A nurse is planning an in-service about types of child maltreatment for a group of staff members. Which of the following examples should the nurse plan to include when discussing manifestations of neglect?

A. Encourage client to use incentive spirometer every 4 hr: While using an incentive spirometer is important to prevent postoperative pulmonary complications, standard practice recommends using it every 1–2 hours while awake rather than every 4 hours. Less frequent use may not adequately prevent atelectasis.

B. Elevate the head of the client's bed to a 45-degree position when awake: For a total hip arthroplasty, strict hip precautions are required to prevent dislocation. Elevating the head of the bed excessively can inadvertently flex the hip past recommended limits (usually less than 90 degrees), increasing the risk of injury.

C. Place an abduction pillow between the client's legs: Using an abduction pillow maintains proper hip alignment and prevents adduction of the operated leg, which significantly reduces the risk of hip dislocation postoperatively. This is a standard and critical component of post-hip arthroplasty care.

D. Use a sequential compression device on the client's unaffected leg: Sequential compression devices are used bilaterally to prevent venous thromboembolism unless contraindicated. Applying it to only the unaffected leg does not provide complete prophylaxis and is not standard practice.

A. Instruct the nurse to discuss their beliefs with the client: Sharing personal beliefs with the client can impose the nurse’s values and compromise patient autonomy. Professional boundaries require that nurses provide nonjudgmental care and avoid influencing a client’s decisions based on personal or spiritual views.

B. Reassign the nurse to a different client: The nursing code of ethics supports a nurse’s right to conscientious objection, provided that patient care is not compromised. Reassigning the nurse ensures that the client receives timely, unbiased care while respecting the nurse’s moral beliefs. This action maintains both ethical integrity and continuity of care.

C. Report the nurse to the ethics committee: Refusal based on genuine moral or spiritual beliefs is not inherently an ethical violation if the nurse follows proper procedures and ensures patient care is not abandoned. Escalating to the ethics committee is unnecessary when reassignment can resolve the issue effectively.

D. Inform the nurse that this action is a violation of the nursing code of ethics: The code of ethics allows nurses to decline participation in procedures that conflict with deeply held beliefs, as long as they do not abandon the client. Labeling the action as a violation is inaccurate and disregards ethical provisions supporting moral integrity.