Nokea
The nurse is assessing a Southeast Asian woman who presented to the emergency department with complaints of a headache and nausea. The client is accompanied by her adult son. Upon assessment, the nurse notes long, pale red welts on both arms. Which actions should the nurse take next? Select all that apply.
- A. Ask if she has used any home remedies.
- B. Assess cultural health beliefs and practices.
- C. Report the use of coin rubbing to social services.
- D. Remove the adult son from the room immediately.
- E. Recognize the redness as a result of a traditional form of healing.
Correct Answer: A,B,E
Rationale: The nurse should ask the client if she has used any home remedies. The nurse should assess cultural health beliefs and practices and understand that 'coining or coin rubbing' is a traditional form of healing. The nurse should recognize the redness as a result of a traditional form of healing. Coining is an attempt to heal an illness and is not harmful to the client. The nurse should not report the use of coining to social services because the practice is not abuse. The son should not be removed from the room unless the client requests it.
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The nurse is caring for a client who primarily speaks Spanish. An interpreter is currently unavailable. The nurse must perform a dressing change. What should the nurse do in order to enhance communication with this client prior to changing the dressing?
- A. Use relatives to interpret because an interpreter is unavailable.
- B. Speak slowly and allow the client time to interpret what is being said.
- C. Use many nonverbal cues and repetition to reinforce what is being said.
- D. Use common words in the nurse's language, because the client is likely to be familiar with them.
Correct Answer: B
Rationale: When caring for a client who speaks a language that is different from the nurse's, it is ideal for the nurse to call on a dialect-specific interpreter designated by the health care agency that is the same age and same gender as the client. If an interpreter is unavailable, the nurse should speak slowly and allow the client time to interpret what is being said. The nurse should avoid the use of relatives as interpreters to minimize bias and misinterpretation. The nurse should avoid using nonverbal facial expressions and body language, because they could be misinterpreted by the client. The nurse should use common words in the client's language if known; the nurse should become familiar with Spanish terms that are frequently used in health care.
An Arab Muslim female client has been stabilized following an assault in the parking lot of a local restaurant. The nurse manager is making assignments for the oncoming shift. Which action by the nurse manager is the most appropriate to ensure the client's comfort?
- A. Assign the best male nurse to the client.
- B. Assign the client a female nurse for every shift.
- C. Allow the client to pick which nurses she would like to care for her.
- D. Remove all of the client's clothing each shift to perform a skin assessment.
Correct Answer: B
Rationale: Information about family and gender roles will greatly influence the nurse's plan of care. Arab Muslim women can only be cared for by a female. Assigning a male nurse to care for this client would be inappropriate. It would also be inappropriate to place the client in a position to choose which nurse will care for her. Unless medically necessary, the client should not need to have a skin assessment every shift. If it is required, a female must be present to assist in the skin assessment.
The nurse is caring for an older Orthodox Jewish client of the opposite sex whose condition is terminal. The nurse is implementing a plan of care and wishes to communicate this plan with the client and family. The nurse should be aware of what end-of-life spiritual and religious practices when planning and communicating with the client and family? Select all that apply.
- A. The client may demonstrate a high level of anxiety.
- B. Religious laws are suspended during times of severe illness.
- C. During the process of dying, visitors and conversation should be kept to a minimum.
- D. Family members may not shake hands or make direct eye contact with members of the opposite sex.
- E. Clients that are of the Orthodox Jewish faith are usually very quiet and do not express what they are thinking or feeling.
Correct Answer: A,B,D
Rationale: Outward expressions of anxiety are commonly seen among Orthodox Jewish members, especially older individuals. The Orthodox Jew strictly follows the laws of Judaism; however, during times of severe illness, Jewish laws are not observed if doing so will endanger the client's health. In the Orthodox Jewish faith, members generally will not shake hands or make direct eye contact with members of the opposite sex. During times of illness or death, the Orthodox Jewish community, including family and friends, will frequently visit and are considered the nucleus of the Jewish culture. Clients of the Orthodox Jewish faith are generally very verbal about what they are feeling, especially in the older population.
The nurse is participating in end-of-life care for a client who has recently immigrated from Vietnam. Which interventions should the nurse consider in the plan of care for this client? Select all that apply.
- A. Respect family wishes for use of herbal medicines.
- B. Recognize that the use of healers is a common practice.
- C. Have direct conversations with the matriarch of the family.
- D. Acknowledge that lack of eye contact does not mean disinterest.
- E. Allow someone from the family to stay with the body after death until burial.
Correct Answer: A,D
Rationale: Herbal medicine plays an important role in the care of the dying client, and family wishes to incorporate its use in care should be acknowledged and discussed with the primary health care provider. The nurse must realize that direct eye contact is considered impolite and should not be interpreted as a sign of disinterest. Southeast Asians have strong traditional families and extended families with male dominance. Healers are a practice of Native Americans. Staying with the body until burial is a practice associated with the Jewish religion.
The nurse is caring for a postoperative client with spiritual and culturally based eating and food requirements. Which interventions demonstrate the nurse's spiritual and cultural consideration of the client? Select all that apply.
- A. Encouraging the client to try new foods only until healing is complete
- B. Suggesting the substitution of similar foods for the culturally appropriate ones
- C. Asking the client to explain the factors that are important to his eating practices
- D. Including the family in discussions regarding the preparation of accepted foods
- E. Discussing the nutritional requirements the client currently has postoperatively
Correct Answer: C,D,E
Rationale: Spiritual and cultural consideration reflects attempts to maintain familiar customs to achieve the same healthy responses expected of our Western culture customs. Gaining knowledge of the customs and their importance to the client will be the basis for an understanding that allows for flexibility and compromise when necessary. Including the family in the discussion will assist with the process as will discussing the needs the client has at this particular time in order to formulate a plan to meet the needs while maintaining cultural customs. Encouraging new foods in place of the usual foods may be viewed as being insensitive and showing a lack of concern. Substitution is not always necessary.