Exhibits

A nurse is reviewing the electronic medical record of a client who is at 29 weeks of gestation. Which of the following findings should the nurse report to the provider? (Click on the exhibit tabs for additional information about the client. There are three tabs that contain separate categories of data.)

Rationale:
A. Encourage cultural practices to be incorporated into their care: Respecting and incorporating a Muslim client’s cultural and religious practices promotes culturally competent and patient-centered care. This approach fosters trust, comfort, and cooperation between the client and healthcare team.

B. Incorporate hot and cold practices into the client's care: Hot and cold theory is typically associated with Hispanic, Asian, and Middle Eastern folk medicine traditions, but not all Muslim clients follow this practice. Care should be based on the client’s individual beliefs.

C. Acknowledge that the client may be cared for by a male provider: Many Muslim women prefer to be cared for by female providers due to religious and cultural values of modesty. The nurse should make reasonable efforts to accommodate this preference whenever possible.

D. Have the client remove any face coverings to obtain their history: Muslim women who wear a niqab or hijab may choose to keep their face covered for modesty. The nurse should not insist on removal unless necessary for identification or assessment, and even then, it should be done privately with sensitivity to religious beliefs.

Rationale:
A. "Avoid exercising in warm places.": Heat can temporarily worsen symptoms of multiple sclerosis, such as fatigue, weakness, and spasticity, due to slowed nerve conduction. Clients should exercise in cool environments or use cooling techniques to prevent symptom exacerbation.

B. "Walk with your feet close together.": Walking with feet close together can increase the risk of imbalance and falls in clients with MS, who often have gait disturbances. Maintaining a wider stance or using assistive devices improves stability and safety during ambulation.

C. "Decrease your daily fluid intake.": Fluid restriction is not recommended for MS and can lead to dehydration and urinary tract complications. Adequate hydration helps maintain bladder function and overall health.

D. "Apply an ice pack to spastic muscles.": Cold therapy does not effectively relieve muscle spasticity in MS; instead, heat may temporarily reduce muscle stiffness. Ice packs are more appropriate for acute inflammation or injury rather than chronic spasticity.