A community health nurse is planning to offer community programs that benefit as many clients as possible. Which of the following ethical principles should the nurse use to guide their planning?

Rationale:

A. Raise the head of the client's bed to a high-Fowler's: Placing the client in high-Fowler’s position increases hip flexion beyond 90 degrees, which raises the risk of dislocation following a hip arthroplasty. Proper positioning involves limited hip flexion.

B. Keep an abduction pillow between the client's legs: An abduction pillow maintains proper alignment by keeping the legs apart and preventing internal rotation or adduction of the hip, both of which increase the risk of dislocation after surgery.

C. Elevate the client's affected leg on a pillow when in bed: Elevating the affected leg on a pillow may cause external rotation or misalignment of the hip. Unless prescribed, this practice may inadvertently increase the risk of hip dislocation.

D. Position the client's knees slightly higher than the hips when up in a chair: Having the knees higher than the hips promotes hip flexion beyond 90 degrees, a common cause of prosthesis dislocation postoperatively. Proper chair height and posture help prevent this complication.

Rationale:

A. Eat a light snack before bedtime: A light snack can prevent hunger from interfering with sleep and promote relaxation. Complex carbohydrates or small amounts of protein may help induce sleep without causing gastrointestinal discomfort.

B. Perform exercises prior to bedtime: Vigorous physical activity before bed can stimulate the body and make it harder to fall asleep. Exercise is beneficial when done earlier in the day, ideally several hours before bedtime.

C. Stay in bed at least 1 hr if unable to fall asleep: Staying in bed while unable to sleep can create negative associations with the bed and worsen insomnia. It's more effective to get up, engage in a quiet activity, and return to bed once sleepy.

D. Take a 1-hr nap during the day: Long daytime naps can reduce sleep pressure at night and interfere with falling or staying asleep. If needed, naps should be limited to 20–30 minutes and taken early in the day.