course material

1. 100 word positive post with three references due 12/09/20 at 11:00 am
MainpostCase study:JC, an at-risk 86-year-old Asian male is physically and financially
dependent on his daughter, a single mother who has little time or money for her father’s
health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD),
b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec
20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual
exam and states “I came for my annual physical exam, but do not want to be a burden to my
daughter.”Discussion: Diversity and Health AssessmentsIntroduction Health care
providers should exhibit knowledge of population diversity and treat all patients with
respect regardless of their culture and belief system. This is essential in understanding
patient’s lifestyle, and behavior which may affect their health care. Accepting patient’s
culture in a nonjudgmental manner creates a unique relationship between the patient and
the healthcare provider. Therefore, APRN’s should be cognizant of patient’s culture, beliefs,
lifestyle, and socioeconomic status as it relates to healthcare. A culturally competent
healthcare provider accustoms his/herself to the exclusive needs of patients with cultures
that are different from his or her own. Being accustomed to the belief’s and values of a
patient lays the foundation for a trusting patient-provider relationship (Ball et al.,
2019).Socioeconomic, Spiritual, Lifestyle, and Cultural Factors Associated with the
Patient The case study presents an 86-year-old Asian male that is physically and
financially dependent on his daughter who is a single mother with little money to care for
the patient’s healthcare needs. Understanding the Asian culture is relevant to providing
care to this elderly patient. I will verify patient’s preferred language, ask about patient’s
preference with a healthcare provider regarding race or ethnicity, gender, and age. Ensuring
respect for this patient despite his financial and physical dependency will encourage a
trusting relationship between the patient and the health care provider. Asian culture is
known to teach respect for parents and family is a priority over self. Additionally, in Asian
culture adult children are required to make financial, physical, and social sacrifices for their
parents that are aging (Miyawaki, 2015). As a healthcare provider, I will welcome this
patient, show respect by avoiding eye contact as some Asian countries consider making eye
contact as rude. Maintaining eye contact is not done with individuals of East Asian cultural
backgrounds. Also, the Japanese culture, teaches against maintaining eye contact with
others as it is believed to disrespectful (Uono & Hietanen, 2015). I will make the
patient understand that I am familiar with culture of adult children caring for their aged
parents. I will explain to the patient that he should not consider himself a burden to his

2. daughter as the daughter is maintaining the requirement of their culture. This will
encourage a relaxing environment that will enable the patient to feel accepted and ready to
relate with the health care provider. Respect for the patient’s spiritual and religious belief is
also vital. The patient should be asked about any spiritual belief that may affect his
healthcare when sick or dying. Also, the APRN should inquire about spiritual or religious
groups that the patient may belong that could be supportive in providing some assistance to
his healthcare. Spirituality and faith help Asian-Americans manage the turmoil of adapting
to a new country, by providing a safe environment where immigrants can socialize and be of
assistance to one another (Lee & Eun-Kyoung, 2017).Sensitive Issues I will inquire if
the patient is compliant with taking his medications as prescribed and access for the use of
over the counter, herbal, or traditional medications. This is especially important as the
patient takes lisinopril 10mg QD, prilosec 20mg QD, B12 injections monthly, and cipro
100mg QD. To avoid drug interactions, it is important to ask about additional medications
that the patient may be taking. Examples of Chinese herbal medicine include astragalus,
ginger, licorice, panax ginseng, and schizandra. Traditional medicine is used across Asian
societies for daily health maintenance, and treatment of certain medical conditions. Also, in
China, Japan, and Korea, traditional medicine has become almost or equivalent to
conventional medicine (Mu et al., 2020). Furthermore, the functionality of the patient
will be accessed to determine the level of dependency on the daughter. Activities of daily
living like feeding, bathing, wearing clothes, grooming will be accessed. Asking about
financial assistance with purchasing medications, proper feeding and housing is vital to
ensure the overall needs of the patient are catered for. Due to socioeconomic status and
financial constraint of the patient and his caregiver (daughter), I will recommend the help of
a social worker to provide the services of a home health nurse and home health nursing
assistant. This will ensure that patients’ needs are met, and the patient takes his
medications in a timely manner thereby relieving the responsibility on the patient’s
daughter. In addition, the services of physical and occupational therapy will be sorted to
help strengthen any weak muscles or extremities to ensure some dependence with physical
activities. I will explain to the patient that my recommendation for a social worker is to help
him meet his daily needs and not to disrespect him. This will maintain patients pride and
ego.Targeted questions to assess health risksDo you have health insurance, or do you pay
out of pocket for your medications?Do you take your medications as prescribed?Do you
check your blood pressure at home?Would you want to receive help with feeding, clothing,
bathing, or moving around your home?Do you experience any pain or difficulty in
urinating?In the las two weeks have you experienced sleep disturbances, decreased
appetite, feeling of sadness, hopelessness, or guilt, thoughts of committing suicide and poor
concentration.In what way do you think you are a burden to your daughter?How often do
you eat and what type of food do you eat?Do you take any herbal, traditional or over the
counter medications? The questions above are used to access the patient’s access to
his medications and if he is compliant with taking his medications. The need to access for
patient’s knowledge about checking his blood pressure due to his history of hypertension.
Accessing patient’s willingness to receive outside resources like home health assistance is
essential to providing the needed healthcare. Question about urinating accesses the history

3. of prostatitis. Accessing for depression in the elderly is crucial to determine the patient’s
mental state. Elderly Asian immigrants in the US are at risk of depression (Seungah & Eun-
Kyoung, 2017). Evaluating the patients feeding habits and if the patient takes any
medication outside his prescribed medications determines the patient’s health
risk.ReferencesBall, J., Dains, J., Flynn, J., Solomon, B., Stewart, R. (2019). Seidel’s guide to
physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier
Mosby.Lee, R., Eun-Kyoung, O. (2017). Faith, spirituality, and values among Asian-American
older adults: An exploratory factor analysis of the multidimensional measures of religion
and spirituality. Mental Health, Religion & Culture, 19 (8), 920–
931. doi:10.1080/13674676.2017.1290593Miyawaki, C. (2015). A review of ethnicity,
culture, and acculturation among Asian caregivers of older adults. SAGE Journals.
https://doi.org/10.1177/2158244014566365 https://journals.sagepub.com/doi/full/10.1
177/2158244014566365Ryu, S., & Lee, O. E.-K. (2016). Faith, spirituality, and values among
Asian-American older adults: An exploratory factor analysis of the multidimensional
measures of religion and spirituality. Mental Health, Religion & Culture, 19 (8), 920-931.
https://doi- org.ezp.waldenulibrary.org/10.1080/13674676.2017.1290593Uono, S.,
Hietanen, J. (2015). Eye contact perception in the West and East: A cross-cultural study. Plus
One. https://doi.org/10.1371/journal.pone.0118094Xin, B., Mu, S., Tan, T., Yeung, A., Gu, D.,
Feng, Q. (2020). Belief in and use of traditional Chinese medicine in Shanghai older adults:
A cross-sectional study. BMC Complement Medicine and Therapies 20 (128).
https://doi.org/10.1186/s12906-020-02910-
x. https://bmccomplementmedtherapies.biomedcentral.com/articles/10.1186/s12906-
020- 02910-x