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CHINESE CASE STUDY #1 An elderly, Asian-looking man is admitted to the emergency

ID: 237794 • Letter: C

Question

CHINESE CASE STUDY #1

An elderly, Asian-looking man is admitted to the emergency room with chest pain; difficulty breathing; diaphoresis; vomiting; pale, cold, clammy skin; and apprehension. Three people, speaking a mixture of English and a foreign language to one another, accompany him. The nurse tries to speak English with the man, but he cannot understand anything she says. Accompanying the elderly man are two women (one elderly and very upset and one younger who stands back from the other three people) and one younger man.

The younger man states that the elderly man, whose name is Li Ying Bin, is his father; the elderly woman, his mother; and the younger woman, his wife. The son serves as the translator. Li Ying Bin comes from a small village close to Beijing. He is 68 years old, and he has been suffering with minor chest pain and has had trouble breathing for 2 days. He is placed in the cardiac room, and the assessment continues.

Mr. Li is on vacation, visiting his son and daughter-in-law in the city. His son and daughter-in-law have been married for only 1 year, but the son has lived in the West for 7 years. Mr. Li’s daughter-in-law looks Chinese but was born in the United States. She does not speak very many words of Chinese. Further physical assessment reveals that Mr. Li has a history of “heart problems,” but the son does not know much about them. Mr. Li had been to the hospital in Beijing but did not like the care he received there and returned home as soon as possible. He goes to the local clinic periodically when the pain increases, and the health-care provider in China used traditional Chinese medicine, herbs, and acupuncture. In the past, those treatments relieved his symptoms.

Medications are ordered to relieve pain, and Mr. Li undergoes diagnostic procedures to determine his cardiac status. The studies reveal that he did sustain massive heart damage. Routine interventions are ordered, including heart medications, anticoagulants, oxygen, intravenous fluids, bedrest, and close monitoring. His condition is stabilized, and he is sent to the cardiac intensive-care unit. In the cardiac unit, the nurse finds Mrs. Li covering up Mr. Li until he sweats, and Mrs. Li argues with the nurse every time her husband is supposed to dangle his legs. She complains that he is too cold and brings in hot herbal beverages for him to drink. She does not follow the nurse’s and physician’s orders for dietary restrictions, and she begins to hide her treatments from the staff. Her son and daughter-in-law try to explain to her that this is not good, but she continues the traditional Chinese medicine treatments.

Mr. Li is a very quiet patient. He lies in bed and never calls for help. He frequently seems to be meditating and exercising his arms. When he does talk to his son, he speaks of the airplane ride and the problems of being so high. He believes that may have caused his current heart problem. Mr. Li also wonders if Western food could be bad for his system. Mr. Li’s condition gradually deteriorates over the next few days. Nurses and physicians attempt to tell the family about his condition and possible death, but the family will not talk with them about it. Mr. Li dies on the 5th day.

9. Why must the physician be careful with the amounts of medication ordered?

10. Mrs. Li is curt, demanding, and disagreeable toward her daughter-in-law. Why does she act this way?

11. Explain why Mr. Li blames the airplane ride and the Western food for his heart attack. Why does he meditate and do exercises?

12. Is Mr. Li’s stoicism during dying surprising? Why do the family members refuse to discuss his health and possible death?

13. What is the preferred method for handling the remains of a deceased Chinese person?

Explanation / Answer

Why must the physician be careful with the amounts of medication ordered?

Since the patient’s wife is already trying to add the traditional medicines along with the treatment meted by the hospital, the doctor should make an attempt to find out what the traditional medications consist of. Based on these he should keep his dosages for requirement of the patient.

Mrs. Li is curt, demanding, and disagreeable toward her daughter-in-law. Why does she act this way?

The clash is resulted basically because the mother in law expects the daughter in law to be full-fledged in Chinese traditions but since she is brought up in US, there are disagreements in regards to behavior and lack of knowledge towards Chinese traditions.

Explain why Mr. Li blames the airplane ride and the Western food for his heart attack. Why does he meditate and do exercises?

Chinese culture also includes Falun Gong or Falun Dafa, it is a meditation exercise that is believed by Chinese that has healing powers. The patient is probably missing his culture and is regretting moving to US and has a denial state of being away from his tradition mindset back home as compared to US.

Is Mr. Li’s stoicism during dying surprising? Why do the family members refuse to discuss his health and possible death?

Stoicism mentions to long-term pleasure or pain without displaying emotion, and it is measured as a positive peculiarity in Chinese culture. This brands us to comprehend that why the family members did not discuss the health with the doctors.

What is the preferred method for handling the remains of a deceased Chinese person?

Chinese funeral rituals include a customary of traditions approximately related with Chinese folk religion, with dissimilar cremations dependent on the phase of the deceased, the reason of demise, and the deceased's wedded and social positions. While conventionally inhumation was preferred, in the current day the deceased are time and again incinerated rather than buried.

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