Religion Content

Hindu

A polytheistic religion that was formed from a variety of different religious practices. In Hinduism, salvation is achieved through a spiritual oneness of the soul, atman, with the ultimate reality of the universe, Brahma. To achieve this goal, the soul must obtain moksha, or liberation from the samsara, the endless cycle of birth, death, and rebirth. As a result of these basic teachings, Hindus believe in reincarnation, which is influenced by karma (material actions resulting from the consequences of previous actions), and dharma (fulfilling one's duty in life). Because all forms of animal life possess souls, Hindus believe in ahimsa, or that all life is sacred. and should not be harmed (i.e. sacred cow). Most Hindus are vegetarians so that they do not harm other living beings. The belief in reincarnation, karma, and dharma also provides the religious justification for the existence of the rigid social structure known as the Caste System.

An 88-year-old female Jewish client is admitted to the hospital and diagnosed with diabetes. Which type of insulin is refused by this client?

A. Beef B. Pork C. Synthetic D. Fish Answer B is correct. Pork is not allowed in the diet or medications of Jewish clients. Both synthetic and beef insulins are allowed, so answers A and C are incorrect. There is no such thing as a fish insulin, so answer D is incorrect.

The client is a practicing Hindu. Which food should be removed from the client's tray?

A. Bread B. Cabbage C. Steak D. Apple Answer C is correct. In the Hindu religion, beef is prohibited. All breads, vegetables, and fruits are allowed, so answers A, B, and D are incorrect.

Which medication will most likely be refused by a Muslim client?

A. Insulin B. Cough syrup C. NSAIDs D. Antacids Answer B is correct. Most cough syrups contain alcohol, which is forbidden in the Islamic religion. Attempts should be made to obtain a cough suppressant that does not contain alcohol. The client will most likely take insulin, nonsteroidal anti-inflammatory drugs, and antacids, so answers A, C, and D are incorrect.

The condition of an Arab client who is terminally ill deteriorates and death seems imminent. If the client is hospitalized in the mainland United States, the nurse should position the bed facing which direction?

A. Northeast B. Southeast C. West D. South Answer B is correct. At the time of death, the Muslim client will wish to be positioned facing Mecca, which is to the southeast of the United States. Answers A, C, and D are therefore incorrect.

An infant is admitted with a volvulus and scheduled for surgery. The parents are Jehovah's Witnesses and refuse to sign the permit. Which action by the nurse is most appropriate?

A. Obtain a court order. B. Call the doctor. C. Tell them that the surgery is optional. D. Monitor the situation. Answer B is correct. A volvulus is an emergency situation in which the bowel is twisted. Refusal of treatment can lead to death, so the next action to take is to call the doctor. It might require a court order to get a permit for the surgery or the court might comply with the parent's wishes, so answer A is incorrect. The surgery is not optional, so answer C is incorrect. Volvulus is an emergency situation and action must be taken if the child is to survive. Monitoring only waste precious time, so answer D is incorrect.

A 90-year-old client from Thailand is diagnosed with terminal cancer. The family seems unconcerned and, although they do not refuse treatment for the client, they do not assist with treatment. Which of the following is the nurse's likely assessment of this behavior?

A. The family believes in the cycle of life and that death is a step into the next cycle. B. The family is in denial concerning the diagnosis and needs further teaching. C. The family is planning to get another opinion regarding the diagnosis. D. The family is not concerned with the treatment and care of the client. Answer A is correct. Clients who practice the Hindu religion believe that death is part of the cycle of life. There is no data to support answers B, C, or D as an answer.

African Americans

African Americans often have strong religious affiliations. Many are affiliated with Christian denominations—notably Baptist and Church of God in Christ. Many follow Islam. Maintaining good health is associated with good religious practice. Many churches maintain a health ministry, through which congregations and parish nurses support good health with flu shots, blood pressure checks, and health education. Before the advent of health ministries, African American churches had mission volunteers who attended services and administered to parishioners. African Americans are becoming increasingly health conscious, seeking health screenings and treatments, although health literacy in this population tends to vary by generation. Older African Americans may be suspicious of clinicians, believing their health is personal and up to God's will. Because they may be reluctant to share personal or family issues, building a trusting relationship is key.

