A nurse is caring for a client who is dying. The nurse should incorporate the principle of nonmaleficence into practice by taking which of the following actions?
Withholding a dose of narcotic pain medication when the client has respiratory depression
Discussing advance directives with the client and the client's family
Providing comfort care measures to the client
Allowing the client's family unlimited visitation at the time of death
The Correct Answer is A
Rationale:
A. Withholding a dose of narcotic pain medication when there is respiratory depression aligns with nonmaleficence, as it prevents further harm by not exacerbating the client's respiratory issues.
B. Discussing advance directives is important but is more related to autonomy and respect for the client’s wishes rather than nonmaleficence.
C. Providing comfort care is a supportive measure but does not specifically address nonmaleficence in terms of preventing harm.
D. Allowing unlimited visitation respects family wishes but does not directly relate to the principle of nonmaleficence regarding the client’s immediate medical needs.
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Correct Answer is B
Explanation
Rationale:
A. "If you let us know ahead of time that you plan to perform a procedure, we could do better job of having the supplies available." may be perceived as placing blame and does not address the immediate concern of the provider's anger.
B. "It must be very frustrating when you don't have what you need to perform the procedure." acknowledges the provider's frustration and validates their feelings, which can help de-escalate the situation and improve communication.
C. "I will help you with this procedure instead of the staff nurse." does not address the underlying issue and might not resolve the conflict or improve the situation.
D. "You should think about how you make others feel when you lose your temper." is confrontational and may escalate the situation further rather than resolving it.
Correct Answer is B
Explanation
Rationale:
A. "It is time to sign the consent so your treatment can begin." dismisses the client's valid question about alternative options and does not address their concern.
B. "Have you discussed other treatments with your provider?" is an appropriate response as it encourages the client to seek information about alternatives from their healthcare provider, who can offer comprehensive options and explanations.
C. "I can inform the surgeon you do not want the surgery." does not address the client's question about alternatives and assumes the client’s decision without further discussion.
D. "I would not have this type of surgery if I were you." is a personal opinion and is not appropriate for a nurse to provide, as it is not based on the client’s individual medical needs or informed consent principles.