PREPU Spirituality chap. 42
*A nurse has developed a plan of care to meet the needs of a client with the nursing diagnosis of Spiritual Distress. What would be an expected outcome?*
*Identify factors in life that challenge spiritual beliefs.* Goals and expected outcomes for clients in spiritual distress do not need to be individualized. An appropriate expected outcome would be that the client will identify factors in life that challenge spiritual beliefs.
What spiritual need is believed to underlie all religious traditions and is common to all people?
*Love and relatedness* According to Shelly and Fish (1988), there are three spiritual needs underlying all religious traditions and common to all people: (1) the needs for meaning and purpose, (2) love and relatedness, and (3) forgiveness.
Which of the following group of terms best defines spiritual distress?
*Alienation, despair* Terms that define spiritual distress include spiritual pain, alienation, anxiety, guilt, anger, loss, and despair.
While admitting a clilent who is having elective surgery tomorrow, the nurse asks if he has a preferred religion or faith. The client indicates that he does not believe in a higher power and therefore has no preferred religion. The nurse knows that which of the following terms describes the client's feelings about religion?
*Atheist* An atheist is a person who denies the existence of a higher power. An agnostic is one who holds that nothing can be known about the existence of a higher power. Jehovah's Witnesses are an organized religion. A spiritualist is one who believes in spirituality.
What factor is necessary to express and experience spirituality?
*Connectedness with other people* People express and experience spirituality through love and connectedness with other people. Love develops from the basic human need to love and be loved and is necessary to spiritual wholeness.
The son of a dying female client is surprised at his mother's adamant request to meet with the hospital chaplain and has taken the nurse aside and said, "I don't think that's what she really wants. She's never been a religious person in the least." What is the nurse's best action in this situation?
*Contact the chaplain to arrange a visit with the client.* The nurse's primary duty is to honor the client's request for a meeting with a spiritual advisor.
A nurse is caring for an infant who requires a treatment procedure. What would be most important for the nurse to do to help support the infant's spiritual needs?
*Encourage parents to be present during the treatment.* Hospitalization and illness potentially disrupt an infant's basic trust in parents. As parents play an instrumental role in the lives of infants and newborns, attention given to recognizing the needs of parents can in turn assist in meeting infant needs. Therefore, supporting the spiritual needs of parents by listening, offering support, and promoting stability will also help to meet the infant's needs. Nurses can support and encourage parents to be present and involved in the caring process with infants, such as encouraging the parents to be present during the medical treatment. There is no need for the nurse to ask for a child specialist to be present during the treatment. Instead, the nurse should involve the parents in the caring process as the infant will feel more secure and comfortable in the presence of the parents. Explaining that it will be over soon or providing the infant with toys or a feeding bottle will do little to comfort the infant
A nurse overhears a client telling a family member that a belief in God is the only thing helping in the fight against a terminal illness. Which of the following is this client demonstrating?
*Faith* Faith refers to a confident belief in something for which there is no proof or material evidence. It can involve a person, idea, or thing, and it is usually followed by action related to the ideals or values of that belief.
Then nurse is caring for a hospice client who tells the nurse that she is worried about how she has treated a younger sister. She asks the nurse how to make things right. The nurse recognizes this as which of the following spiritual needs?
*Forgiveness* According to Shelly and Fish (1988), there are three spiritual needs underlying all religious traditions and common to all people: (1) the need for meaning and purpose, (2) the need for love and relatedness, and (3) the need for forgiveness.
A client tells a nurse that he does not think he can have the recommended heart surgery because transfusions are against his religion. What is the best response of the nurse in this situation?
*Obtain all the information needed for the client to make an informed decision.* The nurse's role is to assist the client in obtaining the information needed to make an informed decision and to support the client's decision making. Because what the nurse says, and the way it is said, may powerfully influence the client's decision, it is important to maintain objectivity. Conflicts that resist resolution may be referred to an ethics committee or consult team.
Your patient today is Robert, who is hospitalized for a cystectomy related to bladder cancer. He reveals to you that he feels some spiritual distress without telling you specifics. Which of the following is the appropriate priority action?
*Perform a spiritual assessment* If the patient reveals a spiritual problem, use interview questions to determine the specific nature of the problem, its probable causes, related signs and symptoms, when it began and how often it occurs, how it affects everyday living, the severity of the problem and whether it can be treated independently by nursing or needs to be referred, and how well the patient is coping with the problem. Praying with patients should not be initiated by the nurse unless there is no pastoral care available and the patient requests it.
A college foreign exchange student is living with a family in England and is confused about the daily Catholic prayers and rituals of the family. The student longs for the comfort of her fundamentalist Protestant practices and reports to the campus nurse for direction. The nurse recognizes the student is experiencing which type of spiritual distress?
