Culture

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A client is 2 days postoperative of a hip replacement. The prescriber removed the gauze dressing and gave the patient and nurse instructions to keep the site open to air. In the afternoon, the nurse observed the client rubbing an oil on the surgical site. What is likely the client's rationale regarding the application of the complementary oil?

Tea tree oil has antibacterial properties. Tea tree oil is an alternative therapy that has antifungal and antibacterial uses. Clients use it to treat burns, insect bites, irritated skin, and acne. The nurse should review the prescriber's instructions with the client and also call the prescriber to report the tea tree oil application on the surgical site. Fish oil is an oral therapy used for treatment of coronary disease. Baby oil can make the skin smooth but does not make the skin of a surgical incision smooth. Antiperspirants decrease the secretion of moisture and not vasoconstriction.

An elderly Jewish client received a lunch tray that consists of a cheeseburger, French fries, and an apple. The client tells the nurse to remove the tray. What is the nurse's understanding of why the client wants the tray removed?

Clients of the Jewish faith do not allow the mixture of dairy and meat.

A nurse is completing an admission assessment. Which question is most appropriate for a nurse to use for a spiritual screening during admission?

"How can we support your spiritual beliefs and practices?" The nurse can ask the client how to support spiritual beliefs and practices to obtain more information. If the nurse asks about religion, it may be a small part of the person spiritual life. Asking about prayer is an assumption that the client is prayerful. Asking about the purpose or mission in life is not screening about spirituality.

A client on vacation experiences severe allergy symptoms, headache, and sinusitis (without respiratory distress). This client adamantly declines any supportive medications when offered. The nurse questions the client and learns the client receives weekly acupuncture treatments for these symptoms. What is the nurse's best response?

"Let us try this until you can have acupuncture." The nurse should respect the client's choice of alternative treatments. It is respectful to offer choices until the client can again access acupuncture treatment. Acupuncture is not experimental. The nurse should not ignore the client's right to choose any treatment, but at the same time an attempt should be made to get the client to accept treatment that will be immediately beneficial.

A nurse is making a home visit to a pregnant client at 20 weeks' gestation who is a member of the local Hmong community. The nurse is assisting the client with meal planning to promote optimal nutrition during her pregnancy. Based on the nurse's understanding of the client's culture and food preferences, which foods would the nurse suggest? Select all that apply.

FISH< CHEESE< EGGS. For the Hmong culture, pregnancy is considered a heat loss event, thus the client may prefer to eat hot (yang) foods to maintain balance. Examples of hot foods include fish, cheese, and eggs. Potatoes are considered a cold (yin) food. Whole grains are neither hot or cold but are considered neutral foods.

A nurse is making a home visit to a client who is receiving chemotherapy as part of the treatment plan for cervical cancer. The client reports nausea as a side effect of treatment. The client asks the nurse, "I do not want to put any other medicines in my body. Do you have any suggestions for a natural remedy to help with my nausea?" Which suggestion would the nurse most likely make? Select all that apply.

LAVENDER, GINGER, PEPPERMINT. Substances such as lavender, ginger, and peppermint have been associated with reducing episodes of nausea associated with chemotherapy. Chamomile and melatonin would be useful to address difficulty sleeping.

A deceased client is a member of a culture where the family is expected to bathe the body after death. What should the nurse do to support the client and family at this time?

Provide the needed supplies to the family. In cultures where the family is expected to bathe the body, the family should be given the necessary supplies and left alone in the room with the body. The nurse should not interfere by participating with the family or directing the bathing procedure. The nurse should not bathe the body and expect the family to observe the process. Cultural practices are to be acknowledged and honored and facility personnel can permit the family to complete the task of bathing.

The client on hospice explains to the nurse, "I asked my child to pray with me because I am a very spiritual person, but my child declined and is not a believer anymore." Based on this conversation with the client, what is the best action for the nurse to initiate?

Ask if the client would like to meet with the hospital chaplain. The best action is to ask the client if a chaplain can meet the spiritual need for prayer. It would not be useful to address this client's need with the child who cannot meet this need. It is not clear if other family members are available and can meet this need. It is not appropriate for the nurse to make an assumption that meditation is the equivalent of prayer for this client.

The nurse is caring for a client who is a recent immigrant from China. Through the hospital interpreter, the client expresses an unwillingness to eat the fried fish that was on the meal tray, describing it as "too hot." What is the nurse's best action?

Ask the interpreter to ask the client about the specific meaning of the description of "hot." In many Asian cultures, foods are categorized on a continuum of cold to hot that is independent of their physical temperature. Consequently, it is important for the nurse to assess the precise meaning of the client's statement before taking further action such as changing the client's diet. It is appropriate to assess the client's food preferences, but this data should come from the client, not the interpreter.

The nurse is providing care for a client who immigrated three months ago. The nurse observes that the client is reluctant to make eye contact when responding to the nurse's questions. What is the nurse's best response?

Consider the norms around nonverbal communication in the client's culture. Norms around verbal and nonverbal communication vary widely among cultures; the nurse should be aware of and accommodate these differences whenever possible. It is not normally necessary or possible for clients to receive care from nurses of a similar culture. Mimicking the client's avoidance of eye contact may not put the client at ease. Avoidance of eye contact is not suggestive of a more significant culture-bound syndrome.

An Orthodox Jewish pregnant woman comes to the labor and birth suite with her birth attendant. Her partner is also present in the room. The woman is about to give birth when the nurse observes the partner move to the head of the bed outside the view of the birth. The nurse interprets this action as:

reflecting of the couple's religious beliefs and practices. In the Orthodox Jewish faith, a lack of physical contact between the husband and wife during labor and birth is a religious practice. Additionally, the husband will stand in a place where the birth cannot be seen or a drape will be placed for the delivery so that he cannot view the birth. The husband's movement away from the wife does not demonstrate a lack of interest, the husband's anxiety, or the husband's role in the family as head of the household.

A client hospitalized with Crohn's disease is experiencing a migraine aura. The client requests that the client's chiropractor be allowed to visit even though it is after visiting hours. What is the nurse's best response?

"Tell me what helps your migraines outside of the hospital." Unless previous arrangements have been made for chiropractic care or craniosacral therapeutic massage, the nurse should engage the client in a discussion of what treatments have been helpful outside of the hospital. This is best done before the full migraine symptoms present. It is demeaning and opinionated to dismiss chiropractors as not "real doctors." Offering a medication may be premature without a full migraine assessment history. The nurse must also have full knowledge of all available medication orders to offer medication at this point. Having pain is not a reason to deny a client from having a visitor.

The Orthodox Jewish family of a client admitted for cochlear implantation expresses outrage at their child being served a pork dish after they identified their religion to the nursing staff. What is the nurse's best response?

Recognize their request and respectfully take corrective action. The nurse must acknowledge that this apparently simple breach holds profoundly serious meaning to this family. It is important to acknowledge their request and respectfully take corrective action. These actions may require repeated interventions with the family, as well as the nurse investigating the events that contributed to the erroneous meal being delivered. This would include removing the offending food and obtaining an appropriate replacement for the child. Apologizing may be helpful, but reassuring them it won't happen again is inappropriate and may be seen as insincere at this point. It is inappropriate to reciprocate their anger and call the kitchen to complain.

Which therapeutic modality would be used to treat an individual diagnosed with somatic symptom disorder?

relaxation exercises. Relaxation exercises will help decrease anxiety in a client with somatic symptom disorder. In a somatic symptom disorder, no threat of suicide exists. ECT and aversion therapy are not therapeutic strategies for this disorder.


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