Answer to Question 1
A
In some cultures, nursing care decisions are not considered solely the wishes of the patient (the American way) but must take into consideration the wishes and decisions of all family members. Because family commitment and involvement are strengths of the patient's cultural group, the nurse should incorporate them into teaching and follow-up care for the patient.
Choosing a family spokesperson would work if there were a designated member of the cultural group to whom others defer. In this case, with the cultural strength being family involvement, the nurse would be wise to ask those people who are important to the patient if they would like to participate.
Encouraging the family to check in on the patient is a good intervention, involving many family members, but it is too narrow in focus to be the best answer.
Reminding the patient that following changes will lead to a longer life with family is a paternalistic statement and does not allow for involvement of the family, an identified cultural strength.
Answer to Question 2
B
For many cultures, the nurse must recognize the importance of family (or others) in health care decision making and in health care behavior. The nurse should reconsider the discharge teaching plan and include the male relative in creating a new one. This demonstrates sensitivity by following the patient's cultural cues.
The relative may not have the expertise or skill to actually assist with the teaching. Plus, without including him when planning the teaching, the patient has a high risk of not following through with the plan.
Confidentiality is an important concept in health care, but as nurses work with patients from increasingly diverse cultures, the implementation of confidentiality may need revision. This patient clearly wants her male relative included in her health care, and the nurse should follow the patient's lead.
Trying to teach the patient when the relative is absent will most likely create a conflict between patient and nurse with the end result being noncompliance on the patient's part. The nurse needs to follow the patient's cultural cues and include the relative.
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