A charge nurse observes a licensed practical nurse (LPN) tell a client that she will return with a medication to help relieve the client's nausea. The LPN does not return with the medication. The charge nurse should reinforce which of the following ethical principles with the LPN?

A. A client who has active bleeding from a puncture wound of the left groin area – Although this client is at risk for significant blood loss, the immediate priority is to assess and address any potential cardiac issues in clients with respiratory distress.

B. A client who has a raised red skin rash on his arms, neck, and face: While a rash may indicate an allergic reaction or infection, it is not immediately life-threatening compared to active bleeding.
C. A client who reports right-sided flank pain and is diaphoretic: Flank pain and diaphoresis could indicate various serious conditions such as kidney stones or myocardial infarction, but active bleeding requires more immediate intervention.

D. A client who reports shortness of breath and left neck and shoulder pain – This client is experiencing symptoms that may indicate a serious cardiac event, such as a myocardial infarction or pulmonary embolism, which requires urgent evaluation and intervention. The combination of shortness of breath and pain in these areas raises the highest concern for potential life-threatening conditions.

A. A client who has peripheral vascular disease and has an absent pedal pulse in the right foot is the highest priority. An absent pedal pulse indicates potential arterial occlusion, which could lead to tissue ischemia and necrosis if not addressed promptly. This situation is critical and requires immediate intervention to restore circulation and prevent permanent damage.

B. A client who has methicillin-resistant Staphylococcus aureus (MRSA) and has an axillary temperature of 38°C (101°F) is not the highest priority. A mild fever in a client with MRSA indicates infection, but it is not immediately life-threatening. This client needs monitoring and possible adjustment of antibiotics, but the situation does not require urgent intervention.

C. A client who is postoperative following a laminectomy 12 hr ago and is unable to void is concerning, as it could indicate a complication such as urinary retention or spinal nerve damage. However, it is not immediately life-threatening and can be addressed after the more critical issue of a potential arterial occlusion in the client with peripheral vascular disease

D. A client who is newly diagnosed with pancreatic cancer and is scheduled to begin IV chemotherapy: While this client's diagnosis and treatment plan are significant, they may not require immediate intervention compared to the potential complications of urinary retention in the postoperative client.