3.9 Putting It All Together

Client Scenario

Mrs. Rosas is a 76-year-old client admitted to the cardiology floor with an exacerbation of heart failure. The client’s primary language is Spanish, and she has a limited understanding of English. The client’s daughter is present in the room and reports that the client has been experiencing increased swelling in her ankles and increased shortness of breath over the last three weeks.  During the admission assessment the nurse attempts to collect additional information related to current symptoms, diet, and history. The client nods in response to questions and converses quietly in Spanish with her daughter. The nurse notes that the client does not respond to questions appropriately and is unable to converse in English. She defers to her daughter to provide interpretation of questions and relay information.

Based on the assessment information that has been gathered, the nurse plans the following care for Mrs. Rosas:

• The nurse will obtain interpreter services in order to facilitate client communication. In-person interpreter or language line telephone services will be utilized to ensure that the client receives information about her care.
• The nurse will eliminate distractions such as the television, hallway noise, etc., to decrease sources of additional stimuli in the communication experience.
• The nurse will communicate directly with the client, utilizing appropriate eye contact, and nonverbal cues to enhance the communication experience.

As a result of these interventions by the nurse to promote culturally sensitive care, Mrs. Rosas engages with staff through the use of interpreter services and actively participates in her own care.