A nurse is caring for a client in an intensive care unit. The client develops delirium while recovering from surgery. To promote safety, which of the following actions should the nurse take?

Choice A Reason:
Autonomy refers to respecting the client's right to make their own decisions about their healthcare. By supporting the client's refusal of medications, the nurse is acknowledging the client's right to self-determination and informed consent. This principle is fundamental in healthcare ethics, as it empowers clients to take control of their own treatment and make choices that align with their values and preferences. Respecting autonomy involves providing the client with all necessary information to make an informed decision and supporting their choice, even if it differs from the healthcare provider's recommendation.

Choice B Reason:
Justice in healthcare refers to fairness and equality in the distribution of resources and treatment. While justice is an important ethical principle, it is not directly related to the nurse's support of the client's refusal of medications. Justice would be more relevant in ensuring that all clients have equal access to care and that resources are allocated fairly. In this scenario, the focus is on the client's individual right to make decisions about their own treatment.

Choice C Reason:
Veracity refers to truthfulness and honesty in communication between healthcare providers and clients. While veracity is crucial in building trust and ensuring informed consent, it is not the primary ethical principle at play when supporting a client's refusal of medication. Veracity would involve providing accurate information about the benefits and risks of the medication, but the act of supporting the client's decision is more closely aligned with the principle of autonomy.

Choice D Reason:
Beneficence involves acting in the best interest of the client and promoting their well-being. While beneficence is a key ethical principle in healthcare, it can sometimes conflict with autonomy. In this case, the nurse may believe that taking the medication is in the client's best interest (beneficence), but the client has the right to refuse treatment (autonomy). Supporting the client's decision respects their autonomy, even if it means not following what the nurse believes to be the best course of action for the client's health.

Choice A reason:
The statement "Assist the client to use new coping strategies" is important but not the first step. Before introducing new coping strategies, it is essential to build a foundation of trust and rapport. This can only be achieved by first establishing confidentiality guidelines.

Choice B reason:
The statement "Help the client to make behavioral changes" is also crucial but not the initial step. Behavioral changes require a trusting relationship and a safe environment, which are established through clear confidentiality guidelines.

Choice C reason:
The statement "Share information with the client about her disorder" is necessary for education and empowerment but should come after establishing trust. The client needs to feel secure that their information will be kept confidential before they can fully engage in learning about their condition.

Choice D reason:
The statement "Establish confidentiality guidelines with the client" is the correct response. Establishing confidentiality is the first step in building a therapeutic nurse-client relationship. It ensures that the client feels safe and secure in sharing personal information, which is essential for effective treatment and care.