Case Studies
Read the case studies below. Answer two of the case questions in the
form at the end of the page.
| Case #1 |
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At a rural health clinic sponsored by the School of
Nursing, three Hispanic female migrant workers were diagnosed with
cervical dysplasia.
The Public Health Department sponsored and publicized a health
fair for migrant workers, specifically focusing on cervical
and skin
cancers. Five migrant workers attended the health fair. |
What should have been considered when planning the health
fair
regarding the culture and characteristics of the migrant workers?
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Case #2
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| The Wu family recently migrated from Taiwan. Two
months after their arrival in Denver, CO, grandmother Wu fell ill
and was diagnosed with a metastatic gastric ulcer. The granddaughter,
who was instrumental in bringing the family to Denver, is a nurse
who is employed in the coronary care unit. The family asked the
oncologist and oncology nurse to relay all information to the granddaughter
rather than the patient. |
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What cultural differences and potential barriers
exist?
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| Case #3 |
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Mr. Jones is a 72-year-old African American, who has prostate cancer.
As a result, he is receiving chemotherapy. The clinic nurse noted
that Mr. Jones is late for his chemotherapy appointments and sometimes
comes on the wrong day. The nurses in the clinic prepared a calendar
for Mr. Jones, but the schedule did not seem to help him keep his
appointments. |
How can the nurse collaborate with the patient to reduce
alterations in time/space perceptions related to appointments?
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Case #4
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| While visiting her children in the United States,
Mrs. Juana Perez was diagnosed with pancreatitis.
She was
admitted to the hospital and her daughter,
Anna, took charge of her care, pampering her with attention and
services, which often interfered with appropriate care.
Anna would refuse to have her mother sit on a chair or ambulate,
saying that Mrs. Perez was too ill and weak. She insisted that
her mother continue taking an herbal tea from Bogota. Even though
Anna took charge of her mother’s care, Mr. Pedro Perez,
made all the decisions regarding the treatment plan for Mrs.
Perez.
|
 |
How can the nurse achieve treatment
and care outcomes for
the patient while at the same time supporting
and
appreciating
the daughter’s role in the care of her mother?
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| Case #5 |
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The urban wellness center maintains a satellite
clinic in rural Kentucky. The physician and nurse drive
45 miles
to the
clinic once a week and to see approximately 40 patients. For
the last two years, the clinic patient schedule generally drops
by 50% during the planting and harvest season. The drop in the
patient population is causing financial difficulties for the clinic. |
What other ways can the clinic
accommodate its
patients’ work
schedules regarding appointments?
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Case #6
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| A nurse is working in a low-income, predominantly African American
community. Though the community has verbalized the need for cancer
screening programs, these programs are not well attended. When
the nurse asked a community leader why the screenings are not well
attended, the community leader replied, “What is the use
of a screening? There is nothing we can do anyway.” |
 |
What type of attitude is the community leader demonstrating?
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| Case #7 |
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Mrs. Sanchez is a 75-year-old Puerto Rican woman
living in New York. She has had a colostomy for colon cancer. The
home health nurse noted that Mrs. Sanchez adds brandy to her black
coffee and takes several varieties of herbal teas. |
What are some culture-related behaviors concerning
the use of alcoholic beverages for health reasons?
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Case #8
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| Mrs. Lowenstein was diagnosed with a breast mass
by mammography. Her genetic profile also showed specific
mutation of BRCA
1 and
BRCA 2, indicating that her female descendants may be at high risk
for breast and ovarian cancers. |
 |
What are the considerations of patient counseling
based on genetic predisposition?
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| Case #9 |
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Sarah is a devout Catholic, educated in Catholic
schools and now, is the principal of a Catholic high school. She
sought medical attention because she felt tired, bloated, and was
losing weight.
After her gynecologist told Sarah that she had ovarian cancer,
Sarah became very silent and withdrawn. The nurse noticed that
Sarah was crying and saying repeatedly, “It’s my fault.
This cancer is God’s punishment because I had an abortion
when I was in high school.” |
How might the client’s
beliefs about disease causation
impact her decisions about
treatment?
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Case #10
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| Dr. de la Cruz is a Filipino physician employed as
a family practitioner in New Jersey. She was admitted to the hospital
for surgery for breast cancer. While caring for Dr. de la Cruz,
the nurse noticed a statue of the Virgin Mary, a prayer book, and
a rosary on her table. Dr. de la Cruz also had a crucifix pinned
to her gown. |
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What religious icons are present in this scenario?
How can the nurse include these articles to provide support?
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| Case #11 |
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Abu Fulani has terminal pancreatic cancer. Mr. Fulani
is an immigrant from Saudi Arabia and practices the Islamic faith.
Although he states that he has severe pain, he believes that pain
and suffering are manifestations of Allah’s will. He refuses
pain medications because he believes that they will hasten his
death. The family has rearranged the room so that Mr. Fulani faces
east at all times.
When Mr. Fulani died, his son insisted on washing and dressing
his body, while the family retired to another room. |
What were the cultural aspects of pain and pain management
in this situation? What are some rituals and burial procedures
of other cultures?
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