A nurse is preparing a community health program for adults at risk for cardiovascular disease. Which of the following should the nurse include as a modifiable risk factor?

Choice A reason: Veracity

Veracity refers to the ethical principle of truthfulness and honesty. In the context of nursing, it involves providing accurate and complete information to patients. While veracity is crucial in maintaining trust between the nurse and the patient, it is not directly related to the decision to discontinue a medication due to adverse effects.

Choice B reason: Fidelity

Fidelity involves being faithful to commitments and promises made to patients. It includes maintaining confidentiality and being loyal to the patient’s best interests. Although fidelity is important in the nurse-patient relationship, it does not specifically address the ethical considerations involved in discontinuing a harmful medication.

Choice C reason: Nonmaleficence

Nonmaleficence is the ethical principle of doing no harm. In this scenario, discontinuing the experimental chemotherapy medication due to evidence of rapidly advancing kidney failure aligns with the principle of nonmaleficence. The nurse and healthcare team are acting to prevent further harm to the patient by stopping a treatment that is causing significant adverse effects.

Choice D reason: Autonomy

Autonomy refers to respecting the patient’s right to make their own decisions about their healthcare. This includes providing the patient with all necessary information to make informed choices. While autonomy is a fundamental ethical principle, the decision to discontinue the medication in this case is primarily based on preventing harm, which aligns more closely with nonmaleficence.

Choice A reason:

An infant who has pertussis and is receiving oxygen via nasal cannula: Pertussis, also known as whooping cough, is a highly contagious respiratory disease that can be particularly severe in infants. The fact that the infant is receiving oxygen indicates respiratory distress, which is a critical condition requiring immediate attention. Infants with pertussis are at high risk for complications such as pneumonia, apnea, and respiratory failure. Therefore, this patient should be assessed first to ensure their airway and breathing are adequately supported.

Choice B reason:

A school-age child who has diabetes mellitus and requires blood glucose monitoring: While it is important to monitor blood glucose levels in children with diabetes mellitus to prevent hypo- or hyperglycemia, this condition is generally more stable and manageable compared to the acute respiratory distress seen in the infant with pertussis. Blood glucose monitoring can be scheduled and managed, making it a lower priority in this context.

Choice C reason:

An adolescent who was admitted to the unit in sickle cell crisis and is ready for discharge instructions: Sickle cell crisis can be extremely painful and requires careful management. However, if the adolescent is ready for discharge, it indicates that their condition has stabilized. Providing discharge instructions is important but can be deferred until more critical patients are assessed.

Choice D reason:

A toddler who has both arms in casts and needs to be fed his breakfast: While this toddler requires assistance with feeding due to their casts, this situation does not pose an immediate threat to their health. Feeding can be managed after ensuring that more critical patients, such as the infant with pertussis, are stable.