Case Study, Chapter 11, Assessing Culture

A 22-year-old Asian female client visits a health care facility complaining of discomfort in her

abdomen. The client is attending graduate school at a local university and lives on campus. Her

parents are concerned, and they accompany her. When the nurse asks them to step out of the

room while the physical exam is being conducted, the parents hesitate for a few minutes and then

leave reluctantly. They come back into the examination room and the father states “I want to

know what is wrong with my daughter.” The client seems embarrassed and states that her parents

are very traditional. When the nurse and the client are alone, the client states that it has been

painful for her to urinate. She also states that she has been having vaginal itching for a week and

that there is a “bad” smell “down there.” When assessing the client further, the nurse observes

the client to be very apprehensive and continuously asks if there is anything wrong. When

performing the abdominal exam, the client appears guarded and the nurse smells a foul odor

coming from her perineal area. Upon further assessment, the nurse notices a discharge on the

client’s underwear. The client states “Please don’t tell my parents—they will not understand.”

(Learning Objectives: 5, 7)

Questions:

a. How should the nurse assure the client that she is an adult and that, according to the

privacy laws, the health care team will not relay any medical information to her parents

unless she agrees to it?

b. In assessing clients of different cultures, what important aspects of cultural competence

are necessary for the nurse to know?