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Paloma Hernandez, a 26-year-old Spanish-speaking patient, presents with worsenin
Paloma Hernandez, a 26-year-old Spanish-speaking patient, presents with worsening abdominal pain for two consecutive days. It’s essential to consider various factors that may influence her health, including socioeconomic, spiritual, lifestyle, and cultural aspects.
Socioeconomic Factors:
Paloma’s socioeconomic status may impact her access to healthcare, understanding of medical information, and ability to comply with prescribed treatments. Assess her insurance coverage, employment status, and any financial barriers to obtaining healthcare.
Language and Cultural Factors:
Since Paloma primarily speaks Spanish, language can be a significant barrier to effective communication. Consider the potential for misinterpretation, especially if relying on family members for translation. Ensure the use of professional interpreters or bilingual healthcare providers to enhance accurate communication (Namazi et al., 2019).
Cultural Health Beliefs:
Explore Paloma’s cultural beliefs regarding health and illness. Some patients may prefer traditional or alternative medicine, and understanding these preferences can help tailor the treatment plan. Consider asking about any cultural practices related to healthcare (Shahin et al., 2019).
Family Dynamics:
Given that Paloma’s daughter has been involved in translation during previous visits, assess the family’s role in decision-making and support. Inquire about the family’s understanding of Paloma’s condition and their involvement in her care (Wang & Geng, 2019).
Lifestyle Factors:
Explore Paloma’s daily habits, including diet, exercise, and stress levels. Dietary habits may contribute to her abdominal pain, and understanding her lifestyle can help tailor interventions and recommendations.
Spiritual Factors:
Inquire about Paloma’s spiritual or religious beliefs. Some individuals may derive comfort and support from their faith, and understanding this aspect can guide discussions about coping mechanisms and support systems.
Sensitive questions to build a comprehensive health history and assess health risks:
Can you describe the nature of your abdominal pain?
Understanding the characteristics of the pain can provide insights into potential causes.
Have you experienced any changes in your diet or eating habits recently?
Dietary factors can contribute to abdominal pain, and this question helps explore lifestyle-related causes.
Can you tell me about any cultural or home remedies you’ve tried for your symptoms?
This question helps in understanding the patient’s cultural health practices and beliefs.
How would you describe your stress levels recently?
Stress can exacerbate abdominal pain, and assessing stress levels is crucial for a holistic understanding of the patient’s health.
Are there any specific concerns or fears you have regarding your health?
This question allows the patient to express personal worries and helps in addressing any emotional or psychological aspects of their health.
Being sensitive to Paloma’s cultural background, involving professional interpreters, and addressing potential socioeconomic barriers will contribute to effective communication and the development of a culturally competent care plan.
References:
Namazi, M., Sadeghi, R., & Behboodi Moghadam, Z. (2019). Social Determinants of Health in Menopause: An Integrative Review. International journal of women’s health, 11, 637–647. https://doi.org/10.2147/IJWH.S228594Links to an external site.
Shahin, W., Kennedy, G. A., & Stupans, I. (2019). The impact of personal and cultural beliefs on medication adherence of patients with chronic illnesses: a systematic review. Patient preference and adherence, 13, 1019–1035. https://doi.org/10.2147/PPA.S212046Links to an external site.
Wang, J., & Geng, L. (2019). Effects of Socioeconomic Status on Physical and Psychological Health: Lifestyle as a Mediator. International journal of environmental research and public health, 16(2), 281. https://doi.org/10.3390/ijerph16020281Links to an external site.
SECOND POST Week 2 Discussion Post
It is imperative for healthcare practitioners, as pointed by Kim et al. (2019), to consider various factors including sexual orientation, specific lifestyles, culture, as well as beliefs when performing health assessment. Such factors, Kim et al. (2019) adds, can influence care givers’ perception regarding the patient’s health. Throughout this discussion, I will assess the impact of cultural and diversity awareness on health assessment by focusing on the case of Mono, a 44 y/o Filipino patient, whose blood thinner labs are out of range, despite the patient’s medication adherence.