What practices should be known regarding Christian Science?

Alcohol and tobacco are considered drugs and are not used. They may refuse medical treatment and view health in a spiritual framework (NEED TO DISCUSS ADVANCE DIRECTIVES AND END OF LIFE CARE). They may request that a Christian science practitioner be notified to come (makes situation less stressful).

What food items are prohibited for Mormonism?

Alcohol, Tobacco, and beverages containing caffeine stimulants (coffee, tea, colas).

What food items are prohibited for Hinduism

All meat and animal by-products (lard, etc)

Amish

An Anabaptist Christian denomination and Swiss-German ethnic group found primarily in the United States and Ontario, Canada, that are known for restrictions on the use of modern devices such as automobiles and telephones.

Jehovah's Witness

Believe taking blood into body is morally wrong. Will not allow transfusions of whole blood or its components. Doesn't promote donation or receipt of organ through which blood is passed. Some members will not eat food to which blood has been added.

European Americans

Christianity is the most common religion practiced by European Americans. Many Christians in The U. S. attend church or Sunday school regularly and on religious holidays, and many children attend private Protestant or Catholic schools. Most states also have an active Jewish population. The remaining 19% of the population practice other religions or follow no religious traditions. The practices of traditional Western medicine are favored. Western medicine is characterized by rigorous safety protocols with treatments and medications that must pass a strict review before they can be used for patient care. Health care providers use methods developed according to medical and scientific traditions. Treatments may include medication, surgery, chemotherapy, radiation, and physical therapy. Western medicine differs from Eastern medicine in its approach to treatment. Western medicine's greatest strength is in trauma care and therapies for acute problems. Increasing attention is being paid to preventive medicine to address growing rates of chronic diseases. The holistic approach of Eastern medicine is increasingly being incorporated into traditional medical treatment. Illnesses and conditions are uniquely treated according to the way a particular patient experiences a disease. For example, patients with fibromyalgia may use meditation or massage therapy to reduce stress and improve muscle function. Eastern medicine's greatest strength is in the area of treating the whole person—mind, body, and spirit—not just the disease.

Kosher (means "fit" or "proper")

Describes food that is permissible to eat under Jewish dietary laws. In general, kosher means that food should be clean. Meat and milk dishes may not be eaten together or prepared using the same utensils or dishes. Jews also may not eat pork, shellfish, or animals that have not been ritually slaughtered. Jews have different practices regarding these rules.

What should be known regarding Hinduism?

Dietary restrictions vary according to sect, but certainly no BEEF. Death rituals specify practices and who can touch corpse (FAMILY ONLY). They believe in charms/bracelets, try to leave them on if possible. Girls over 7 can't be seen naked by a man.

Christian Scientists

For healing, members prefer to rely solely on prayer by themselves and Christian Science practitioners, supported at times by Christian Science nurses. Members decide for themselves what care they will accept if they should find themselves in a health care facility. Members prefer to be free from the use of drugs, medicines, and medical surgery. Members may accept medical assistance on occasion (e.g., setting a broken bone). Members accept medical treatment if the laws of the land so dictate (e.g.,immunizations). Christian Scientists obey God and the laws of the land.

Asian Indians

In India, nearly 83 percent of Indians are Hindus. Indians are also Muslim, Sikh, Jain, Buddhist, Parsis, Christian, Jewish, and Zoroastrian. While Hindus believe in one God, they worship many forms of gods and goddesses in temples or at home and read from holy scriptures (Vedas, Upanishads, and Gita). Indians tend to accept and respect most Western medical practices, including regular exams, screening procedures, transfusions, and surgeries, although they may prefer to receive blood from persons in their own family or religion. Along with Western medical practice, Indian immigrants may also use faith and spiritual healing, including ritual acts and reciting charms, and the belief that yoga eliminates certain physical and mental illnesses. Hindus and Sikhs believe that disease is due to karma, the result of one's actions in past lives. They may also attribute illness to body imbalances, which create toxins that can accumulate in weaker areas of the body, resulting in conditions such as arthritis. Many older Indian immigrants use home remedies based on the Indian medicine system called Ayurveda (knowledge of life/health), which uses spices and herbs for cold, congestion, and heart problems. Remedies may include turmeric paste as an antiseptic, ginger and lime juice for stomach ache, and buttermilk stored in an iron utensil for anemia.

