A client has recently undergone a kidney transplant.
Which of the following diet and activity recommendations should the nurse provide?

Choice A rationale

A ventilator-dependent patient requires complex and specialized respiratory care, including ventilator management, suctioning, and frequent assessments for complications such as pneumonia or acute respiratory distress syndrome. This level of care demands advanced knowledge and experience in critical care, which a nurse with only six months of experience floated from a surgical unit may not possess, potentially compromising patient safety.

Choice B rationale

A patient recently returned from a bronchoscopy and biopsy is at risk for immediate post-procedure complications such as hemorrhage, pneumothorax, or respiratory distress. These potential acute events require prompt and skilled assessment, intervention, and monitoring, which necessitate an experienced nurse with a strong understanding of respiratory physiology and post-procedural care, beyond what a novice nurse might have.

Choice C rationale

A patient on airborne precautions for tuberculosis requires meticulous adherence to infection control protocols to prevent disease transmission. This includes proper use of N95 respirators, negative pressure rooms, and visitor management. While important, managing airborne precautions is a critical skill. However, a nurse with only six months of experience and floated from a surgical unit may not have sufficient experience with medical unit patient acuity or the complexities of managing a communicable disease.

Choice D rationale

Teaching about incentive spirometry is a routine and relatively low-risk intervention, focusing on patient education and demonstrating proper technique. This task aligns well with the skill set of a nurse with six months of experience, even if floated from another unit, as it does not typically involve complex assessments or high-acuity interventions, making it an appropriate assignment for skill reinforcement and patient engagement.

Choice A rationale

Allowing a new mother to hold her stillborn infant demonstrates the ethical principle of beneficence and respect for autonomy. Beneficence involves acting in the best interest of the client, providing comfort and emotional support during a profound loss. Respect for autonomy allows the mother to make choices regarding her grief process and bonding, acknowledging her inherent right to self-determination even in tragedy.

Choice B rationale

Confirming a signed consent form aligns with the ethical principle of autonomy and fidelity. Autonomy ensures the client's right to self-determination and informed decision-making regarding their healthcare. Fidelity involves upholding professional promises and commitments, which includes ensuring all legal and ethical prerequisites for procedures, like informed consent, are meticulously fulfilled prior to intervention.

Choice C rationale

Refusing to disclose client information to the media exemplifies the ethical principle of confidentiality, which is a facet of fidelity. Confidentiality protects sensitive client data, safeguarding their privacy and fostering trust within the therapeutic relationship. Fidelity mandates honoring commitments to privacy and acting as a trustworthy steward of patient information, even under external pressure.

Choice D rationale

Keeping an appointment with a client directly demonstrates the ethical principle of fidelity. Fidelity refers to the commitment to honor promises and maintain loyalty. By consistently attending scheduled appointments, the nurse upholds their professional obligations and builds trust with the client, demonstrating reliability and dedication to the therapeutic relationship. This action directly reflects trustworthiness.