Caring for Korean, Puerto Rican, & Jordanian Populations

Full Answer Section

         

1. • Hepatitis B (HBV): East Asian populations, including Koreans, have a higher prevalence of chronic Hepatitis B infection. This is often due to perinatal transmission. Nurses should ensure Korean American patients are screened for HBV, vaccinated if not immune, and monitored for liver disease if they are chronic carriers.
   • Type 2 Diabetes: While Asian Americans generally have a lower BMI, Korean Americans may have a similar or higher prevalence of Type 2 diabetes compared to White populations, and often develop it at a lower BMI. This suggests a different physiological predisposition. Nurses should be aware of this risk and provide appropriate screening and education, even for those who appear to be at a "healthy" weight.
   • Hypertension (High Blood Pressure): Some research suggests a higher prevalence of salt sensitivity among Asian populations, including Korean Americans, which can contribute to hypertension. Nurses should consider dietary sodium intake when assessing blood pressure and providing dietary counseling.
   • Osteoporosis: While often considered a lower risk group than Caucasians, Asian women, including Korean Americans, can be at risk for osteoporosis, particularly post-menopause.
   • Genetic Variations in Drug Metabolism: Some East Asian populations, including Koreans, may have variations in enzymes (e.g., CYP2D6, CYP2C19) that metabolize certain medications. This can affect drug efficacy or increase the risk of side effects for drugs like some antidepressants, antipsychotics, beta-blockers, and proton pump inhibitors. Nurses should be mindful of potential dosing adjustments or increased monitoring.
2. Physiological Responses:
   • Alcohol Flush Reaction: A significant portion of East Asians, including Koreans, have a genetic variant (ALDH2 deficiency) that leads to reduced alcohol metabolism. This results in the "alcohol flush reaction" (facial flushing, nausea, rapid heart rate) even after consuming small amounts of alcohol. Nurses should be aware of this common biological response and not misinterpret it as an allergic reaction or simply intoxication.
   • Lactose Intolerance: A high prevalence of lactose intolerance is found in many Asian populations, including Koreans, due to a decrease in lactase enzyme production after infancy. Nurses should inquire about dairy consumption and potential symptoms when assessing dietary intake or GI issues.

 

How Stereotyping Puerto Ricans as Similar to Other Hispanic Americans Can Lead the Nurse to Errors in Patient Care

  Stereotyping Puerto Ricans as "just like other Hispanic Americans" is a significant pitfall that can lead to numerous errors in patient care, as the term "Hispanic" encompasses a vast array of diverse cultures, histories, socio-economic realities, and health profiles.

Sample Answer

          When providing care, a nurse must be aware of both general biological variations that may be more prevalent in certain ethnic groups and the dangers of stereotyping.  

Biological Variations Among Korean Americans

  While it's crucial to remember that individuals within any ethnic group have genetic diversity, certain biological variations may be more commonly observed in Korean Americans due to shared genetic heritage. Nurses should be aware of these potential predispositions:

1. Genetically-Linked Conditions:
   • Gastric Cancer: There is a higher incidence of gastric cancer among Koreans and Korean Americans compared to the general U.S. population. This is thought to be due to genetic predispositions, dietary factors (high sodium intake, preserved foods), and a higher prevalence of Helicobacter pylori infection. Nurses should be vigilant about screening and symptom assessment.