A nurse is teaching a class on ethical principles.
The nurse should include that protecting a client's safety by not causing harm refers to which of the following ethical principles?

Choice A rationale

Frequent enemas are sometimes used in the management of Hirschsprung's disease, but their primary purpose is to empty the bowel of accumulated stool, not to stimulate bowel movements. The disease is characterized by an absence of ganglion cells, which prevents normal peristalsis, making stimulation ineffective.

Choice B rationale

Avoiding medications that can cause constipation is crucial for children with Hirschsprung's disease. Since their colon lacks the necessary ganglion cells for normal peristalsis, any further slowing of bowel transit due to medication can exacerbate fecal impaction and increase the risk of enterocolitis.

Choice C rationale

Maintaining a high-fiber diet is generally contraindicated in Hirschsprung's disease. High-fiber diets increase stool bulk, which can worsen constipation and impaction in a colon that is unable to propel stool effectively due to the absence of ganglion cells in the affected segment.

Choice D rationale

There is no specific evidence or recommendation for strict adherence to a low-protein diet in the management of Hirschsprung's disease. Dietary interventions primarily focus on managing constipation and preventing enterocolitis, rather than protein restriction, which can impact growth and development.

Choice E rationale

Daily laxative use is generally not recommended as a primary long-term management strategy for Hirschsprung's disease. While laxatives might provide temporary relief, they do not address the underlying physiological defect and can lead to dependency or electrolyte imbalances. Surgical correction is the definitive treatment.

Choice F rationale

Surgical intervention is the definitive treatment for Hirschsprung's disease. This involves removing the aganglionic segment of the bowel, allowing for normal peristalsis to be restored. Without surgery, the child will continue to experience severe constipation, impaction, and potential life-threatening complications like enterocolitis.

Choice G rationale

While complications like enterocolitis in Hirschsprung's disease may necessitate emergency department visits, the goal of management is to minimize these occurrences through appropriate medical and surgical interventions. Frequent visits for routine bowel management indicate suboptimal long-term care, not a planned approach.

Choice A rationale

The epiphyseal plate, or growth plate, is a cartilaginous area responsible for longitudinal bone growth in children. A fracture in this region can disrupt the normal physiological process of endochondral ossification, potentially leading to premature fusion or damage to the growth cartilage, resulting in limb length discrepancies or angular deformities.

Choice B rationale

While significant trauma can cause localized damage, a fracture at the epiphyseal plate primarily impacts the cartilage growth process and is not typically associated with a systemic loss of bone marrow. Bone marrow is largely confined within the medullary cavity and trabecular spaces of the bone.

Choice C rationale

The healing process for fractures, including those at the epiphyseal plate, is generally faster in younger children due to their higher metabolic rate, increased cellular activity, and robust periosteal blood supply. Pediatric bones have excellent regenerative capacity compared to adult bones, leading to more rapid remodeling.

Choice D rationale

While severe fractures can compromise local blood supply, the epiphyseal plate itself receives its vascularization from specific metaphyseal and epiphyseal arteries. A fracture can disrupt this supply, but the primary concern with epiphyseal fractures is damage to the chondrocytes and the ongoing process of bone elongation.