While interacting with the patients to obtain the information necessary to assess their health necessities, Kim et al. (2019) notes that, it’s imperative for the care givers to practice cultural humility as well as cultural competency. Tang et al. (2020) defines blood thinners as anticoagulant medication that are used to reduce blood clots. Blood thinners are categorized into two types, antiplatelets and anticoagulants. Antiplatelets, for instance dipyridamole and aspirin, as pointed by Komiyama and Hasegawa (2020), target the platelets and prevent them from forming lumps as well as preventing them from sticking to the walls of the blood vessels. On the other hand, anticoagulants, according to Komiyama and Hasegawa (2020), are medications that are used to prevent blood clots. These drugs, for instance Enoxaparin and Heparin, are often used and can be taken as intravenous infusion or as a pill. As Rivera-Caravaca et al. (2021) notes, care givers cannot use antiplatelets and anticoagulants together to prevent blood clot formation.
Some food products that are rich in Vitamin K, as Rivera-Caravaca et al. (2021) explains, typically impact the working of blood thinners, since Vitamin K is a vital blood clotting factor. Accordingly, significant Vitamin K quantities typically increase the risk of formation of heavy blood clot, which consequently hinder the action of blood thinners. Rivera-Caravaca et al. (2021) mentions omega-3 fatty acids and saturated fats, which are also present in some food, as the other factors that interfere with the working of blood thinner and hence, reduce its effectiveness. In this particular case, as the care giver, it is imperative to remain sensitive to the patient’s culture as well as making sure that I remain open to preferred differences and various views in lifestyles.
The patient in this case scenario has been prescribed a course of blood thinners. The patient however, shows no improvement despite taking the prescription as directed. The patient’s culture and lifestyle preferences play a major role in the patient’s current condition. The patient has been consuming foods such as tofu and fish, both of which are rich in Vitamin K and omega-3 fatty acids. Accordingly, the blood thinners aren’t working on the patient. As Rivera-Caravaca et al. (2021) notes, some omega-3 fatty acids and saturated fats typically make blood thinners less effective and instead, increase the risk of blood clot formation.
When communicating with the patient, the care giver should encourage the patient to change their diet as quickly as possible, while protecting the patient’s ethics. The healthcare practitioner should take the decision of the patient to stop taking the blood thinner medicine into consideration and should discuss this with the patient. Given the patient has the right to refuse any recommended treatment plan at any time, the healthcare practitioner must respect this choice and provide an alternative to medication. It’s important for the care giver to evaluate the specific cultural, lifestyle, and socioeconomic factors that are associated with the patient so as to determine their beliefs on medical care, including medications and vaccinations, their view on their current situation, as well as their support outside and inside of their home. Care givers, as Tang et al. (2020) mentions, should provide a safe environment that is rich in community resources and support as this will ensure that they do their part in an already unsteady as well as possibly unfamiliar environment for the patient.
Considering this scenario, factors, and risks identified and discussed, the questions selected will focus on gathering patient-centered information in order to address the medical needs of the patient while also carefully allowing for her diversity. The targeted questions will include:
Have you been taking your “blood thinners” as directed?
How do you feel?
Did you experience any side effects as a result of the medication?
Do you have frequent nosebleeds or bleeding from cuts from razors when shaving?
Do you have any vitamin K rich foods such as kale, and spinach?
How often do you exercise?
How often do you eat tofu or fish?
References
Kim, S, Lee, H., Lee, Y., and Lee, J. (2019). Physical examination competence as a predictor of diagnostic reasoning among new advanced practice nurse students: a cross-sectional study. Contemporary Nurse, 55(4-5), 360-368. https://doi.org/10.1080/10376178.2019.1670707Links to an external site.
Komiyama, M., and Hasegawa, K. (2020). Anticoagulant Therapy for Patients with Coronavirus Disease 2019: Urgent Need for Enhanced Awareness. European cardiology, 15, e58. https://doi.org/10.15420/ecr.2020.24Links to an external site.
Rivera-Caravaca, J.M., Harrison, S.L., and Buckley, B.J.R. (2021). Efficacy and safety of direct-acting oral anticoagulants compared to vitamin K antagonists in COVID-19 outpatients with cardiometabolic diseases. Cardiovasc Diabetol 20, 176. https://doi.org/10.1186/s12933-021-01368-6Links to an external site.
Tang, N., Bai, H., Chen, X., Gong, J., Li, D., & Sun, Z. (2020). Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy. Journal of thrombosis and haemostasis: JTH, 18(5), 1094–1099. https://doi.org/10.1111/jth.14817Links to an external s
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