Order ID | 53563633773 |
Type | Essay |
Writer Level | Masters |
Style | APA |
Sources/References | 4 |
Perfect Number of Pages to Order | 5-10 Pages |
Challenges of Nursing among the Asian Community
Challenges, Nursing, Asian, Community
Respond to this discussion
The male Asian patient presents with challenges for the nurse. The Asian culture is rich
in tradition and highly patriarchal (Centers for Disease Control and Prevention, 2008).
Many Older Asian patients may blend Western and Eastern medical practices. Holistic
practices are used frequently with an emphasis on restoring a balance (Centers for
Disease Control and Prevention, 2008).
In the Chinese culture the eldest male is the decision maker and the leader of the family
(Centers for Disease Control and Prevention, 2008). The nurse will have to understand
that while the daughter is actively involved with the healthcare of the patient, the patient
will make all the decisions himself.
The patient may have values based on Confucian values (Centers for Disease Control
and Prevention, 2008). The patient may speak in parable to address a topic. Chinese
patients believe that physical illness results in their life being out of balance or a caused
from ancestral interference (Centers for Disease Control and Prevention, 2008).
The questions that should be asked to the patient target health needs while also
addressing tenets of the Asian Culture. The nurse must be able to adapt to the various
demographics and proved culturally competent care (Center for Disease Control and
Prevention, 2020)
The history of hypertension and dietary deficiencies should be addressed within the few
questions. Ball et al (2019) suggest that Chinese patients may need to be educated on
monosodium glutamate and sodium filled soy sauce. Asking the patient if there are any
cultural concerns can make the patient feel more at ease.
Some possible questions to ask the patient are:
What does your diet consist of? Are you following a low sodium diet? Are you using
and herbal supplements or home remedies? Are there any cultural concerns that I
should be aware of? Are you aware of outside help and what services are available?
Do you smoke?
References
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel's
guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO:
Elsevier Mosby.
Center for Disease Control and Prevention. (2020, October 21). Cultural Competence In
Health And Human Services. Retrieved from:
https://npin.cdc.gov/pages/cultural-competence
Centers for Disease Control and Prevention. (2008). Promoting Cultural Sensitivity: A
Practical Guide for Tuberculosis Programs That Provide Services to Persons from
China. Atlanta, GA: U.S. Department of Health and Human Services
RESPOND#2 Pls Respond to this discussion
Agonist-to-Antagonist Spectrum
Medications that are agonists have both an affinity to a receptor and efficacy once they
reach the targeted receptor (Berg & Clark, 2018). This means that an agonist drug
binds to the target receptor and changes the activity of the receptor to elicit a response
(Berg & Clark, 2018).
An Antagonist has an affinity to the target receptor but does not change the receptor's
activity. When an antagonist medication binds to the targeted receptors, they reduce
the number of receptors available for the agonist, thus reducing the overall response of
the receptors (Berg & Clark, 2018). The inhibitory effect of an antagonist can be
overcome by increasing the number of agonists available (Berg & Clark, 2018).
The affinity and efficacy of a medication rely on the drug's structure and the receptor,
which is distinctive to each drug-receptor coupling (Berg & Clark, 2018). Medications
with high affinity and efficacy will elicit a more significant response, while a drug with low
affinity and efficacy will produce a lower response (Berg & Clark, 2018). The amount of
medication and the number of available receptors also contribute to the reaction (Berg &
Clark, 2018).
There are full and partial agonists. A full agonist has high affinity and efficacy, while a
partial agonist has a low affinity or low efficacy or both (Berg & Clark, 2018). This
means that a full agonist produces the greatest response while a partial agonist
produces less than an optimal response (Berg & Clark, 2018). There are also inverse
agonists, which have a negative efficacy that decreases the activity of a targeted
receptor (Berg & Clark, 2018).
G Couple Proteins and Ion Gated Channels
Neurotransmitter receptors are classified as ion gated channels or g-coupled-protein
receptors. Ion gated channels respond rapidly. An ion flux runs through the channels,
which quickly changes the membrane potential and neuronal activity (Camprodon &
Roffman, 2016).
The g-coupled-protein receptors respond slower (Camprodon & Roffman, 2016). They
use a secondary messenger system that involves multi-enzyme cascades (Camprodon
& Roffman, 2016). The secondary messenger system produces modifications such as
protein phosphorylation which turns on or off the signal at specific branch points
(Camprodon & Roffman, 2016).
The Role of Epigenetics in Pharmacologic Action
Epigenetic changes do not change DNA but modify how DNA regulates whether a gene
is turned on or off (medlineplus.gov, 2021). These changes vary among individuals and
are influenced by personal behavior such as diet and environmental factors such as
pollutants (medlineplus.gov, 2021). It is important to note that these changes are
reversible (medlineplus.gov, 2021).
Epigenetic modifications affect DNA methylation, histone modifications, chromatin
remodeling, and microRNA's, which act as regulatory molecules and affect
homeostasis, and disease processes (Rasool et al., 2015). The modifications in these
mechanisms can lead to various disease states, including neurodegenerative diseases
such as schizophrenia (Rasool et al., 2015). If the basis of the disease is of epigenetic
origin, traditional drug therapies may not be effective (Rasool et al., 2015).
Pharmacoepigenomics provides insights on how medications can modulate the
epigenome and explain the individual variations in drug effectiveness and adverse side
effects ( Swathy & Moinak, 2017). DNA methylation can cause impairment of
neurotransmitter systems resulting in schizophrenia (Swathy & Moinak, 2017). The
epigenetic changes in miRNAs also contribute to schizophrenia (Swathy & Moinak,
2017). Due to the reversibility of these epigenetic defects, it could be possible to
reverse these defects with drug therapies (Swathy & Moinak, 2017).
Studies have shown that typical antipsychotics such as chlorpromazine and haloperidol
can induce epigenetic changes (Swathy & Moinak, 2017). The question is, Are the
epigenetic changes from the antipsychotic medication helping reverse the epigenetic
defects or enhance them?
References
Berg, K. A., & Clarke, W. P. (2018). Making Sense of Pharmacology: Inverse Agonism
and Functional Selectivity. The international journal of neuropsychopharmacology,
21(10), 962–977. https://doi.org/10.1093/ijnp/pyy071
Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating
pathophysiology into clinical case formulation. In T. A. Stern, M. Favo, T. E. Wilens, & J.
F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and
neurotherapeutics (pp. 1–19). Elsevier
Medlineplus.gov (2021). What is epigenetics? U.S. national library of
medicine. https://medlineplus.gov/genetics/understanding/howgeneswork/epigenome/
Rasool, M., Malik, A., Naseer, M. I., Manan, A., Ansari, S., Begum, I., Qazi, M. H.,
Pushparaj, P., Abuzenadah, A. M., Al-Qahtani, M. H., Kamal, M. A., & Gan, S. (2015).
The role of epigenetics in personalized medicine: challenges and opportunities. BMC
medical genomics, 8 Suppl 1(Suppl 1), S5. https://doi.org/10.1186/1755-8794-8-S1-S5
Swathy, B., & Banerjee, M. (2017). Understanding epigenetics of schizophrenia in the
backdrop of its antipsychotic drug therapy. Epigenomics, 9(5), 721-
721–736. https://doi.org.dx.doi.org.ezp.waldenulibrary.org/10.2217/epi-2016-0106
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