What Should the Nurse Do?
Gabriela, a 32-year-old female, presents to the community health clinic with her partner for a routine prenatal checkup. Gabriela, who identifies as a lesbian, is in her 24th week of pregnancy and is excited about expanding her family. She reports mild nausea and occasional headaches but otherwise feels well. Her partner, Caitlin, actively participates in the visit, expressing their joint commitment to a healthy pregnancy. Gabriela has a history of hypothyroidism, controlled with medication, and has undergone fertility treatments to achieve this pregnancy. She is eager to discuss any potential challenges that may arise due to her Hispanic background and is curious about how the health-care team will address the specific needs of their LGBTQIA+ family.
1
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How can the nurse involve both Gabriela and Caitlin in prenatal care to ensure a family-centered approach?
2
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What potential challenges might arise in delivering culturally competent care to Gabriela's family, and how can these challenges be mitigated?
3
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How might historical trauma impact the health-care-seeking behavior of LGBTQIA+ persons, and what steps can nurses take to mitigate the effects of such trauma?
Anh, a 28-year-old female, arrives at the urgent care clinic, seeking assistance for recurring abdominal pain. Anh, of Vietnamese descent, recently immigrated to the United States. She reports symptoms of bloating, discomfort, and occasional diarrhea. Her medical history indicates a previously undiagnosed lactose intolerance. While her physical symptoms are addressed through dietary adjustments, it becomes apparent during the conversation that Anh is experiencing cultural challenges in navigating the U.S. health-care system. She expresses hesitancy in sharing personal information and discussing her health openly due to cultural differences in communication norms. Vital signs are stable, and the psychiatric history is unremarkable.
4
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How can the nurse apply the Cultural Care Theory in providing care for Anh, considering her Vietnamese background and the challenges she faces in navigating the U.S. health-care system?
5
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Using the Transcultural Assessment Model, identify two aspects (other than communication) that the nurse should consider when assessing Anh's cultural needs to ensure culturally competent care.
6
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How might the nurse address Anh's hesitancy in sharing personal information and discussing her health openly, considering the principles of transcultural nursing and culturally competent care?
7
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How can the Four Cs of Culture model be applied in assessing Anh's health concerns. Why is it important for the nurse to explore what Anh considers to be the problem and how she is coping with it?
Camila, a 22-year-old pregnant female, seeks care at the community health clinic for her first prenatal visit. Camila, of Guatemalan descent, is facing various challenges as a person who is under served within the community. She reports symptoms of fatigue, inadequate nutrition, and concerns about the impact of her unstable living situation on her pregnancy. Camila has a limited support system because her husband is frequently absent due to work commitments. She also lacks familial assistance. Her medical history reveals a lack of consistent health-care access and limited prenatal care during previous pregnancies. Vital signs are within normal limits, and the psychiatric history indicates heightened stress and anxiety related to her living circumstances.
8
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In Camila's case, how might her limited support system and unstable living situation contribute to her vulnerability as a person seeking prenatal care, and what steps can the nurse take to address these challenges?
9
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Considering Camila's situation, identify two specific health risk factors that may impact her pregnancy and discuss potential interventions to mitigate these risks.
10
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How do social determinants of health such as economic stability and health-care access contribute to health disparities in certain populations like Camila’s, and how can nurses address these determinants in their care?
11
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Discuss how racial disparities, as highlighted in the example of Black Americans, can impact the experiences of families who are under served within the health-care system and describe what actions nurses can take to address these disparities.
12
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In the case of LGBTQIA+ families, what unique health risk factors during pregnancy and birth might be present, and how can nurses provide supportive care that addresses these factors?