A male Hmong client from Laos is a client at an outpatient mental ...

[Marty]

A male Hmong client from Laos is a client at an outpatient mental health clinic who is being seen for his diagnosis of bipolar disorder.
 
  The importance of lithium testing was stressed in his discharge plans; however, it is discovered that he has had his lithium level checked only once, rather than the three scheduled times. What is the nurse's best action? a. Remind the client about the importance of lithium level testing.
  b. Make scheduled appointments for the client to get his lithium level tested.
  c. Give the client written information regarding the importance of lithium level testing and written instructions on how to make appointments for testing.
  d. Talk with the client to see if there is a reason that he is not getting his lithium levels checked as outlined in his discharge plans.

Question 2

A 25-year-old patient tells the nurse he is living a miserable existence. All his life, he states, he has thought, felt, and acted like a woman while living in the body of a man.
 
  He has lived as a female and dressed in feminine attire for more than a year. He has decided to change jobs so as not to compromise the new identity and now wishes to take the next step with surgery. The first patient request the physician will likely address is: a. Will you order estrogen therapy?
  b. Can you refer me for psychotherapy?
  c. Will you alter my medical records?
  d. Please give me something to make me a man..

[Jordin Calloway]

Answer to Question 1

D
In the Hmong culture, it is believed that loss of blood leads to decreased body strength, which can cause the soul to leave the body, resulting in death. If the nurse did not discuss why the client was not getting his blood levels tested and gave him additional instructions as listed in the other options, the nurse would not understand and would not be able to incorporate the client's cultural beliefs into the plan of care. The nurse and the client can now make revisions that will be acceptable while meeting the needs of the client.

Answer to Question 2

B
Psychotherapy to help anticipate and deal with the psychological issues and adjustments involved in gender reassignment would be undertaken before hormonal therapy and sexual reassignment surgery. Although privacy concerns exist, owing to the unusual nature and possible social stigma associated with gender reassignment, altering medical records would be unethical and an unlikely request. The scenario suggests that the patient prefers life as a woman and would probably not seek to increase his masculinity.

[Marty]

Excellent

[bdobbins]

Gracias!