The nurse is caring for a Jewish client who follows a kosher...

The nurse is caring for a Jewish client who follows a kosher diet. Which foods should the nurse use in meal planning for the client? Select all that apply.

A. Pork
B. Tuna
C. Apples
D. Chicken
E. Potatoes

Correct Answer: B,C,D,E

Rationale: Clients who follow a kosher diet avoid meat from carnivores, pork products, and fish without scales or fins. Fruits and vegetables are considered kosher. Tuna, chicken, potatoes, and apples are also considered kosher and appropriate.

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 caring for a client who is of Asian descent and is assessing for client perceptions regarding nutrition. Which, in addition to the impact of food on disease and illness, should the nurse consider in order to provide culturally competent care?

A. Educational background and employment history
B. Familial support systems and financial well-being
C. Client perception of body weight and size relative to culture
D. Ability to purchase foods necessary for disease management

Correct Answer: C

Rationale: When addressing nutrition for clients with diverse cultural backgrounds, dietary preferences, the impact of food on disease and illness, and client perception of body weight and size relative to culture must be considered. For example, clients who are not part of the Western culture may not consider obesity to be a major health indicator; therefore, teaching regarding weight reduction may be difficult. The other options address social and financial status and are not directly related to cultural considerations with regard to nutrition.

The nurse is caring for a new immigrant from the Philippines. The client is 4 cm dilated and 30% effaced. This is her first child. The mother is grimacing; her pulse, respiratory rate, and blood pressure are elevated. The nurse offers to call the health care provider for an epidural prescription. The mother declines. The nurse should hypothesize that the client declined the epidural for which reason? Select all that apply.

A. Filipino mothers fear drug addiction.
B. Filipino mothers decrease their pain through a verbal release.
C. Filipino mothers prefer to accept treatments for pain from their parteras.
D. Filipino mothers are often stoic and view childbirth pain as a normal part of life.
E. Filipino mothers believe that pain is a form of spiritual atonement for one's past deeds.

Correct Answer: A,E

Rationale: Childbirth experiences differ among different nationalities. Filipino mothers fear drug addiction. They also believe that pain is a form of spiritual atonement. Hispanic and Arab-American mothers are more vocal during childbirth. Mexican mothers have parteras (specially trained persons) attend them during the childbirth process. Vietnamese mothers are quiet during childbirth and view it as a normal part of life.

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.

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.