How do the interventions described in the original post address the influence of culture and socioeconomics on the ability for Juanita to achieve the outcome of asthma education?

How do the interventions described in the original post address the influence of culture and socioeconomics on the ability for Juanita to achieve the outcome of asthma education?

  Asthma is a chronic inflammatory disease of the airways. Educating patients about self-care by focusing on chronic management versus acute episode care is a critical component of caring for patients with asthma (Hinkle 2014, p.637).

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  Juanita is a 10-year-old Hispanic child with severe persistent asthma. Appropriate nursing interventions for educating pediatric patients include using a family-centered approach when teaching, guide children to credible information about their condition and use teaching strategies that are uniquely tailored to the information needs of children (Ladwig 2011, p.494). Consider settings outside traditional health care centers and interdisciplinary approaches for engaging children in preventative health care (Ladwig 2011, p.495).

  Juanita may doubt her ability to have control over her illness and have feelings of powerlessness. Appropriate nursing interventions to help Juanita with feelings of helplessness include providing nursing care that shifts the focus from the disease to the child. Encourage Juanita to share her beliefs, thoughts, and expectations of her illness. Establish a therapeutic relationship with Juanita. Engage her with respectful listening and help her in creating a plan and set goals to manage her condition. Give realistic and sincere praise for accomplishments (Ladwig 2011, p.595).

  The nurse must also consider cultural influences when developing an education plan for Juanita. Latinos are family oriented so, the nurse should use a family-centered approach when providing education. The RN should assess the influence of cultural beliefs, norms, and values when developing an education plan. Culturally appropriate nursing interventions for Juanita include assessing for cultural/ethnic self-care practices, use educational interventions that are tailored to the health literacy needs of the patient, use a medical interpreter but be aware of the possible difficulties when sharing information, and consider involving bilingual members of the community who  are outside the traditional health care system who may assist in the education process as well as be a reliable community resource for Juanita and her family (Ladwig 2011, p.494).

  Ethnic and racial disparities affect morbidity and mortality in asthma, which is higher in inner-city African Americans and Latinos (Hinkle 2014, p.637). Juanita has had multiple Emergency Department admissions for asthma exacerbations. Juanita lives in low-income housing in the inner city where she is chronically exposed to airway irritants and allergens. Due to her multiple emergency department admissions for asthma exacerbations, it may be important for the nurse to collaborate with social work to obtain a pre-discharge home assessment referral to determine the need for safety-related environmental changes (Ladwig 2011, p.417). The nurse can also collaborate with the social worker or case worker in helping Juanita and her family in identifying appropriate community resources for health insurance and a primary care physician. Connecting Juanita and her family with proper community resources will help reduce emergency department admissions.

As a paramedic, I see a lot of people who use the emergency department as a primary care facility. They use it because they don’t have insurance or don’t understand that they should not be using emergency services for non-emergent purposes. I educate each non-emergent patient I see on the appropriate use of emergency services. I’ve seen asthma in the pre-hospital field. Our protocol calls for albuterol for mild wheezing. In more of a respiratory distress type situation, epi IM 1:10000 along with solu-medrol and possibly CPAP.