A nurse is considering the delegation of administering topical medications to an unlicensed assistive personnel (UAP). What is the first query the nurse must ask herself before doing so?

Choice A rationale

Sexually Transmitted Infections (STIs) primarily affect the reproductive system and do not directly cause abnormalities in PaCO2 levels. PaCO2 reflects the partial pressure of carbon dioxide in arterial blood, which is a key indicator of respiratory function and acid-base balance.

Choice B rationale

Chronic Obstructive Pulmonary Disease (COPD) is a group of lung diseases that obstruct airflow, leading to impaired gas exchange. This impaired exchange often results in the retention of carbon dioxide, causing an elevated PaCO2 level on an ABG report, indicating respiratory acidosis.

Choice C rationale

Congestive Heart Failure (CHF) primarily affects the cardiovascular system, leading to fluid overload and potential pulmonary congestion. While severe CHF can indirectly affect gas exchange, the most direct and common cause of abnormal PaCO2 is a respiratory issue like COPD.

Choice D rationale

Chronic Renal Insufficiency or Failure (CRF) primarily affects the kidneys' ability to regulate electrolytes and waste products. While CRF can lead to metabolic acidosis, which can trigger respiratory compensation (altering PaCO2), it is not the most direct or likely cause of an abnormal PaCO2 level on an ABG report.

Choice A rationale

Deception involves intentionally misleading someone. Applying physical restraints for the client's safety, while ethically complex, is a transparent intervention intended to prevent harm, not to deceive the client. The intent is protective, even if the client resists.

Choice B rationale

Advocacy involves supporting the client's best interests and rights. While the nurse's concern for the client's safety is a form of advocacy, the act of physical restraint itself can be seen as limiting the client's autonomy, potentially conflicting with a purely advocacy-based approach.

Choice C rationale

Harm, in an ethical context, refers to physical or psychological injury or damage. While the intention of restraints is to prevent falls and physical harm, the application of restraints can itself cause physical injury (e.g., skin breakdown, nerve damage) or psychological distress (e.g., fear, humiliation, loss of control). Therefore, it is a measure that carries the potential for harm.

Choice D rationale

Paternalism involves making decisions for a client that the healthcare professional believes are in the client's best interest, even against the client's wishes. Applying restraints to prevent the client from harming themselves, despite their resistance, aligns with the concept of paternalism, prioritizing safety over autonomy in this specific situation.