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Of which biological variations among Korean Americans should the nurse be aware?
Describe how stereotyping Puerto Ricans as similar to other Hispanic Americans can lead the nurse to errors in patient care.
Describe the geographical location of Jordan, and indicate how this region of the world and the political turmoil experienced by Jordanians may have a profound political impact on the health and well-being of recently immigrated Jordanian Americans.
Alcohol Metabolism: Many East Asians, including Koreans, have a high frequency of a genetic variation (in the ALDH2 gene) that results in a deficiency of the enzyme aldehyde dehydrogenase. This leads to the rapid buildup of acetaldehyde after consuming alcohol, causing the "Asian flush" (facial flushing, nausea, rapid heart rate). This variation affects alcohol tolerance and may lead to a lower risk of alcoholism, but also influences liver disease risk.
Gastrointestinal Health: There is a generally higher incidence of stomach cancer in Korean populations compared to the general U.S. population, often linked to dietary habits and a higher prevalence of Helicobacter pylori infection. Nurses should ensure appropriate screening and dietary guidance are discussed.
Lactose Intolerance: A high percentage of Asian populations, including Korean Americans, have some degree of lactose intolerance due to the inability to digest lactose, which should be considered when advising on calcium intake and nutritional supplementation.
Stereotyping Puerto Ricans as similar to other Hispanic Americans can lead to significant errors in patient care by promoting clinical generalizations that ignore critical cultural, genetic, and environmental differences.
| Area of Error | Problem with Stereotyping |
| Diet and Nutrition | Assuming a "standard" Hispanic diet. Puerto Rican cuisine often uses significantly different staple foods, spices (e.g., sofrito), and cooking fats compared to Mexican or Central American diets. Misinformation can lead to ineffective diabetes or hypertension management. |
| Genetic Predispositions | Lumping all Hispanic groups together obscures unique genetic risk factors. For example, Puerto Ricans have a higher prevalence of asthma and bronchial hyperresponsiveness compared to other Hispanic groups, and a higher incidence of type 1 diabetes. A nurse relying on broad stereotypes might miss these specific risk factors during assessment. |
| Language and Health Literacy | While Spanish is spoken, key cultural and medical terms may differ significantly (Puerto Rican Spanish). Furthermore, many Puerto Ricans are U.S. citizens, but their unique history, including potential migration back and forth between the island and the mainland, impacts health access, insurance status, and health literacy in ways distinct from recent immigrants from other Latin American nations. |
| Health Beliefs | Beliefs regarding folk medicine or espiritismo (spiritualism) may be unique to Puerto Rican culture, influencing attitudes toward Western medicine. Stereotyping can prevent the nurse from asking culturally specific, open-ended questions necessary to integrate these beliefs into the care plan. |
By failing to recognize the unique culture and biology of Puerto Ricans, the nurse provides non-patient-centered care, leading to miscommunication, distrust, and potentially poorer health outcomes.
Jordan (The Hashemite Kingdom of Jordan) is located in the Middle East, specifically in the Levant region of Western Asia.
It is a largely landlocked nation (except for a small southern coast on the Red Sea's Gulf of Aqaba).
It is bordered by Syria to the north, Iraq to the east, Saudi Arabia to the south and east, and Israel and the Palestinian territories (West Bank) to the west.
When caring for Korean American patients, the nurse should be aware of several biological variations that may influence medication dosage, screening, and dietary education:
Pharmacogenetics (Drug Metabolism): A significant variation is the higher prevalence of slow metabolizers of certain drugs, particularly those metabolized by the cytochrome P450 enzyme system, such as CYP2D6 and CYP2C19. This can affect the metabolism of common psychiatric medications (antidepressants, antipsychotics) and cardiovascular drugs, potentially leading to increased blood levels, heightened toxicity, or ineffective treatment unless dosages are adjusted.