Question

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 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 pounds

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?

Answer 1

-Urine analysis reveals the presence of blood in the urine it indicate either kidney disease or kidney damage.

-Increased serum creatine level

-Elevated (BUN) Blood urea nitrogen(reveals the kidney injury)

--Advice the patient that garlic is a herbal remidies for controlling blood pressure.He can take it once the blood pressure is stable.Eating garlic take time to reduce blood pressure,Now his blood pressure is very high This may leads to the fatal conditon when it is untreated.

---Stay with them and clarify their doubt

--Tell them that it is a normal procedure done to evaluate the blood values for the diagnosis.

--Explain to them how to draw blood if possible

Tell the patient that there is a visiting hours allowed by the hospital only two attendent will be allowed during the visiting hours.kindly co operate with us .so that we can prevent cross infection .Taking rest will help to reduce blood pressure.