What should be known regarding Roman Catholics?

Infants should be baptized 1-6 months after birth. Anointing of the sick is encouraged. Fasting and abstinence from meat optional during Lent, none on Ash Wednesday and on Fridays during lent.

Cambodians

Many Cambodians are Theravada Buddhists, one of the two major branches of Buddhism. Other Cambodians practice Islam, Cham, Christianity, or animist religions. Khmer often attribute good health to equilibrium, adopting the Chinese philosophy of balancing hot and cold. Many Khmer also believe in the inherent properties of balancing hot and cold foods. Food is deemed either hot, cold, or neutral. For example, chicken is hot, vegetables are cold, and rice is neutral. Khmer people who eat a traditional Cambodian diet eat rice at all three meals and prefer warm tea or water to drink. Most Khmer do not use ice and rarely consume dairy products. Many are lactose intolerant. Khmer who subscribe to traditional beliefs attribute illness to natural or super natural powers. Illness may be considered punishment for sins committed in a past life. Many believe evil spirits or ancestors cause mental illness. Khmer may seek traditional practices before they seek Western medicine, and often hold traditional healing ceremonies in the home. They may reject or not appreciate the value of preventive care, screening, or early detection. In the hospital, many family and friends may visit patients and often like to sleep in the patient's room. Khmer may fear surgery and giving blood due to the belief that these procedures will result in heat loss.

Russian

Many Russian immigrants practice Judaism or Eastern Orthodox Christianity, Russia's traditional and largest religion. The Eastern Orthodox church is widely respected by both believers and nonbelievers, who see it as a symbol of Russian heritage and culture. Many Russian immigrants in the US also belong to Christian Baptist and Pentecostal churches. Smaller numbers of Russians follow other Christian religions, such as Roman Catholicism, Armenian Gregorian, and various Protestant denominations. As a product of the anti-religion policy of the former Soviet Union established in the early 1900s, many Russian immigrants are atheists. Some Russians believe that disability or illness is caused by something the individual did not do right, such as not eating well or not dressing warmly enough. Good health is equated with absence of pain. Illnesses that do not cause pain often go undiagnosed and under-treated. Immigrants may not answer questions regarding a family history of mental illness or past treatment, as it is culturally shameful. Bad health news may not given to a person who is gravely ill or disabled. It is commonly believed that the individual needs to be at peace so physical and emotional conditions do not worsen. The family prefers to receive the news first, then decides whether or not to tell the patient of the condition and prognosis.

Diet and Religion

Many religious groups have specific dietary rules and restrictions, usually based on a religious reason or to safeguard health, such as the Kosher (fit to eat) rules of Judaism, the Halal rules of Islam, or the vegetarian diets of many religions.Vegetarianism includes total vegetarianism -- a vegan diet that allows only food of plant origin; lacto-vegetarianism that adds dairy products; lacto-ovo- vegetarianism that adds dairy products and eggs; and semi-vegetarianism that includes dairy products, eggs and limited amounts of poultry and fish. No vegetarian diet allows red meat. When in doubt- a vegan diet with no caffeine works!

Muslim/Islam

May prefer female heath care providers due to modesty, may require interpreter, forbids premarital sex/unmarried pregnancy uncommon, few restrictions on pregnant physical activities, very modest, men accompany women at delivery, father calls "praise to Allah" in newborn right ear after delivery, breastfeed, large family groups visit, prayer 5 times day, discourage women from fasting, usually circumcise boys, do not eat pork, typically vegetarian dishes

Ethiopians

Nearly half of the population in Ethiopia is Muslim, and half Christian, with Ethiopian Coptic Orthodox accounting for most Christians. A common belief among Ethiopians is that well being is based on a balance of spiritual, physical, social, and environmental forces. Illness can be attributed to God, destiny, nature, demonic spirits, emotional stress, or a breach of social taboos or vows. Ethiopian medicine relies heavily on magical and supernatural beliefs, such Mental illness and some physical illnesses, such as epilepsy, are commonly attributed to evil spirits. They generally resist psychiatric treatment for themselves and other family members. Patients should be reminded not to double or triple dose if they miss a medication. This is especially important because many Ethiopians frequently fast for religious reasons and may not take their medications during these times. Some patients may fear surgery and the process of blood donation, and require additional information and reassurance.

