R.M., a 68-year-old male from Fiji, came into the emergency department with complaints of increased headache, dizziness, and blurred vision.
Managing Care in a Culturally Considerate Manner

Patient Profile

R.M., a 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 (Normodyne) 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 lb
The remainder of physical exam unremarkable
Diagnostic Studies

ECG reveals left ventricular hypertrophy
Chest x-ray shows cardiomegaly
What further cultural assessment would you obtain?
How would you address his statement about the use of garlic?
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?
How would you respond to the patient’s request to have all of his family in the room?