Managing care in a culturally considerate manner patient profile

Managing Care in a Culturally Considerate Manner

Patient Profile

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 labetalol (Normodyne) and IV furosemide (Lasix) and was admitted to the cardiac unit for observation.

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
• The remainder of physical exam unremarkable

Diagnostic Studies

• ECG reveals left ventricular hypertrophy
• Chest x-ray shows cardiomegaly

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 de-escalate      the situation?
4. How would you respond to the patient’s request      to have all of his family in the room?