Question

Discussions Calendar R.M., a 68-year-old male from Fiji, came into the emergency department with complaints of increased headache, dizziness, and blurred vision. His blood pressure in the emergency room was 201/120. He received IV propranolol and IV furosemide and was admitted to the cardiac unit for observation. Roster Subjective Data • States "I don't feel well, but I don't want all this medicine. I heard that garlic could help my high blood pressure and make it all better • Asks "I want all of my family with me in my room-can't my family all come in? • Wife is at bedside; several family members are in the hall. Objective Data Physical Examination • Temperature: 98.3 F; respirations: 22: pulse: 88: blood pressure: 210/120 • Oxygen saturation: 95% on room air • Height 5'10" 198 lb • Remainder of physical exam unremarkable Diagnostic Studies • ECG reveals left ventricular hypertrophy • Chest x-ray shows cardiomegaly Discussion Questions 1. What further cultural assessment would you obtain? 2. How would you address his statement about the use of garlic? 3. While attempting to draw R.M's lab work, two children, his sister, several grandchildren, nieces, and nephews were all asking for information. Culturally speaking, list three ways to deescalate the situation? 4. How would you respond to the patient's request to have all of his family in the room? Case Progression Two days after the health care provider initiated medication therapy, R.M's blood pressure has decreased to 148/90. He is being discharged on metoprolol 100 mg orally twice daily and furosemide 80 mg orally daily, with instructions to follow a low-salt diet. 5. What resources might be useful to you in providing discharge instructions? 6.Outline specific patient teaching points for a low-salt diet. including culturally appropriate foods 7. If you were R.M's nurse, how would you describe yourself so that you provide care in a culturally sensitive manner You can edit the discussion topic until a comment is posted

please add references if used. Need answer asap thansk

Answer 1

1.Some of the other cultural assessment which could be obtained from the patient are

• Place of origin, residence ,believes and practices (this gives a clear image from the demographic and geographical location of a patient what they think and follow in regards to health and illness
• Linguistic assessment:whether the patient is comfortable in the universal language or prefers a native language (this can develop therapeutic relationships and rapport between patient and healthcare professionals)
• What type of treatment he prefers usually when falling sick(thus enables to know his practices of what he does in case of falling sick by following traditional or western treatment)
• His relationship with the family and the decision makers(enables to identify who makes the decisionin regards to care of the patient)

2.His statement in regards to garlic can be answered the following way

• Garlic is good for health when taken on daily basis as it can prevent the formation of plagues in the arteries and block it, causing raised blood pressure and other heart problems but it cannot act immediately to reduce a very high blood pressure.So an alternative is needed to act immediately which can bring down the very high elevated blood pressure now and prevent complications

3.Some of the ways to de escalate the situation are

• Explain the procedure and its need for the patient
• For diagnostic purpose
• Support them psychologically and reassure them that no harm will be caused to the patient by doing procedure
• Inculcate professional confidence that the procedure are carried put on the best interest of the patient to save him and prevent any major complications

4.The patient has to be explained about

• the hospital's rules and regulations in regards to the visitors
• it is one way of the infection control practice that is by restricting too many relatives (for patient as well as relatives)
• Childrens are not allowed because they are very tender and so their immunity against infection. This can put the child under greater risk of infection and making them sick.