*Spiritual alienation* Spiritual alienation occurs when an individual is separated from her/his faith community. Spiritual guilt is the failure to live according to religious rules. Spiritual anger is the inability to accept illness. Spiritual loss occurs when one is not able to find comfort in religion.
*A dying client requests that the nurse pray with him. The nurse is not accustomed to praying aloud but is comfortable praying silently. What is the best approach for this nurse to follow to pray with this client?*
*The nurse should select a formal prayer or Bible passage to use to pray aloud.* A nurse unaccustomed to praying aloud or in public may find it helpful to have a Bible passage or formal prayer readily available for praying. If the nurse is not comfortable praying with the client, she should call the hospital chaplain or find another individual who is comfortable.
*Which of the following factors should be the primary factor in a nurse's decision whether to pray with a patient?*
*The patient's openness to being prayed for* Many factors influence the nurse's decision to pray with a patient. Central among these, however, is the question of whether the patient is open to this possibility. This factor is more important than the nurse's familiarity with specific prayer traditions, the patient's medical condition, or the presence or absence of a chaplain.
A client scheduled for complex heart surgery has been reading the Bible for hours each day, cries often, and is not sleeping well. What might these observations cue the nurse about the client?
*These behaviors are signs of spiritual distress.* Many clients find it difficult to talk about their spiritual beliefs and problems but may have behavioral indicators of spiritual distress. Significant behavioral observations include sudden changes in spiritual practices, mood changes, sudden interest in spiritual matters, and disturbed sleep.
*A nurse is caring for a patient who practices Daoism. Which religious beliefs would the nurse keep in mind when planning care for this patient? (Select all that apply.)* a) Inherent in Daoism is the appreciation of life and the desire to keep the body from untimely or unnecessary death. b) They worship one God revealed to the world through Jesus Christ. c) Allah, who is all-seeing, all-hearing, allspeaking, all-knowing, all-willing, and allpowerful, is their one God. d) The universal principle is the mysterious biologic and spiritual life rhythm or order of nature. e) They oppose the "false teachings" of other sects. f) They believe that health is a manifestation of the harmony of the universe, obtained through the proper balancing of internal and external forces.
*They believe that health is a manifestation of the harmony of the universe, obtained through the proper balancing of internal and external forces.* *• The universal principle is the mysterious biologic and spiritual life rhythm or order of nature.* Daoism (Taoism) beliefs include that there is a "medicinal" concern for maintaining and prolonging human health and life (sheng); knowing and living a natural life—following the Tao—is the secret of both health and sagehood; and long tradition of seeking pragmatic medical techniques, along with its religious techniques of meditation and ritual for establishing a harmony of body and spirit, humanity, and nature (holistic approach). Allah is a belief of Islam religion. The concept of "false teachings" is a part of the Jehovah's
A client whose left foot was surgically removed due to gangrene tells the nurse that focusing more on his spiritual life helped him overcome the loss of his foot. The nurse interprets the client's statement as reflecting which of the following about the spiritual dimension?
*being in harmony with the universe* The spiritual dimension seeks harmony with the universe, strives for answers about the infinite, and comes into focus when the person faces emotional stress, physical illness, or death. Worshiping with family and friends or seeking joy from materialistic objects can make a person happy on an individual level, but spiritual dimensions go beyond religious affiliation and inspire reverence, awe, meaning, and purpose even for those who do not believe in any god.
The parents of three children ages 4, 7, and 11 years are interested in fostering spiritual development in their children. The nurse informs the parents that the development of a child's spirituality is best accomplished by ...
*educating through parental behaviors.* A child's parents play a key role in the development of the child's spirituality. What is important is not so much what parents teach a child about God and religion, but rather what the child learns about God, life, and self from the parent's behavior.
A nurse is assisting a terminally ill female client with bathing. The client tells the nurse that she has great respect and faith in a particular spiritual leader. The nurse interprets this information as fulfilling which need for the client?
*sense of security for present and future* Whatever the spiritual or religious beliefs the person holds and practices, these beliefs contribute to a sense of security for the present and future; give meaning to life, illness, other crises, and death; guide daily living habits; drive acceptance or rejection of other people; furnish psychosocial support within a group of like-minded people; provide strength in meeting life's crises; and give healing strength and support. However, spiritual beliefs do not guarantee that a person gains financial power and strength, the power to perform miracles, or the ability to live longer
A nursing instructor is preparing a class presentation on spiritual care. What would the instructor include as an essential component? Select all that apply. a)Limited verbal communication b) Trust c) Narrow definition of spirituality d) Empathy e) Self-awareness
*• Trust* *• Empathy* *• Self-awareness* Essential elements in implementing spiritual care are commitment to the nurse-client relationship, good communication skills, trust, empathy, self-awareness, and acceptance of a broad definition of spirituality.
