When children immigrate to another culture, a variety of salient variables influence their adaptation. Among internationally adopted children, these variables include early history, changes in socioeconomic status, awareness of multiple issues impacting the child post-adoption, availability of social networks, and anti-immigration sentiments in the host culture. The change in socioeconomic status of children adopted from the former Soviet Union is a positive influence with the concomitant improvement in the child's nutrition and health care. Many internationally adopted children have spent time in institutional environments that constitute a culture in and of itself. The orphanages are microenvironments which may be closed to the influences of the larger culture. The environmental components of the orphanage transmit a collection of traits and values which, taken as a whole, constitute the orphanage culture. Adoptive parents must facilitate the children's adjustment to a new cultural milieu with different language, food, and customs. Further, children must adapt to the culture of the family, a culture that may have been previously unknown. Nurses can promote the adaptation of these families by increasing awareness of the multitude of issues that impact internationally adoptive families.