A charge nurse observes a client fall while ambulating with an assistive personnel and notes that the client's gait belt was not in place. When reviewing the incident report, the charge nurse finds that the report does not mention the gait belt. Which of the following ethical principles should the charge nurse follow?

Choice A Reason:
Whether the facility ethics committee reaches a consensus on the case is incorrect. While an ethics committee may provide guidance and recommendations, its decision alone typically does not determine whether a surgery will be performed. Ethics committees are advisory bodies and their decisions may not necessarily override the wishes of the patient or their legal representative.
Choice B Reason:
Whether the client's refusal is based on religious belief is incorrect. Religious beliefs may influence a patient's decision-making process, but they do not automatically determine whether a surgery will be performed. Healthcare decisions are generally based on medical factors, patient autonomy, and legal considerations rather than solely on religious beliefs.
Choice C Reason:
Whether the client understands the risk of refusing the procedure is incorrect. Patient autonomy and informed consent are essential principles in medical ethics. Understanding the risks and benefits of a medical procedure is important for informed decision-making. However, even if the client understands the risks of refusing the procedure, they still have the right to refuse treatment based on their personal preferences and values.
Choice D Reason:
Whether the partner is the client's durable power of attorney for health care is correct. A durable power of attorney for healthcare, also known as a healthcare proxy or surrogate decision-maker, is legally authorized to make medical decisions on behalf of the patient if the patient is unable to do so themselves. If the partner is designated as the client's durable power of attorney for healthcare, they have the legal authority to make decisions regarding the surgery, even if the client refuses. This is because the surrogate decision-maker is tasked with acting in the best interests of the patient when the patient cannot make decisions for themselves.

Choice A Reason:
The patient should be elevated 45-90° before inserting a nasogastric tube helps prevent aspiration and facilitates tube insertion.
Choice B Reason:
Assisting the client into a fetal position on his side in preparation for a lumbar puncture is a proper positioning technique to facilitate the procedure and minimize discomfort for the client.
Choice C Reason:
Assessing the client's gag reflex following an esophagogastroduodenoscopy (EGD) is standard practice to ensure the client's safety and ability to protect their airway after the procedure.
Choice D Reason:
Maintains the chest tube collection device below the level of the insertion site when ambulating the client is correct. Chest tube management is critical to prevent complications such as air leaks, tension pneumothorax, and tube dislodgement. When ambulating a client with a chest tube, it's essential to keep the collection device below the level of the insertion site to ensure proper drainage and prevent air from entering the pleural space. If the collection device is positioned above the insertion site, it could result in fluid or air backflow into the patient's chest cavity, which can lead to complications.