Student Name: N/A
Patient Initials: T.M.
Nursing Diagnosis: Hypertension, hypercholesterolemia, morbid obesity, degenerative joint disease (arthritis)
Related to:
As evidenced by:
Assessment
(Subjective & Objective Data
Supporting Nursing Dx)
Pertinent Data:
Patient was an 83-years-old
woman named Teadora
Matthews residing in
Midwestern United States;
she is a retired seamstress
raised in Romania who
immigrated as a young adult
to the United States and
married an American; she
lives with her daughter and
grandchildren; despite her
old age she remains active in
her social and family life:
she volunteers at the church
she attends to on a regular
basis and is the primary
caregiver for all of her
grandchildren.
Within the past two years
she developed hypertension,
hypercholesterolemia,
morbid obesity and a
degenerative joint disease
(arthritis).
Arthritis has become her
NRSE 4570 - Diversity
Nursing Care Plan
Planning Goal Implementation Rationale Evaluation of Goal
Desired Outcome (2) (Interventions performed to meet goals) (Reason for Interventions & citation (Goal met or unmet) Support statement
(Specific/Measurable/time-limited) Minimum 3 per outcome of source) with assessment data
(Independent, Dependent,
Collaborative)
Patient Will: Nurse Will: Why: What Happened:
Long term goals:  The patient presents with an The use of Labetalol for  Two hours after the
 The first long-term goal ongoing hypertensive crisis hypertensive crisis has administration of the Labetalol
is to ensure compliance which is the most immediate been well-established and and rest the patient’s blood
from the part of the threat to her wellbeing and there is plenty of evidence pressure dropped to an
patient who, as requires immediate medical for its use (Zell-Kanter & acceptable 120/85 mmHg.
mentioned in her attention; as such, 100 mg Leikin, 1991), which is  Labetalol was prescribed at an
assessment, for personal of Labetalol will be why it is currently initial dose of 100 mg PO
reasons related to her administered orally and the considered the first-line q12hr, to be increased
upbringing, tends to patient will be observed for treatment in such gradually every 2 days until her
minimize all issues and the subsequent two hours pathologies by the vast hypertension is reliably
refuse to acknowledge until her blood pressure is majority of all current controlled.
she has a medical issue brought within a normal guidelines (Lebel,  The patient accepted the
or any complaints range as well as bed rest. Langlois, Belleau, & referral to a physical therapist
derived from her  Additionally, the patient Grose, 1985; Zell-Kanter and a dietitian and consultation
arthritis. This would was referred to a physical & Leikin, 1991). was scheduled within the next
include educating her and therapist for physiotherapy week.
her primary caregiver sessions and a dietitian to
(her daughter) about the design her new dietary
importance of effectively guidelines.
addressing medical
issues as soon as they
present themselves.
 Implementing lifestyle
changes (by creating an
main source of complaints
and interfered with her daily
life and is what finally
convinced her to seek
medical attention for the
first time.
As part of the initial
interview with the patient,
an assessment of his
cultural diversity and
background was performed
with the aim to better
accommodate her
idiosyncratic needs and
tailor the treatment to meet
her diverse needs; this
assessment revealed the
belief system she was
raised in and the culture of
the healthcare environment
in her nation of origin. The
assessment revealed a
slight distrust from the
patient towards the
healthcare system
(dominated in Romania by
the government which kept
it in extremely poor
conditions during the
period of Communist rule)
plus a strong reticence to
voice complaints or to
admit any ill effects or
limitations on her daily life
due to her ailments to the
point that she lived for
years with excruciating
joint pain while
maintaining her regular
schedule without allowing
appropriate exercise plan,
a diet adapted
specifically for the
patient) for the patient to
treat her obesity and high
cholesterol levels will
also be critical, and for
this, educating the patient
regarding her medical
issues will also be
important. The weight
loss will help with all of
three of her diagnosis,
including her arthritis
(especially in the joints
of the lower limbs).
 Physical and
occupational therapy will
also be recommended for
the patient to help with
her arthritis.
Short term goals:
 The short-term goal will
be to reduce her blood
pressure immediately and
prescribe an
antihypertensive
medication.
 Non-Steroidal Anti-
Inflammatory Drugs like
either Ibuprofen or
Diclofenac will also be
prescribed, which will
have the added benefit of
reducing the risk of a
heart attack.
 said issues to affect it to
avoid projecting any
weaknesses which she
reasoned would be
‘embarrassing’ and
‘dishonorable’.

S:
 Despite being an older
(82-years-old) retiree, the
patient still has a very
active social and family
life which her current
medical issues (especially
the joint disease) have
interfered with as these
have not allowed her to
carry out her daily
activities.
 She uses topical OTC
remedies (in the form of
ointment and analgesic
NSAID patches) to help
with her joint pain which
she applies to the afflicted
joints every day; with
moderate relief.
 She comments that she
prefers to “fight through
the pain” which he did for
a long time, rather than
seek medical assistance
given her tough upbringing
in a former Communist
state in Eastern Europe
(Romania) at the time of a
dictatorship in a rural
setting that required her to
work from a young age.
O:
On examination the
following findings were
recorded:
 BP: 162/105 mmHg
 T: 98.7°
 SpO2: 98%
 R: 11
 Weight: 224 lb
 The patient assessed her
own pain at 9 on the scale
of 1 to 10 after the Brief
Pain Inventory was applied
to her.

References
Andrews, M., Boyle, J. S., & Collins, J. (2003). Transcultural Concepts in Nursing Care (Fourth ed.). (D. DiPalma, H. Kogut, D.
Griffith, H. Ewan, & E. Kors, Eds.) Philadelphia, Pennsylvania, United States of America: Lippincott Williams & Wilkins.
Retrieved October 11, 2022
Lebel, M.-E., Langlois, S., Belleau, L., & Grose, J. (1985, June 10). Labetalol infusion in hypertensive emergencies. (P. H. van der
Graaf, K. M. Giacomini, & K. Allegaert, Eds.) Clinical Pharmacology and Therapeutics, 37(6), 615-618.
doi:10.1038/clpt.1985.98
Narayan, M. C. (2003, September 3). Cultural assessment and care planning. (J. E. Brogan, M. Anthony, A. Dabrow-Woods, R. Davis,
& B. Patrick, Eds.) Home Healthcare Now, 21(9), 611-618. doi:10.1097/00004045-200309000-00011
Palmer, K. (5 de May de 2021). Cultural Diversity in Nursing. (J. Jibilian, L. May, T. Willard, & A. K. Haugabrook, Edits.)
Recuperado el 11 de October de 2022, de Southern New Hampshire University (SNHU):
https://www.snhu.edu/about-us/newsroom/health/cultural-diversity-in-nursing
Zell-Kanter, M., & Leikin, J. B. (1991, March 15). Oral labetalol in hypertensive urgencies. (J. D. White, W. J. Brady, & N.
Flomenbaum, Eds.) American Journal of Emergency Medicine, 9(2), 136-138. doi:10.1016/0735-6757(91)90174-i