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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.
A nurse should be aware of several biological and physiological variations common among Korean Americans that may affect healthcare and prescribed treatments:
Genetic Conditions: There is a higher prevalence of certain genetic disorders compared to other populations. This includes Alpha-1 Antitrypsin Deficiency (though less common than in some European groups, it's a known risk factor), and specific forms of gastric cancer.
Pharmacogenetics and Metabolism: A significant percentage of East Asian populations, including Koreans, are slow metabolizers of certain drugs due to variations in liver enzyme activity, particularly Cytochrome P450 (CYP) enzymes like CYP2D6 and CYP2C19. This can affect the required dosage of common medications such as:
Psychotropic drugs (antidepressants, antipsychotics).
Beta-blockers (used for hypertension).
Codeine (opioid pain reliever), which may be ineffective or cause toxicity at standard doses.
Alcohol Metabolism: Many Korean individuals carry genetic variations (specifically in the Aldehyde Dehydrogenase 2 (ALDH2) gene) that result in "Asian flush" or alcohol flushing syndrome. This causes the rapid accumulation of acetaldehyde, leading to facial flushing, nausea, and rapid heart rate. This biological difference means many Korean patients may be less prone to alcoholism but may experience more severe reactions to alcohol-containing medications or sanitizers.
Body Size and Bone Density: While generally having a lower BMI compared to the Western average, some studies suggest Korean women have a tendency toward lower bone mineral density, potentially increasing the risk for osteoporosis later in life.
Stereotyping Puerto Ricans as being similar to all other "Hispanic Americans" (a vast, heterogeneous group) can lead to significant errors in patient care, primarily related to language, immigration status, and cultural assumptions about autonomy and family structure.
Immigration and Legal Status Error: Puerto Ricans are U.S. citizens by birth. Stereotyping them as immigrants who may be undocumented or limited in English proficiency can lead a nurse to unnecessarily question their legal status or health insurance eligibility, causing offense, mistrust, and delaying care. Furthermore, a nurse might miss the specific socioeconomic challenges related to migration from the island to the mainland, which are unique to American citizens moving within U.S. jurisdictions.
Health Beliefs and Fatalism: While many Hispanic cultures share the concept of personalismo (emphasis on personal relationships), Puerto Rican health beliefs can be distinct. A nurse may incorrectly assume a fatalistic view of disease (such as susto or mal de ojo found in some other Latin American cultures) when the patient's primary concern may be tied to spiritual practices specific to Puerto Rican heritage, like espiritismo (spiritism), which may influence their acceptance of treatment.