NURS 6512 wk 2 Discussion
Scenario: Mono Nu, a 44 year-old Filipino patient comes to the clinic today to have his “blood thinner†labs drawn since he started them two weeks ago. Upon assessing the labs the nurse practitioner notes that he is still out of range. When assessing the patients compliance both stated that he had been taking them just as prescribed. He has been doing well and eating a diet rich in fish and tofu. He doesn’t understand why his medications are not working.
Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
References:
Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2023). Seidel’s guide to physical examination: An interprofessional approach (10th ed.). St. Louis, MO: Elsevier Mosby.
Chapter 1, “Cultural Competencyâ€
This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.
Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby.
Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center.
Chapter 2, “Evidenced-Based Clinical Practice Guidelinesâ€
Centers for Disease Control and Prevention. (2020, October 21). Cultural competence in health and human servicesLinks to an external site.. Retrieved from https://npin.cdc.gov/pages/cultural-competence
This website discusses cultural competence as defined by the Centers for Disease Control and Prevention (CDC). Understanding the difference between cultural competence, awareness, and sensitivity can be obtained on this website.
United States Department of Human & Health Services. Office of Minority Health. (n.d.). A physician’s practical guide to culturally competent careLinks to an external site.. Retrieved June 10, 2019, from https://cccm.thinkculturalhealth.hhs.gov/
From the Office of Minority Health, this website offers CME and CEU credit and equips healthcare professionals with awareness, knowledge, and skills to better treat the increasingly diverse U.S. population they serve.
Coleman, D. E. (2019). Evidence based nursing practice: The challenges of health care and cultural diversityLinks to an external site.. Journal of Hospital Librarianship, 19(4), 330–338. https://doi.org/10.1080/15323269.2019.1661734
Young, S., & Guo, K. L. (2016). Cultural diversity trainingLinks
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6512 Week 2 Discussion Post
Several factors influence treatment for an individual patient. The client in the case study has been prescribed blood thinners with anticoagulant effects (Thachil, 2021). Thus, blood thinners are used to prevent the formation of blood clots (Thachil, 2021). However, despite adhering to the prescriptions, the client’s blood thinners are ineffective in improving his condition. Studies show that food products rich in vitamin K affect blood thinners’ working mechanism since this vitamin is essential for blood clotting (Steffel et al., 2018). A person’s diet’s high amount of vitamin K increases blood clot formation risk and makes blood thinners ineffective in preventing blood clotting. Additionally, consuming food rich in omega-3 fatty acids and saturated fats lowers blood thinners’ efficacy. The client’s diet consists of fish and tofu with a high concentration of vitamin K and omega-3 fatty acids. Therefore, the patient’s diet significantly contributes to his blood thinners’ ineffectiveness.
Nurse practitioners should be sensitive to the client’s cultural beliefs and lifestyles when interacting with him during the clinical interview. Studies show that NPs’ cross-cultural communication competencies determine health outcomes when dealing with patients from different cultures (Vella et al., 2022). Therefore, the client should appreciate the client’s diet as a way of respecting his culture. Additionally, the NP should educate the client on the benefits of changing his diet and health while protecting his cultural values and lifestyle. Specifically, the NP should inform the client that a diet with a low concentration of vitamin K and omega-3 fatty acids will enhance the efficacy of his blood thinners.
The following questions enable practitioners to build the client’s health history and detect health risks.
- Do you have a history of cardiovascular diseases (CVDs) or other chronic illnesses?
- Do you have a family history of CVD?
- Are you taking other medications?
- Do you exercise regularly? How often?
- Have you experienced any adverse drug reactions related to blood thinners?
- Would you like the current treatment therapy to be altered?
References
Steffel, J., Verhamme, P., Potpara, T. S., Albaladejo, P., Antz, M., Desteghe, L., … & Heidbüchel, H. (2018). The 2018 European Heart Rhythm Association Practical Guide on using non-vitamin K antagonist oral anticoagulants in patients with atrial fibrillation. European Heart Journal, 39(16), 1330-1393.
Thachil, J. (2021). You can bleed, you are on blood thinners! Journal of Thrombosis and Haemostasis, 19(5), 1379-1380.
Vella, E., White, V. M., & Livingston, P. (2022). Does cultural competence training for health professionals impact culturally and linguistically diverse patient outcomes? A systematic review of the literature. Nurse Education Today, 105500.