60-Year-Old Korean National's Visit to Medical Center: The Need for an Interpreter

The patient who was brought at the medical center for diagnosis was a sixty-year-old Korean national and a neighbor and close friend. The nurse welcomed the patient but discovered that an interpreter was essential due to the language barrier between them (Shen, 2015). A medical interpreter was called to pass information from the nurse to the patient and vice-versa in a way that the latter understood everything that was going on. The nurse was also keen on the patient's non-verbal cues like facial expressions, eye contact, and his vocal tones (Kienzler, Spence, & Wenzel, 2019). The medical practitioner practiced active listening by taking time to listen to the patient after asking every question. The goal was to ensure that the patient felt heard and validated since he was in a vulnerable position. The room in which the patient was interviewed was comfortable with moderate lighting and temperature. The nurse also used therapeutic communication to prompt the patient to disclose their private health information (Mixer, Lindley, Wallace, Fornehed, & Wool, 2015). A close-ended questionnaire was used where the patient was required to give a yes/no answer to the questions asked. The questions were asked in a manner that ensured that the patient was comfortable by allowing him to express his views freely (Shen, 2015). The direct questions were asked to fil any missing information like the patient's names, age, and nationality, among others.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Save 25%

Impaired Physical Mobility

Nursing Diagnosis

The patient has impaired physical mobility that was caused by a surgical incision. Impaired physical mobility was evidenced by the patient's slowed and limited movement. The patients felt pain while walking and reported discomfort upon the slightest movement.

Short-Term and Long-Term Goals

The short-term goal is that after eight hours, the patient will be able to show some techniques that will enable him to resume normal activities with comfort. He should also be able to walk at a regular pace while feeling minimal or no pain in his limbs. The long-term goal is that the patient should be able to walk for at least fifty feet without requiring the support of any equipment or person and without feeling any pain. Secondly, the patient should be able to perform some physical exercises like jogging.

Interventions and Their Rationales

The first intervention is assisting the patient in performing muscle exercises like knee bends and standing on their toes (Morais et al., 2017). The rationale for this activity is to enhance balance and strengthen compensatory body parts. The second intervention is to provide the patient with a safe environment, for instance, by raising the bed rails. The rationale for this action is to ensure that the patient is safe by reducing the risk of falls. The other intervention is the provision of a foam mattress. The rationale for this intervention is to decrease pressure on the patient's skin and tissues that can compromise circulation (Morais et al., 2017). The other intervention is showing the patient the use of mobility devices like crutches and walkers. The rationale for this intervention is to enhance the level of the patient's activities.

Expected Outcomes

After twenty-four hours of the nursing interventions, the patient will be able to walk for at least fifty feet without any support and with minimal discomfort. The client will show long-term improvements, and his physical mobility will be enhanced (Morais et al., 2017).

Decreased Cardiac Output

Nursing Diagnosis

The patient has signs of decreased cardiac output. He has a thready pulse, breathlessness, and hypoxemia. From when the patient arrived, there were signs of fatigue, agitation, and his level of consciousness was extremely low. The patient had tachycardia whereby his heartbeat was rapid (100 times per minute) and irregular. The patient's skin is warm and dry.

Short-Term and Long-Term Goals

The first, short-term goal is that in twelve hours, the patients should have a normal pulse rate. Secondly, the patients should not show signs of fatigue. The long-term goal is that the cardiac output will adjust to normal. Secondly, the pulse rate should adjust to normal.

Interventions and Their Rationales

The first intervention is to limit all fluids and sodium. The rationale for this intervention is to decrease heart demands and reduce extracellular fluid volume (Matos et al., 2019). Secondly, fluid intake should be monitored. The rationale for this intervention is that the poorly performing ventricles may not tolerate increased fluid volumes. The third intervention is examining the patient by listening to the heart sounds for rhythm and heart rate. The rationale for this action is to find symptoms that might lead to heart failure like tachycardia (Matos et al., 2019). The other intervention is checking for any chest pains, their duration, location, and severity. The rationale for this action is to know if there is an inadequate supply of blood to the heart.

Expected Outcomes

In twelve hours, the patient should have a regular heart rate. In the future, the patient is expected to have a steady pulse, fatigue, and no chest pains.

Anxiety

Nursing Diagnosis

The psychosocial cultural nursing diagnosis established is anxiety. A psychological evaluation was performed where the nurse engaged the patient in discussing his thoughts and feelings. The patient said that he is from Korea but currently an immigrant in the country. The nurse used the facilitation with responses technique to encourage the patients to talk and express his thoughts. A translator was used, but the nurse focused on the patient while observing the latter's body language and eye contact. The nurse used the Diagnostic and Statistical Manual of Mental Disorders to establish that the patient suffers from anxiety.

Short-Term and Long-Term Goals

The short-term goal is that in three to four hours, the patient should have improved concentration. The patient should also have reduced anxiety. For the long-term goal, the patient should have a posture, gestures, and activity levels that depict decreased anxiety levels. Secondly, the patient should be able to freely express themselves without fear.

Interventions and Their Rationales

The first intervention is to evaluate the patient for any presence of culture-bound anxiety state. The rationale for this intervention is to establish the context in which the anxiety is being experienced (Mixer et al., 2015). The second intervention is to use the presence of tough with permission from the patient and encourage him to express himself or clarify his concerns. A medical interpreter can be used, but the nurse must focus on the patient's body language and eye contact. The rationale for this intervention is to be supportive and be approachable so that the client can open up (Mixer et al., 2015). The other intervention is to familiarize the patient with the environment and to make him feel comfortable. The rationale for this action is to promote comfort and decrease the patient's anxiety (Mixer et al., 2015). Since the patient comes from a different cultural background, the nurse must practice active listening for the patient to feel heard and validated.

Expected Outcomes

In three hours, the patient should be able to demonstrate improved concentration and focus. The patient should be able to identify and verbalize the reasons for his anxiety.

References

Kienzler, H., Spence, C., & Wenzel, T. (2019). A Culture-Sensitive and Person-Centred Approach: Understanding and Evaluating Cultural Factors, Social Background and History When Working with Refugees. In An Uncertain Safety (pp. 101-116). Springer, Cham.

Matos, L. N., Guimaraes, T. C. F., da Silva Lima, V. C., Dantas, A. C., Cavalcanti, L. A. C. T., & Brandao, M. A. G. (2019). Decreased cardiac output: Diagnostic accuracy in heart transplant candidates. Journal of Nursing Education and Practice, 9(11).

Mixer, S. J., Lindley, L., Wallace, H., Fornehed, M. L., & Wool, C. (2015). The relationship between the nursing environment and delivering culturally sensitive perinatal hospice care. International journal of palliative nursing, 21(9), 423-429.

Morais, P. C. A., Mauricio, T. F., Moreira, R. P., Guedes, N. G., Rouberte, E. S. C., Ferreira, J. D. F., & de Lima, P. A. (2017). Nursing diagnosis of Impaired Physical Mobility in elderly people at primary health care. International Archives of Medicine, 10.

Shen, Z. (2015). Cultural competence models and cultural competence assessment instruments in nursing: a literature review. Journal of Transcultural Nursing, 26(3), 308-321.