NR 391 Week 5 Discussion Question: Transcultural Perspectives Across Lifespan
Select and read ONE of the chapters of particular interest to you listed in
... [Show More] Assignments under Required Readings. Discuss what information you should obtain to develop and implement culturally appropriate care plans for an individual of this group. A brief case study or exemplar may be one way to present your information. For example, how would you provide culturally- appropriate care for an elderly female who is Muslim and presents to the Emergency Department with chest pain?
The chapter that I selected to read was chapter 8, Transcultural Perspectives in the Nursing Care of Older Adults as this chapter discusses the care that is required for the older population. Currently, in a few of our clinics, the majority of our census is older adults. A few of our clinics are located in lower income, poor economic areas. I have found that these patients seem to be much sicker than patients that go to our other clinics that are located in a more enriched community. Not only are these patients’ dialysis patients, but almost all of them having numerous co-morbidities. The availability of resources in the community will affect any older client’s options for care and the individual’s movement on a continuum of care (Andrews & Boyle, 2016, p. 214). It is important as a nurse that we are culturally competent so that the care plan that is developed adapts to the patients cultural needs. In order for me to individualize the patients care, I would need to understand the patient’s values, practices and cultural beliefs. I will also need to ascertain the patients presenting problem and possible cultural influences it may have. Having this information will assist me, the patient and the interdisciplinary team attaining positive results.
Betty is a 40 year old woman of Hispanic descent who presented to the Dialysis clinic today with her father for her dialysis treatment. Upon arrival, patient was showing signs of pain/discomfort in her facial expressions and body language. Her chief complaint was a headache, shortness of breath and bi-lateral leg and ankle edema. Her blood pressure was 174/95, pulse 80, lungs clear, +3 leg and ankle edema and was 3 kilograms over her dry weight. The patient has a history of diabetes Mellitus type 2, impaired renal function and hypertension. Her family history consists of diabetes, hypertension, coronary heart disease and cancer. She has a smoking history of 15 years and just recently quit tobacco use 6 months ago.
During the assessment the nurse directs the questions to the father as he is considered the head of the family and makes all the decisions. The nurse inquires if he was aware of when her headache started. Betty waits for her father to respond and then she adds to the conversation that she has had the headache for two days. The nurse asked the father if Betty has been taking her blood pressure medications. It is found that the patient ran out of her blood pressure medications and has not obtained the refill. Instead, the family decided to utilize herbal medicine instead. The nurse continues the questions which are focused on her food and liquid intake. The nurse asked the father if she was eating and drinking more than usual. The father stated he was unsure and refers to Betty to respond. During the discussion with Betty and her father it was found that they have been attending a two day festival.
It will be important to educate and raise the patient’s awareness regarding the importance of taking blood pressure medications and to follow a renal diet and fluid restriction. During this educational session the nurse will be standing close to the patient and her father as the details of the educational session are reviewed. Because people stand closer to each other in most Latino cultures, physical proximity is also perceived as being more personable (Juckett, 2013). This allows the patient and the father to be comfortable with the nurse and is encouraged to ask questions regarding the subjects discussed.
It is important for the nurse to obtain data regarding the patients presenting problem and possible cultural influences. In this particular case study, the patient’s culture had an impact on her health as she had a festival that she had celebrated with her family and did not follow her normal renal diet or fluid intake limit. It was also discovered that the patient switch over to an herbal remedy for her hypertension without consulting with her physician. Knowing about the patients culture is an important part of the care we give our patients.
Andrews, M. M., & Boyle, J. S. (2016). Transcultural concepts in nursing care (7th ed.). Philadelphia: PA. Wolters Kluwer.
Juckett, G, (2013). Caring for Latino Patient: American Family Physician, Jan 1:87 (1) 48-54 [Show Less]