What should be known regarding Jehovah's Witness?

No infant baptisms. Use of tobacco and alcohol discouraged. Blood transfusions are not allowed (may take non-blood plasma expanders). They are prepared to die rather than break God's law.

What food items are prohibited for Islam?

Pork, alcohol products, animal shortenings, gelatin made with pork/marshmallow.

What food items are prohibited for Seventh Day Adventism?

Pork, certain seafood including shellfish, and fermented beverages.

What food items are prohibited for Judaism?

Pork, predatory fowl, shellfish and scavenger fish (shrimp, crab, lobster), mixing milk and meat dishes at same meal, and blood by ingestion (raw meat).

Seventh Day Adventists

Saturday is designated as a holy day.

Native Americans

Spirituality is central to the identity of the American Indian, and is viewed holistically. People and nature are interconnected. Every animate and inanimate form of life has a spirit and is considered sacred. For example, water is viewed as a sacred, life-sustaining source and a way of connecting with the earth. The head and hair are considered particularly sacred. Respecting and nurturing life and developing a positive relationship with the spirits is core to Indian spirituality. Indians nurture that relationship through prayer and a purification ritual in a sweat lodge. They burn sage and sweet grass, and smoke a special ceremonial tobacco for cleansing, blessings, and healing. Drumming, dancing, and singing also are traditional spiritual expressions associated with healing. American Indians have endured decades of assimilation policies designed to strip them of their identity and integrate them into the dominant society. Many Indian people who grew up in the mid-twentieth century describe a feeling of shame in their heritage during that time. This was partly due to the fact that it was illegal for Indians to practice their religious ceremonies until the American Indian Religious Freedom Act was passed in 1978. As a result, many Indians today have Christian ties or practice no religion at all.

Mennonite

Strive for pacifism, no military or public service is allowed. Members are exhorted to live a plain life, live simply, at peace with others, Quakers and Mennonites are similar in beliefs

Somalians

The majority of Somalis are Sunni Muslims. For Somalis, Islamic religious teachings provide meaning for living, dying, health, child rearing, and family life. In Islam, prayer is performed five times a day: at dawn, noon, mid-afternoon, sunset, and in the evening. Prayer can take place at home, at school, in the workplace, outdoors, or in a mosque. Hands, face, and feet are washed before prayer. Islam forbids eating pork, drinking alcohol, and touching or being near dogs. Ramadan is observed as the most important Islamic holiday, a month long holiday during which people refrain from taking medications, and eating and drinking during daylight hours, with the exception of pregnant women, the very ill, and young children. In Islamic tradition, the right hand is considered the correct and polite hand to use for daily tasks such as eating, writing, and greeting people. There is no word for stress in the Somali language. Health prevention is practiced primarily through prayer and living a life according to Islam. Many Somalis believe that an individual cannot prevent illness, as the ultimate decision is in God's hands. They believe that illness may be caused by a communicable disease, by God, by spirit possession, or by the "evil eye." Mental illness is often believed to be caused by spirit possession or as a punishment from God. Traditional spiritual healers use religious rituals for healing. Patients often wear amulets, believed to have medicinal value and to keep evil spirits away.

Hispanic Americans

The majority of immigrants from Latin America are Roman Catholic Christians, who attend church regularly, pray to God, Jesus, the Virgin Mary, and saints. They light candles, observe baptisms and confirmations, maintain home shrines, and visit shrines throughout Mexico or Latin America when possible. Catholic Hispanics/Latinos celebrate religious holidays, including Christmas, Easter, and holy days. Hispanics/Latinos may consult folk healers or spiritualists, especially if they lack health insurance. Herbal teas are popular remedies for some conditions, including yerba buena (spearmint) and te de manzanilla (chamomile). Be gracious. Acknowledge the patient's arrival and offer them a seat. Building respect is essential. Establish a relationship with the family before care begins. Use a non-confrontational tone. Be receptive to family suggestions.

