Cultural Awareness and Health Practices Chapter 5

1. A client is diagnosed with cancer and is told that surgery followed by chemotherapy will be necessary. The client states to the nurse, "I have read a lot about complementary therapies. Do you think I should try any?" The nurse should respond by making which appropriate statement? 1. "I would try anything that I could if I had cancer." 2. "No, because it will interact with the chemotherapy." 3. "Tell me what you know about complementary therapies." 4. "You need to ask your primary health care provider about it."

"Tell me what you know about complementary therapies." Rationale: Complementary (alternative) therapies include a wide variety of treatment modalities that are used in addition to conventional treatment to treat a disease or illness. These therapies complement conventional treatment, but they should be approved by the person's primary health care provider (PHCP) to ensure that the treatment does not interact with prescribed therapy. Although the PHCP should approve the use of a complementary therapy, it is important for the nurse to explore the complementary therapies first with the client, which would eliminate option 4. The statement in option 2 is inappropriate. Similarly, option 1 is an inappropriate response to the client. Option 3 addresses the client's question and encourages discussion. Test-Taking Strategy: Use therapeutic communication techniques. Eliminate options 1, 2, and 4, because they are nontherapeutic. Option 3 is the only option that addresses the client's question and encourages discussion. Review: therapeutic communication techniques.

Buddhism Religions and Dietary Preferences? Religion and End-of-Life Care?

-Alcohol is usually prohibited. Many are lacto-ovo-vegetarians. Some eat fish, and some avoid only beef. -A shrine to Buddha may be placed in the client's room. Time for meditation at the shrine is important and should be respected. Clients may refuse medications that may alter their awareness (e.g., opioids). After death, a monk may recite prayers for 1 hour (need not be done in the presence of the body).

Church of Jesus Christ of Latter-Day Saints (Mormon/Christianity) Religions and Dietary Preferences? Religion and End-of-Life Care

-Alcohol, coffee, and tea are usually prohibited. Consumption of meat may be limited. The first Sunday of the month is optional for fasting. -A sacrament may be administered if the client requests.

Jehovah's Witnesses (Chrisitianity) Religions and Dietary Preferences? Religion and End-of-Life Care?

-Any foods to which blood has been added are prohibited. They can eat animal flesh that has been drained. -Members do not believe in sacraments. Members are not allowed to receive a blood transfusion.

Eastern Orthodox Religions and Dietary Preferences? Religion and End-of-Life Care?

-During Lent, all animal products, including dairy products, are forbidden. Fasting occurs during Advent. Exceptions from fasting include illness and pregnancy; children may also be exempt. -A priest anoints the sick. Other sacraments before death include anointing of the sick and Holy Eucharist.

Hinduism Religions and Dietary Preferences? Religion and End-of-Life Care?

-Many are vegetarians. Those who eat meat do not eat beef or pork. Fasting rituals vary. Children are not allowed to participate in fasting. -Rituals include tying a thread around the neck or wrist of the dying person, sprinkling the person with special water, and placing a leaf of basil on the tongue. After death, the sacred threads are not removed, and the body is not washed.

Judaism Religions and Dietary Preferences? Religion and End-of-Life Care?

-Orthodox believers need to adhere to dietary kosher laws: meats allowed include animals that are vegetable eaters, cloven-hoofed animals, and animals that are ritually slaughtered. Fish that have scales and fins are allowed. Any combination of meat and milk is prohibited. During Yom Kippur, 24-hour fasting is observed. Pregnant women, children, and seriously ill individuals are exempt from fasting. During Passover, only unleavened bread is eaten. -Prolongation of life is important (a client on life support must remain so until death). A dying person should not be left alone (a rabbi's presence is desired). Autopsy and cremation are usually not allowed.

Islam Religions and Dietary Preferences? Religion and End-of-Life Care?

-Pork, birds of prey, alcohol, and any meat product not ritually slaughtered are prohibited. During the month of Ramadan, fasting occurs during the daytime; some individuals may be exempt from fasting, such as pregnant women. -Second-degree male relatives such as cousins or uncles should be the contact person and determine whether the client or family should be given information about the client. The client may choose to face Mecca (west or southwest in the United States). The head should be elevated above the body. Discussions about death usually are not welcomed. Stopping medical treatment is against the will of Allah (Arabic word for God). Grief may be expressed through slapping or hitting the body. If possible, only a same-gender Muslim should handle the body after death. If this is not possible, non-Muslims should wear gloves so as not to touch the body.

10. A nursing student is asked to identify the practices and beliefs of the Amish society. Which should the student identify? Select all that apply. 1. Many choose not to have health insurance. 2. They believe that health is a gift from God. 3. The authority of women is equal to that of men. 4. They remain secluded and avoid helping others. 5. They use both traditional and alternative health care, such as healers, herbs, and massage. 6. Funerals are conducted in the home without a eulogy, flower decorations, or any other display. Caskets are plain and simple, without adornment.

