What Should the Nurse Do?
Maria, a thirty-year-old female, comes to the primary care clinic reporting persistent fatigue, headaches, and difficulty sleeping. Maria reveals that she recently lost her job, which has added financial strain to her life. She expresses a preference for alternative healing practices and mentions consulting a traditional healer in her community for spiritual guidance. Maria has a history of hypertension and has been managing her blood pressure with medication. She is generally healthy but notes increased stress levels recently. Maria prefers natural remedies and has sought guidance from traditional healers in the past for spiritual and emotional well-being. Vital signs show an elevated blood pressure of 140/90 mmHg, a heart rate of 82 bpm, a respiratory rate of 18 breaths per minute, and a temperature of 98.6°F (37°C).
1
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What cultural cues or verbal/nonverbal expressions from Maria might reveal her beliefs about health and illness? How can recognizing these cues help tailor the nursing approach to her cultural context?
2
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How can the nurse proactively address unconscious bias when interacting with Maria, considering her cultural background? What strategies can be employed to ensure culturally competent and unbiased care?
Dolores, a forty-five-year-old female, presents at the community health clinic for a routine checkup. She recently immigrated from Mexico and speaks limited English. Dolores reports feeling fatigued and experiencing occasional headaches. Her medical history includes hypertension and type 2 diabetes, both well-managed with medications. During the assessment, her blood pressure is elevated (150/90 mmHg), and she exhibits signs of distress when trying to communicate her symptoms in English.
3
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What immediate actions can be taken to address Dolores's elevated blood pressure and ensure her comfort in the health-care setting?
4
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What culturally sensitive strategies can be employed to improve communication with Dolores and gather a more accurate medical history?
Tan, a sixty-year-old Vietnamese male, presents at the hospital emergency department with complaints of severe abdominal pain and difficulty breathing. He communicates primarily in Vietnamese, and his daughter, who is bilingual, serves as his interpreter. Tan has a history of chronic obstructive pulmonary disease (COPD) and recently underwent abdominal surgery for a gastrointestinal issue. Vital signs reveal an elevated respiratory rate and decreased oxygen saturation.
5
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What cultural cues did you observe in Tan’s communication style, and how might these cues impact the nursing care provided?
6
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How can you involve Tan’s daughter in a way that respects cultural practices and enhances communication to ensure the provision of comprehensive care?
7
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How will you assess the effectiveness of the interventions implemented to address Tan’s symptoms and involve his daughter in the care process?
8
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Francine, a new graduate nurse, was offered a full-time position on the dialysis floor of an acute care hospital. The new hire process includes a six-week training program that allows the new hire to observe and work closely with a seasoned employee. On Francine’s first shift, she realizes that she has been assigned to shadow Muhammad. Muhammad has been an employee for over ten years and was awarded Nurse of the Year two years ago. Francine notices that with each client interaction, he educates the client on both conventional Western medical treatments and traditional healing remedies. Francine is very confused; she thought that Western medicine was superior to that of traditional healing practices. She decides to confront Muhammad.
If you were Muhammad, how would you explain to Francine that her thought process is impacting diversity and inclusion?
Loretta, a seventy-year-old female, arrives at the outpatient clinic with complaints of persistent joint pain and difficulty moving. Loretta has a medical history of rheumatoid arthritis and hypertension, well-controlled with medications. During the assessment, she appears hesitant to share details about her symptoms and seems uncomfortable. Vital signs are all within the normal range: blood pressure of 120/80mm Hg, heart rate of 80 beats per minute, respiratory rate of 16 breaths per minutes, and a temperature of 98.8°F (37°C).
9
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How might cultural factors influence Loretta’s communication style and her willingness to disclose information about her joint pain?
10
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What steps can be taken to foster an inclusive and culturally sensitive environment during the assessment and treatment of Loretta’s joint pain?
11
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How can you modify your communication approach to address potential barriers and ensure Loretta feels comfortable sharing information about her symptoms?