A nurse is reinforcing teaching with a client who has peripheral arterial disease (PAD). Which of the following instructions should the nurse include in the teaching?

A) Justice:
The principle of justice refers to the fair and equitable distribution of resources and the fair treatment of individuals. While it is an important ethical principle in healthcare, it does not specifically address the concept of avoiding harm to the client.

B) Fidelity:
Fidelity, also known as loyalty or faithfulness, relates to the obligation of healthcare professionals to be faithful to the commitments and promises they make to their clients. While fidelity is important for building trust and maintaining professional relationships, it does not directly address the concept of avoiding harm.

C) Non-maleficence:
Non-maleficence is the ethical principle that refers to the duty to do no harm. It emphasizes the obligation to protect clients from harm by ensuring that no unnecessary or unjustified harm is inflicted. In the context of healthcare, non-maleficence guides healthcare professionals to prioritize the safety and well-being of their clients, avoiding actions or interventions that may cause harm. This is the correct choice.

D) Beneficence:
Beneficence is the ethical principle that emphasizes the duty to do good and promote the well-being of others. While it is related to the concept of providing positive benefits to clients, it does not specifically focus on the avoidance of harm.

(A) “Incorporate walking into your daily routine.”: This is the most appropriate instruction for a client with peripheral arterial disease (PAD). Regular exercise, such as walking, can help improve circulation, increase the distance a person can walk without pain, and promote overall cardiovascular health. It’s important to start slow and gradually increase the duration and intensity of the exercise as tolerated. The client should be advised to stop and rest if they experience any pain.

(B) “Elevate your legs while in bed.”: While elevating the legs can help reduce swelling in some conditions, it’s not typically recommended for clients with PAD. Elevation can actually decrease arterial blood flow to the legs, which could worsen symptoms.

(c) “Shop for new shoes during the morning hours.”: This instruction is more relevant for clients with conditions that cause foot swelling, such as heart failure or venous insufficiency. In PAD, the size of the feet does not typically change throughout the day.

(D) “Wear knee length stockings.”: Compression stockings are often used to improve venous circulation in conditions like deep vein thrombosis or chronic venous insufficiency. However, they’re not typically recommended for clients with PAD as they can restrict arterial blood flow.