1, 2, 5, 6 -Rationale: The Amish society maintains a culture that is distinct and separate from the non-Amish society, and some members generally remain separate from the rest of the world, both physically and socially. Family life has a patriarchal structure, and although the roles of women are considered equally important to those of men, they are very unequal in terms of authority. Amish society rejects materialism and worldliness. Members value living simply, and they may choose to avoid technology, such as electricity and cars. They highly value responsibility, generosity, and helping others, and they often work as farmers, builders, quilters, and homemakers. The Amish use traditional health care and alternative health care, such as healers, herbs, and massage. They believe that health is a gift from God but that clean living and a balanced diet help maintain it. They may choose not to have health insurance and instead maintain mutual aid funds for those members who need help with medical costs. Funerals are conducted in the home without a eulogy, flower decorations, or any other display. Caskets are plain and simple, without adornment. At death, women are usually buried in their bridal dresses.

7. The nurse consults with a dietitian regarding the dietary preferences of an Asian American client. Which food should the nurse suggest to include in the diet plan? 1. Rice 2. Fruits 3. Red meat 4. Fried foods

1. Rice -Rationale: Asian American food preferences usually include raw fish, rice, and soy sauce. African American food preferences include chicken, pork, greens, rice, and fried foods. Hispanic Americans prefer beans, fried foods, spicy foods, chili, and carbonated beverages. European Americans prefer carbohydrates and red meat.

5. The nurse is assisting with collecting data from an African American client admitted to the ambulatory care unit who is scheduled for a hernia repair. Which information about the client is of lowest priority during the data collection? 1. Respiratory 2. Psychosocial 3. Neurological 4. Cardiovascular

2. Psychosocial -Rationale: The psychosocial data is the lowest priority during the initial admission data collection. In the African American culture, it is considered intrusive to ask personal questions during the initial contact or meeting. Additionally, respiratory, neurological, and cardiovascular data include physiological assessments that would be priority. Test-Taking Strategy: Focus on the subject, lowest priority during data collection. Use the Maslow's Hierarchy of Needs theory to answer the question. Options 1, 3, and 4 address physiological needs. Review: the characteristics of the African American culture.

4. The client asks the nurse about various herbal therapies available for the treatment of insomnia. The nurse should encourage the client to discuss the use of which product with the primary health care provider? 1. Garlic 2. Valerian 3. Lavender 4. Glucosamine

2. Valerian -Rationale: Valerian has been used to treat insomnia, hyperactivity, and stress. It has also been used to treat nervous disorders such as anxiety and restlessness. Garlic is used as an antioxidant and to lower cholesterol levels. Lavender is used as an antiseptic and fragrance for a mild sedative effect. Glucosamine is an amino acid that assists with the synthesis of cartilage. Test-Taking Strategy: Focus on the subject, a substance that may be used to treat insomnia. It is necessary to remember that valerian has been used to treat insomnia. Review: specific herbal therapies.

8. An antihypertensive medication has been prescribed for a client with hypertension. The client tells the nurse that she would like to take an herbal substance to help lower her blood pressure. Which statement by the nurse is most important to provide to the client? 1. "Herbal substances are not safe and should never be used." 2. "I will teach you how to take your blood pressure so that it can be monitored closely." 3. "You will need to talk to your primary health care provider (HCP) before using an herbal substance." 4. "If you take an herbal substance, you will need to have your blood pressure checked frequently."

3. "You will need to talk to your primary health care provider (HCP) before using an herbal substance." -Rationale: Although herbal substances may have some beneficial effects, not all herbs are safe to use. Clients who are being treated with conventional medication therapy should be advised to avoid herbal substances with similar pharmacological effects, because the combination may lead to an excessive reaction or unknown interaction effects. Therefore, the nurse would advise the client to discuss the use of the herbal substance with the HCP. Test-Taking Strategy: Note the strategic words, most important. Eliminate option 1 first because of the closed-ended word, never. Next, eliminate options 2 and 4, because they are comparable or alike. Review: the limitations associated with the use of herbal substances.

3. The nurse is caring for a group of clients who are taking herbal medications at home. Which client should be given instructions with regard to avoiding the use of herbal medications? 1. A 60-year-old male client with rhinitis 2. A 24-year-old male client with a lower back injury 3. A 10-year-old female client with a urinary tract infection 4. A 45-year-old female client with a history of migraine headaches

3. A 10-year-old female client with a urinary tract infection -Rationale: Children should not be given herbal therapies, especially in the home and without professional supervision. There are no general contraindications for the clients described in options 1, 2, and 4. Test-Taking Strategy: Focus on the subject, safe use of herbal therapies. Note the age in option 3 to direct you to this option. Options 1, 2, and 4 describe adult clients for which there are no contraindications and can thus be eliminated. Review: the indications and contraindications for herbal therapies.

