,
pork products, and alcohol are prohibited by Muslims; medications should not
contain alcohol. Pass food to Pts only with your right hand. During Ramadan,
fasting is required from sunup until sundown.
Pain Management:
Most
individuals are stoic; take cues from family members regarding Pt discomfort.
Pain medication is acceptable.
Death and Dying:
Patients
should face Mecca (NE from the U.S.) when death is imminent.
Taboos and Disrespect:
The left
hand is used for toileting and is considered dirty.
Asian Nurse Heritage
Note:
C, J, K, and V refer to Chinese, Japanese, Korean, and Vietnamese.
Communication:
Primary
language varies with country. Greetings should be formal (C, J, K, V). Direct
eye contact (C, J, K) or invasion of personal space (C, J) may cause
uneasiness. Touch only when necessary (C, J, V). Shaking hands is okay (J, K),
but males should not initiate a handshake with females (V).
Health-care Practices:
Same-gender
health-care provider is strongly preferred by women (C, K, V). Assumption of
the sick role is highly tolerated and long recuperation is encouraged (J). May
seek traditional, alternative treatment first, prior to accepting Western
medicine (C, J, K, V). Likely to refuse blood transfusions (V).
Diet and Nutrition:
Rice is a
staple (J, K, V) and is included in every meal throughout the day, including
snacks (J). Tofu is a staple (C). High intake of sweets may account for high
incidence of tooth decay (J). High incidence of lactose intolerance (J, K, V) and
iron-deficiency anemia (V). Prefer beverages without ice (C).
Pain Management:
May be
reluctant to accept or request pain medication (J, K).
Death and Dying:
Responsibility
for any special arrangements falls to the eldest son (J, K). Mourning can be
elaborate by Western standards (J) and include offerings of food and money (C,
J). The concept of advanced directives may be confusing (J). Strong desire to
die at home (V). Unlikely to consent to an autopsy (V) and organ donation or
transplantation may be unacceptable (J, K, V).
Taboos and Disrespect:
Open discussion
about serious illness and death (J), addiction (J), mental illness (J), direct
eye contact (C, J, V), pointing (V), chopsticks stuck upright in food (C), touching
the head (V), placing feet upon desk or table (V).
Arab Nurse Heritage
Communication:
Primary
language is Arabic. Speech may be loud, expressive, and involve gesturing, with
an emphasis placed on nonverbal communication; avoid misinterpreting as anger
or confrontation. Title is important; ask how Pt or family prefers to be
addressed. Shaking hands (right hand only) is okay, but males should not initiate a handshake with a female.
Health-care Practices:
Same-gender
health-care provider is strongly preferred. Reluctant to share sensitive
medical information with someone other than family and friends.
Diet and Nutrition:
Pork,
pork products, and alcohol are prohibited by Muslims; medications should not
contain alcohol. Bread should accompany all meals. Pass food to Pt only with
your
right hand. During Ramadan, fasting is required from sunup until sundown.
Pain Management:
Most
individuals are stoic around strangers; take cues from family members regarding
patient discomfort. Pain medication is acceptable.
Death and Dying:
Pts should
face Mecca (NE from the U.S.) when death is imminent. Autopsy (if needed),
organ donation, and transplant are acceptable.
Taboos and Disrespect:
The left
hand is used for toileting and is considered dirty.
American Indian Nurse Heritage
Communication:
Primary
language varies from tribe to tribe, but most younger generations are bilingual
(English and their native language). Greetings should be formal. Long periods
of silence are normal. Talking loud is rude. Physical contact from strangers is
unacceptable; however, shaking hands is okay. Respect personal space, as it is
generally greater than that of European-Americans.
Health-care Practices:
A lot of
questioning during an assessment may foster mistrust. Illness is unacceptable;
older Pts, even when seriously ill, must be encouraged to rest.
Diet and Nutrition:
Food has
major significance beyond nourishment, but is not generally associated with
promoting health or illness. Corn is a staple. Diet may be deficient in
vitamin D
due to high incidence of lactose intolerance.
Pain Management:
Most
individuals are stoic and will not ask for pain meds; it is believed that pain
should be endured.
Death and Dying:
Autopsy
and organ donation are unacceptable to traditional American Indians.
Taboos and Disrespect:
Direct
eye contact and/or pointing of finger may be disrespectful.
Cultural Diversity in Health Care
Note: Within the United States there are
more than 400 ethnocultural groups, making it impossible to include cultural characteristics
for all of them. The cultural groups selected for inclusion in this book met at
least one of the following criteria: (a) the group has a large population in
the United States, (b) the group is relatively new in its migration status, (c)
the group is widely dispersed throughout the United States, (d) little is written
about the group in the health-care literature, or the group holds a significant
minority or disenfranchised status.
Guidelines for a Positive Cultural Interaction
■ Be aware that culture has a
strong influence on an individual’s interpretation of and responses to health
care.
■ Assess Pt’s depth of understanding
of English and use an interpreter whenever needed.
■ Ask Pts how they like to be
greeted and what name they prefer.
■ Identify who makes
decisions: Pt, spouse, children, etc.
■ If unsure, ask Pts specific
questions regarding their culture.
■ Be open-minded,
accepting, and willing to learn.
Premature Atrial and Junctional Complex
 |
| Premature Atrial and Junctional Complex |
Rhythm ------------- Irregular whenever a PAC or PJC occurs
P Waves ------------- Present in PAC, but may be hidden in the T wave. Not present in PJC
PRI ------------- Varies in PAC. Not present in PJC
QRS ------------- Normal (0.06–0.10 sec)
Premature Ventricular Complex (PVC)
.jpg "Premature Ventricular Complex (PVC)") |
| Premature Ventricular Complex (PVC) |
Rhythm -------------- Irregular whenever the PVC occurs
P Waves -------------- None associated with PVC
PRI -------------- None associated with PVC
QRS -------------- Wide and bizarre ( > 0.10 sec)
3 AV Block (Complete Heart Block)
.jpg "3 AV Block (Complete Heart Block)") |
| 3 AV Block (Complete Heart Block) |
Rhythm -------------- Both ventricular and atrial are usually regular
P Waves -------------- More Ps than QRSs; No correlation
PRI -------------- Varies greatly
QRS -------------- Usually wider than 0.10 sec
2 AV Block (Mobitz Type-II)
.jpg "2 AV Block (Mobitz Type-II)") |
| 2 AV Block (Mobitz Type-II) |
Rhythm ------------- Atrial regular; Ventricular irregular
P Waves ------------- More Ps than QRSs
PRI ------------- Unblocked Ps usually have a normal PR interval
QRS ------------- Normal, but may also be wide
2 AV Block (Mobitz Type-I,Wenckebach)
.jpg "2 AV Block (Mobitz Type-I,Wenckebach)") |
| 2 AV Block (Mobitz Type-I,Wenckebach) |
Rhythm ------------- Irregular
P Waves ------------- Present
PRI ------------- Gets progressively longer until a QRS is dropped
QRS ------------- Normal (0.06–0.10 sec)
1 AV Block
 |
| 1 AV Block |
Rhythm -------------- Regular
P Waves -------------- Present, one P for every QRS
PRI -------------- Prolonged: > 0.20 sec
QRS -------------- Normal (0.06–0.10 sec)
Ventricular Fibrillation
 |
| Ventricular Fibrillation |
Rhythm --------------- Completely chaotic and disorganized
P waves --------------- None
P-R --------------- N/A
QRS --------------- None
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