A nurse is monitoring a client who is 36 hr postoperative following gastric banding. Which of the following findings should the nurse expect?

A. Beneficence: Beneficence involves actions that promote the well-being of others and provide comfort, support, or care. By sitting with the client to offer emotional support following the loss of a partner, the nurse is actively promoting the client’s welfare and demonstrating compassion, which aligns with the ethical principle of beneficence.

B. Fidelity: Fidelity refers to maintaining trust and keeping promises or commitments to clients. While important in nursing, simply providing comfort through presence does not directly involve promise-keeping, making this principle less applicable in this scenario.

C. Veracity: Veracity is the obligation to tell the truth and provide accurate information. Sitting with the client for emotional support does not involve disclosure or truth-telling, so it is not the primary ethical principle demonstrated here.

D. Autonomy: Autonomy pertains to respecting a client’s right to make their own informed decisions about care. Providing comfort through presence supports well-being but does not involve facilitating or respecting decision-making in this situation.

Rationale:

• Administer lactated Ringer’s: The client is experiencing hyperemesis gravidarum with persistent vomiting and signs of dehydration, including dark, concentrated urine and hypotension. IV fluid replacement with lactated Ringer’s is appropriate to restore fluid and electrolyte balance.

• Initiate NPO status: NPO (nothing by mouth) status may be implemented temporarily to rest the gastrointestinal tract, especially if severe nausea and vomiting prevent adequate oral intake. This allows safe administration of IV fluids and antiemetic medications.

• Measure intake and output: Monitoring intake and output provides objective data to assess hydration status, fluid balance, and response to therapy. Accurate measurement helps guide fluid replacement and detect ongoing losses.

• Administer terbutaline: Terbutaline is a beta-agonist used primarily for preterm labor to relax the uterus. It is unrelated to hyperemesis gravidarum and would not be indicated in this scenario. Administering terbutaline could pose unnecessary maternal and fetal risks.

• Administer metoclopramide: Metoclopramide is a prokinetic antiemetic commonly used in hyperemesis gravidarum to reduce nausea and vomiting. Administering this medication under provider orders supports oral intake and prevents further dehydration and electrolyte imbalance.