Examkin

Question

Difficulty: Very hardReligious and Spiritual Influences on Health

A client who adheres to the Jehovah's Witness faith is admitted to the medical-surgical unit with severe symptomatic anemia following a gastrointestinal hemorrhage. The provider has prescribed a treatment plan to manage the acute blood loss. Identify the appropriate nursing actions the licensed practical nurse (LPN/LVN) should take to support this client's physiological needs while respecting their spiritual beliefs. Select all that apply.

  1. Administer prescribed subcutaneous epoetin alfa to stimulate endogenous red blood cell production.Answer
  2. Inquire privately if the client's personal conscience permits the administration of a prescribed human albumin infusion.Answer
  3. C
    Serve a high-iron dietary tray containing spinach and black pudding to support natural hemoglobin synthesis.
  4. D
    Initiate a prescribed intravenous infusion of fresh frozen plasma to rapidly expand the client's intravascular volume.
  5. E
    Ask the client, 'Why do you feel that receiving a transfusion would compromise your faith if it is necessary to save your life?'
  6. Document the client's choice and immediately notify the registered nurse (RN) if the client declines a prescribed intravenous iron infusion.Answer

Answer

The appropriate actions include administering subcutaneous epoetin alfa, inquiring if the client's conscience permits human albumin, and reporting the refusal of an iron infusion.
The correct actions demonstrate cultural competence, respect for client autonomy, and strict adherence to the LPN/LVN scope of practice. Administering subcutaneous epoetin alfa is within scope and widely accepted in bloodless medicine as it contains no blood components. Human albumin is a minor blood fraction; therefore, accepting it is a matter of personal conscience for Jehovah's Witnesses, making it appropriate for the nurse to respectfully inquire about the client's preference. Finally, documenting and reporting a client's refusal of any treatment ensures proper continuity of care and protects the client's legal right to self-determination.

Step-by-Step Solution

1
Identify the client's spiritual affiliation and core prohibitions.
The client is a Jehovah's Witness, a faith that strictly prohibits the intake or transfusion of whole blood and its primary components (red cells, white cells, plasma, and platelets).
Establishing the absolute spiritual restrictions directs the baseline for both physiological and dietary interventions.
2
Differentiate between primary blood components and minor blood fractions.
Plasma is universally prohibited, whereas albumin is a minor fraction and its acceptance is left to the individual's personal conscience.
Ensures the nurse does not administer forbidden treatments while still advocating for and offering permitted medical options.
3
Evaluate the cultural dietary implications of the prescribed care.
Foods containing animal blood, such as black pudding, must be strictly avoided.
Prevents a severe breach of the client's spiritual dietary laws when attempting to correct nutritional deficits like low iron.
4
Assess the scope of practice and communication standards for the LPN/LVN.
The LPN/LVN can administer subcutaneous medications, must avoid non-therapeutic 'why' questions, and cannot initiate blood products.
Guarantees that care is legally compliant, safe, and culturally sensitive.

Key Concept

Cultural competence for Jehovah's Witness clients regarding blood products, dietary restrictions, and therapeutic communication within the LPN/LVN scope of practice.
Estimated Time:2m 0s
Rate this question

Topics

Religious and Spiritual Influences on Health

More questions from this topic