Vietnamese

Vietnamese people follow a variety of religions. Prior to the Vietnam War (often referred to as the American War by Vietnamese), Buddhism was practiced by 90 percent of the population in Vietnam. Many Vietnamese are Roman Catholics, a remnant of Vietnam's occupation by the French, Portuguese, and Spanish. They also may worship spirits and natural forces, or practice ancestor worship or astrology. Confucianism and Taoism have strongly influenced Vietnamese cultural traditions. Many customs are rooted in both the Confucian respect for education, family, and elders, and the Taoist desire to avoid conflict. Stoicism is a highly respected trait. Many Vietnamese believe that Asian people are different physiologically than white people. Western medicines are thought of as "hot" and too potent for their physiology. As a result, they may not take medicines as prescribed. Many elders do not trust western medicine and use it only as a last resort. They use traditional remedies as well as western medicines but may not reveal this to a provider. Vietnamese patients often resist invasive procedures and immunizations, and see a provider who does not intrude on the body as the best healer. Vietnamese people also believe in the medicinal properties of specific foods, such as mung beans, green beans, and bitter melon, which is believed to help control high blood pressure. Acupuncture is used widely for arthritis pain, stroke, visual problems, and other ailments.

A nurse is preparing a plan of care for a client who is a Jehovah's Witness. The client has been told that the surgery is necessary. The nurse considers the client's religious preferences in developing the plan of care and documents that:

a) faith healing is practiced primarily b) medication administration is not allowed c) surgery is prohibited in this religious group d) the administration of blood and blood products is forbidden (x)

Which of the following meal trays would be appropriate for the nurse to deliver to a client of Jewish faith who follows a kosher diet?

a) pork roast, rice, vegetables, mixed fruit, milk b) crab salad on a croissant, vegetables with dip, potato salad, milk c) sweet and sour chicken with rice and vegetables, mixed fruit, juice (x) d) fettucini Alfredo with shrimp and vegetables, salad, mixed fruit, iced tea

The parents of a critically ill infant are practicing Catholics. The nurse is aware that baptism is an important religious ritual. Which of the following is the best action for the nurse to take?

a. Ask the hospital chaplain to baptize the baby b. Ask the doctor to baptize the baby c. Ask the parents for direction as to who they want to baptize the baby (x) d. Do nothing, because discussing baptism will make the parents more anxious

Daily prayers are often prescribed by certain religions. In the Jewish religion, the kaddish is best described by which of the following? A daily prayer that Jews say:

a. At bedtime. b. Before meals. c. Upon rising in the morning. d. Daily for 1 year after the death of a loved one. (x)

What facets of religion related to health and illness may affect nursing practice?

a. Attitudes about treatment acceptance b. Death and dying practices c. Food preferences and restrictions d. All of the above (x)

Spirituality can best be defined as:

a. Being essential to a person's being, involving a relationship with God or a higher power (x) b. An organized system of beliefs shared by a group of people. c. The acceptance of specific values and rituals. d. Expectations, believing in something that cannot be directly observed.

As defined by NANDA, which of the following characteristics are associated with spiritual distress?

a. Lack of meaning or purpose in life b. Expressing anger toward a Supreme Being c. Sudden changes in spiritual or religious practices d. All of the above (x)

Symbols of religious belief include jewelry, medals, amulets that carry religious or spiritual significance. Some clients may wish to have these symbols with them when hospitalized. Your patient holds a rosary for prayer and comfort. The rosary is a symbol found in which of the following religions?

a. Muslim b. Catholicism (x) c. Judaism d. Seventh-Day Adventist

From assigned readings: How did the Puritans celebrate Christmas?

a. Prayer and reflection b. Feasting and celebration c. Working and devotion d. Fasting and introspection

Which of the following statement best describes religion? Religion:

a. Represents the core of a person's being, involving one's relationship to God or a higher being. b. Is an organized belief system shared by a group of people. (x) c. Reflects beliefs that supernatural forces control health and illness. d. Is unique to the practice of Christianity.

Most religions have a weekly day set aside for rest, prayer, and reading of sacred works. Muslims observe which day of the week as a day of meditation and worship?

a. Sunday b. Friday (x) c. Sundown on Friday until sundown on Saturday d. Saturday