Nokea
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.
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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.
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 conducting a cultural and spiritual assessment on a newly admitted client. Which factors specifically related to culture and spirituality should the nurse address? Select all that apply.
- A. Nutrition
- B. Communication
- C. Insurance coverage
- D. High-risk behaviors
- E. Health care practices
- F. Family roles and organization
Correct Answer: A,B,D,E,F
Rationale: When performing a cultural and spiritual assessment, the nurse should focus on the following factors: nutrition, communication, high-risk behaviors, health care practices, family roles and organizations, workforce issues, biocultural ecology, overview (e.g., heritage), pregnancy and childbirth practices, death rituals, spirituality preferences, and health care practitioners. Asking the client about insurance coverage is not specifically related to culture or spiritual practices.
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.