Nursing Question

nursing discussion question and need guidance to help me learn.

You should respond to your peers by extending, refuting/correcting, or adding additional nuance to their posts. Each reply should be at least 150 words, and contain at least one reference from an academic journal no older than five years. There are four replies total
All replies must be constructive and use literature where possible.
Requirements: 600 words total
NUR-505 Discussion 3
Grace Lavertue
St.Thomas University
Professor Washington-Oats
January 26, 2023
 
Melvin is a one-month-old baby born six weeks prematurely to an Amish family with four other children in the home. His three older siblings attend a local elementary school, and the younger, 4-year-old stays with his aunt due to baby Melvin’s respiratory problems. The physicians have told Melvin’s parents that he may need to be hospitalized if his symptoms do not improve in 2 days.
 
Prenatal and perinatal care for cultural consideration of Amish values, beliefs, and practices
 
Amish perceive children as a gift from God. (Purnell, 2018)  They are considered a blessing to the family, and understanding their value in the Amish community is imperative when caring for an Amish child. The typical Amish household will usually have 5-7 children. Some Amish communities are reluctant to seek prenatal care because they feel uneasy receiving care from an outsider but have expressed a strong need for the best prenatal care for their baby. They would feel more comfortable with someone who understands and respects their values and beliefs. Most Amish women choose home births and have an Amish or non-Amish midwife perform their delivery. While men are typically involved in the prenatal and birthing process, they are stoic and do not show emotions in public situations. Other cultural considerations are that Amish do not carry health insurance, will typically consult with family and church members before making medical decisions, and have limited education. Most of their learning is modeled after a parent, elder, or community member.
When addressing prenatal care with Mary, the provider should be mindful of her limited financial resources and lack of health insurance that may discourage her from pursuing certain diagnostic testing. One area of concern should be a prenatal diet. Since Amish communities are known to eat foods that are high in fat, carbohydrates, and sweets, the chance that Mary could develop gestational diabetes during her pregnancy should be reviewed. Understanding the Amish diet and the foods that are available to her should be a consideration for the provider. Educating Mary can be easily reviewed with food pyramid pictures and diagrams explaining how to incorporate and limit certain foods for a healthy pregnancy and baby. This education does not need to include computers or electronic equipment, which is not recognized in the Amish community.
Amish people put a lot of faith in herbal remedies and supplements. (Anderson & Potts, 2020)  Introducing folic acid to avoid neural birth defects can also be included in Mary’s prenatal care. Since many Amish people learn by following their elders and family members, incorporating visual aids that do not require electronics would be helpful when educating her. Being mindful to ask Mary and her husband if they are agreeable to the plan of care should always be included in each visit. This will help to establish communication and trust between the family and the provider.  
Hereditary diseases common in the Amish community include dwarfism, cartilage hair hypoplasia, and pyruvate kinase anemia. (Purnell, 2018) Considering that Amish people have limited transportation resources and no health insurance, prenatal testing can help establish early perinatal care, avoiding any lags in health care for the baby. The provider should allow time to discuss options and care within the patient’s community. This simple act shows respect for the patient’s customs and belief systems. Giving choices and listening skills are always imperative when establishing a trusting relationship with an Amish patient and their family.
 
References
Anderson, C., & Potts, L. (2020). The amish health culture and culturally sensitive health services: An exhaustive narrative review. Social Science & Medicine, 265, 113466. 
Purnell, L. D. (2018). Transcultural health care a culturally competent approach (4th ed.). Robert G. Martone.
Discussion 3
Stephanie Perez
St. Thomas University 
NUR 505
Professor Washington-Oates
January 26, 2023
 
Mary and I would talk about keeping up with her pregnancy appointments and getting the right nourishment and water. To make sure that there are no underlying issues impacting the pregnancy and that the fetus is developing normally, it is crucial that Mary see her physician on a frequent basis. Another crucial subject to discuss with Mary is nutrition. She has to be aware that increasing her fluid intake will keep her well hydrated, prevent early labor from starting from contractions, and maintain normal amniotic fluid levels. A baby’s optimal growth can also be aided by good diet. Mary has to be told not to consume any unpasteurized cheese, raw seafood, or undercooked red meat. Mary must be given a list of items she shouldn’t eat while pregnant by her healthcare practitioner. It’s also crucial to pay attention when she’s there and keep an eye out for any indications she may give. It is crucial to realize that Amish kids only attend the first eight grades and have turned away from higher education. As a healthcare provider this must be kept in mind when creating a care plan for the Amish because of their lack of resources such as print and electronic media, radio and television. They do not carry the same awareness for popular culture and general knowledge because of lack of exposure (Purnell, 2013). 
 It is important to be aware that most Amish households lack power and that the Amish culture doesn’t often employ electronic labor-saving gadgets while preparing for prenatal education programs with Amish patients. Our culture shouldn’t see this as being resistant to modern medicine and technology. In truth, the Amish community is amenable to employing contemporary technologies in a life-saving circumstance. Because Amish women generally do not seek prenatal care due to reluctance, it is vital to gain their trust and understand that babies are perceived as a gift of God and is one of the contributing factors to their population increase (Purnell, 2013). To establish a rapport with these patients, this needs to be acknowledged and understood. It’s also critical to realize that they don’t view childbirth as a medical condition and want to leave the hospital as soon as possible. Lack of insurance is the main issue that this community is concerned about. Giving them some information about insurance providers for pregnancy and delivery or the cost of a hospital admission could be helpful. They could better grasp the justification for a prolonged stay if it is explained in an educational setting that unexpected difficulties might occasionally occur after childbirth and may necessitate a longer stay in the hospital. The need of hand hygiene should also be discussed. A new mother will send her baby around to the ladies to hold and get to know because of their firm belief that they should warmly welcome a new baby into their group. educating new parents about the need of cleaning their hands properly before holding a newborn infant. This can lessen the chance of exposing microorganisms to a newborn with impaired immune system. The parents must instruct the other children to wash their hands before coming in contact with the new infant, especially in homes with many children. Newborn screening is a crucial issue to discuss since it allows for the early detection of congenital abnormalities in babies, whose prompt treatment can avert negative consequences. Most Amish families are unaware of this screening or lack information by their health care provider while others are concerned with beliefs, costs, travel or privacy (Held, Rice, & Kuhl, 2019).
 Being aware of other cultures may, in my opinion as a healthcare professional, make the difference between delivering proper treatment that will be followed and delivering care that may not be due to cultural differences. Other civilizations also exhibit this, not only the Amish. Removing the cultural barrier may foster a more trustworthy connection between the patient and the healthcare professional, ensuring that the patient will receive the proper care and adhere to the plan. 
 
References
 
Held, P.K., Rice, G.M., & Kuhl, A. (2019, November 4). SAGE Journals: Your gateway to world-class research journals. Newborn Screening for Inherited Metabolic Disorders: Early Identification and Long-Term Care for Patients in the Plain Community, Wisconsin, 2011-2017 – Patrice K. Held, Gregory M. Rice, Ashley Kuhl, Nicoletta Drilias, Mei Baker, James Deline, Gretchen Spicer, Claire Sandrock, Christine M. Seroogy, Jessica Scott Schwoerer, 2019. Retrieved from http://journals.sagepub.com/doi/full/10.1177/0033354919878425
 
Purnell, L. (2013). Transcultural health care: A culturally competent approach. (4th ed.). 
Philadelphia: F.A. Davis Co.

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