A client has with profuse diarrhea from food poisoning contracted at a company picnic 12 hours ago. The nurse's care for this client should include: ...

A. Serum K+ 3.6 mEq/L: Serum potassium (K+) level of 3.6 mEq/L is within the normal range (3.5-5.0 mEq/L) and does not specifically validate fluid volume excess. Serum electrolyte levels can be affected by various factors, including hydration status, renal function, and medications. While hypokalemia (low potassium) may be associated with conditions such as diuretic use or excessive fluid loss, it is not a definitive indicator of fluid volume excess.

B. Urine specific gravity of 1.012: Urine specific gravity measures the concentration of solutes in the urine and can provide information about the client's hydration status. A specific gravity of 1.012 is within the normal range (typically 1.005 to 1.030), indicating that the urine is neither extremely concentrated nor dilute. While changes in urine specific gravity may suggest alterations in fluid balance, a single measurement alone may not be sufficient to validate the client's fluid status, especially in the context of fluid volume excess.

C. Respiratory rate 18: A respiratory rate of 18 breaths per minute falls within the normal range for adults (12-20 breaths per minute) and does not specifically indicate fluid volume excess. Changes in respiratory rate may occur in response to various factors, including respiratory, cardiovascular, or metabolic conditions, but it is not a direct indicator of fluid volume status.

D. +4 Pedal Pulses:

The presence of +4 pedal pulses indicates strong, bounding pulses in the feet. This finding suggests adequate perfusion to the peripheral extremities, which may indicate an appropriate fluid balance. In clients with fluid volume excess, maintaining adequate perfusion to peripheral tissues is essential to prevent complications such as peripheral edema and impaired tissue oxygenation. Strong pedal pulses suggest that perfusion to the lower extremities is not compromised due to hypovolemia or decreased cardiac output, which can be associated with fluid volume deficit.

A. Paternalism: Paternalism refers to the healthcare provider making decisions on behalf of the client without their input or consent, typically for the client's perceived benefit. In this scenario, the nurse is not making decisions for the client but rather honoring an agreement to reassess pain after interventions.

B. Confidentiality: Confidentiality refers to maintaining the privacy and security of client information. It does not directly relate to the nurse's commitment to follow through on a verbal contract with the client regarding pain reassessment.

C. Responsibility: Responsibility involves being accountable for one's actions and obligations in providing care to clients. While responsibility is important in nursing practice, it does not specifically address the nurse's commitment to fulfill a verbal contract with the client regarding pain reassessment.

D. Fidelity: Fidelity, also known as loyalty or faithfulness, pertains to the nurse's obligation to uphold commitments made to clients. In this scenario, the nurse is demonstrating fidelity by returning within the agreed-upon time frame to evaluate the effectiveness of pain interventions as promised to the client. This principle emphasizes the importance of keeping promises and honoring agreements made with clients, thereby building trust and promoting ethical practice in nursing.