A nurse is helping an obese patient alter dietary habits, but the ...

[michelleunicorn]

A nurse is helping an obese patient alter dietary habits, but the patient does not seem to follow through with agreed-upon recommendations. Which action by the nurse would be most beneficial?
 
  a. Ask the patient about foods that have special meanings.
  b. Describe the health risks of not staying on the regimen.
  c. Encourage the patient to keep a food log during the day.
  d. Review dietary teaching to see what is not understood.

Question 2

A nurse is frustrated working with a patient who is from another culture. The patient does not seem to be motivated to learn to provide self-care. A more experienced nurse helps interpret this behavior by stating,
 
  a. Everyone has motivators; you have to find your patient's.
  b. It's possible the patient doesn't understand what to do yet.
  c. The patient's culture may include a dependent sick role.
  d. Your patient is not ready to learn about self-care yet.

[chinwesucks]

Answer to Question 1

A
Dietary habits are particularly difficult to change because food is often imbued with social and cultural meaning. Furthermore, if the patient is the person doing the cooking for the family, the dietary choices affect all members, who may also not like the prescribed regimen. The nurse could assess the meaning that food has for this patient and make alterations in the recommendations so that special foods can be enjoyed in their traditional manner on limited occasions.
People respond much more favorably to messages about the benefits that accrue from making changes; they do not respond as well to threats of vague future repercussions.
Keeping a food log does help patients lose weight, but finding out whether certain foods have special meanings would be more helpful than just having the patient keep a journal of what foods were eaten.
The patient may have some misunderstandings in regard to the dietary teaching, but the nurse should assess for these, not assume they exist.

Answer to Question 2

C
Some cultures include a dependent sick role, and patients from such a culture would consider an instruction to perform self-care as inappropriate. The nurse would be well advised to assess the patient's cultural beliefs regarding health and wellness first.
It is easier to effect change when the nurse can tie the need for change to a motivating factor in the patient's life. However, this answer does not account for cultural diversity.
The patient may well be confused or unsure of what to do, but this answer does not account for cultural diversity.
The patient may not be emotionally or physically ready to learn self-care measures, but this option does not account for cultural diversity.

[michelleunicorn]

Thanks for the timely response, appreciate it

[Kedrick2014]

Gracias!