6. The nurse is planning to reinforce nutrition instructions to an African American client. When reviewing the plan, the nurse is aware that which food may be a common dietary practice of clients with African American heritage? 1. Raw fish 2. Red meat 3. Fried foods 4. Rice as the basis for all meals

3. Fried foods -Rationale: African American food preferences usually include chicken, pork, greens, rice, and fried foods. Asian Americans eat raw fish, rice, and soy sauce. Hispanic Americans prefer beans, fried foods, spicy foods, chili, and carbonated beverages. European Americans prefer carbohydrates and red meat. Test-Taking Strategy: Focus on the subject, dietary preferences for African American heritage. This culture is at risk for hypertension and coronary artery disease. With this knowledge you will be directed to the correct option. Review: the food preferences of the African American culture.

2. The nurse is preparing to assist a client of Orthodox Jewish faith with eating lunch. A kosher meal is delivered to the client. Which nursing action is appropriate when assisting the client with the meal? 1. Unwrapping the eating utensils for the client 2. Replacing the plastic utensils with metal utensils 3. Carefully transferring the food from paper plates to glass plates 4. Allowing the client to unwrap the utensils

4. Allowing the client to unwrap the utensils -Rationale: Kosher meals arrive on paper plates and with plastic utensils sealed. Primary health care providers should not unwrap the utensils or transfer the food to another serving dish. Although the nurse may want to be helpful by assisting the client with the meal, the only appropriate option for this client is option 4. Test-Taking Strategy: The focus of the subject, rituals associated with kosher meals. Options 2 and 3 are comparable or alike and can be eliminated first. To choose from the remaining options, it is necessary to be familiar with kosher rituals. Review: the dietary practices of the Orthodox Jewish client.

9. A Hispanic American mother brings her child to the clinic for an examination. Which is most important when gathering data about the child? 1. Avoiding eye contact 2. Using body language only 3. Avoiding speaking to the child 4. Touching the child during the examination

4. Touching the child during the examination -Rationale: In the Hispanic American culture, eye behavior is significant. It is believed that the "bad/evil eye" can be given to a child if a person looks at and admires a child without touching the child. Therefore, touching the child during the examination is very important. Although avoiding eye contact indicates respect and attentiveness, this is not the most important intervention. Avoiding speaking to the child and using body language only are not therapeutic interventions. Test-Taking Strategy: Note the strategic words, most important. Eliminate options 2 and 3 first, because they are comparable or alike. From the remaining options, select the intervention that is most therapeutic, which is touch. Review: the characteristics of the Hispanic American culture.

Catholic (Christianity) Religion and End-of-Life Care?

A priest anoints the sick. Other sacraments before death include anointing of the sick and Holy Eucharist.

Seventh-Day Adventist (Church of God)

Alcohol and caffeinated beverages are usually prohibited. Many are lacto-ovo-vegetarians. Those who eat meat avoid pork. Overeating is prohibited; 5 to 6 hours between meals without snacking is practiced.

Pentecostal (Assembly of God) Religions and Dietary Preferences?

Alcohol is usually prohibited. Members avoid consumption of anything to which blood has been added. Some individuals avoid pork.

Biologically Based Practices- Aromatherapy, Herbal Therapies, Macrobiotic Diet, Orthomolecular Therapy?

Aromatherapy The use of topical or inhaled oils (plant extracts) that promote and maintain health Herbal Therapies The use of herbs derived mostly from plant sources that maintain and restore balance and health Macrobiotic Diet Diet high in whole-grain cereals, vegetables, beans, sea vegetables, and vegetarian soups Elimination of meat, animal fat, eggs, poultry, dairy products, sugars, and artificially produced food from the diet Orthomolecular Therapy Focus on nutritional balance, including use of vitamins, essential amino acids, essential fats, and minerals

Amish (Chrisitianity) Religion and End-of-Life Care?

Funerals are conducted in the home without a eulogy, flower decorations, or any other display. Caskets are plain and simple, without adornment. At death, a woman is usually buried in her bridal dress. One is believed to live on after death, either with eternal reward in heaven or punishment in hell.

Protestant (Christianity) Religion and End-of-Life Care?

No last rites are provided (anointing of the sick is accepted by some groups). Prayers are given to offer comfort and support.

Roman Catholicism Religions and Dietary Preferences?

They avoid meat on Ash Wednesday and Fridays during Lent. They practice optional fasting during the Lenten season. Children, pregnant women, and ill individuals are exempt from fasting.