A nurse is making a home care visit to a client with a hearing deficit.
What is the best thing she can do to facilitate communication with the client?

Choice A rationale

Infants are at the highest risk for fluid and electrolyte imbalance due to diarrhea because they have a higher percentage of body water compared to adults, and a larger proportion of this water is extracellular. Their kidneys are also immature and less efficient at regulating fluid and electrolytes. Additionally, their higher metabolic rate and greater body surface area to weight ratio lead to increased insensible fluid losses.

Choice B rationale

Adolescents have a body composition and physiological regulatory mechanisms that are more similar to adults, making them less vulnerable to rapid fluid and electrolyte shifts from diarrhea compared to infants. Their kidneys are fully developed and can manage fluid and electrolyte balance more effectively.

Choice C rationale

Young adults also have well-developed regulatory mechanisms and a lower proportion of extracellular fluid compared to infants. While prolonged diarrhea can still lead to imbalances, they are generally more resilient than infants due to their mature physiology.

Choice D rationale

School-age children have a body composition and physiological maturity that places them at a lower risk for severe fluid and electrolyte imbalance from diarrhea compared to infants. Their regulatory systems are more developed than those of infants, allowing for better compensation for fluid losses. .

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.