A nurse is caring for a client who has a terminal illness and states, "I wish to discontinue my treatment.”. The nurse responds by saying, "You have a right to refuse treatment.”. This response demonstrates which of the following ethical principles?

Choice A rationale

Reporting pain as 8 on a scale of 0 to 10 indicates significant discomfort and may require analgesic adjustments. However, pain alone, without accompanying complications, does not constitute the highest priority in postoperative care.

Choice B rationale

Urinary output of 30 mL over 1 hour is below the normal adult range of 30–50 mL/hour, potentially indicating hypovolemia or renal issues. However, it does not outweigh circulatory concerns like leg mottling as the most immediate threat.

Choice C rationale

Mottling in the affected leg suggests compromised circulation, possibly due to a blood clot or arterial occlusion, which can lead to tissue ischemia. Immediate intervention is necessary to prevent irreversible damage or complications like necrosis.

Choice D rationale

Postoperative emesis can lead to dehydration and electrolyte imbalances if persistent. However, it does not pose the same urgent threat as vascular compromise seen in mottling of the affected leg.

Choice A rationale

Checking the calibration of the glucometer ensures accurate blood glucose readings. Calibration is essential to identify potential technical errors that could lead to inaccurate readings, compromising client care. However, this action is preparatory and does not directly address the immediate need to assess the client’s current glucose level for appropriate management.

Choice B rationale

Administering prescribed insulin is critical for controlling blood glucose levels in clients with type 1 diabetes. Insulin administration prevents complications like hyperglycemia or ketoacidosis. However, insulin should be administered based on the client’s current blood glucose level, which must be assessed first to ensure the correct dose and timing.

Choice C rationale

Providing breakfast is important to prevent hypoglycemia and support the client’s nutritional needs. However, breakfast timing must align with insulin administration to optimize glucose control. Assessing the client’s blood glucose level first is essential to determine whether immediate nutritional intervention is required.

Choice D rationale

Obtaining the client’s capillary blood glucose level is the first step in managing diabetes effectively. This action allows the nurse to evaluate the client’s current glucose status, guide insulin administration, and ensure safe provision of meals. Accurate glucose measurement is essential to prevent complications such as hypo- or hyperglycemia.