The nurse completes training in administering chemotherapy before transferring to an oncology unit to ensure they can care for those clients safely. Which ethical principle has the nurse demonstrated?

Safe:
• A nurse cleans their stethoscope before auscultating the client's lungs
• A nurse raises the bed to waist level when completing a physical assessment
• An unlicensed assistive personnel (UAP) helps a client with a steady gait use a cane to ambulate down the hall
• The nurse covers their mouth and nose with their upper arm and elbow during a sneeze

Unsafe:
• A nurse administers medication to a client despite the name on the ID band not matching what the client said
• A client's family lowers all of the side rails on the bed of a client who is on fall precautions

Rationale

• A nurse cleans their stethoscope before auscultating the client's lungs: Cleaning the stethoscope reduces the risk of transmitting pathogens between clients, promoting infection control. This is a standard safe practice in clinical care.

• A nurse raises the bed to waist level when completing a physical assessment: Raising the bed to waist level allows the nurse to maintain proper body mechanics and reduce risk of musculoskeletal injury. This is consistent with safe patient handling protocols.

• An unlicensed assistive personnel (UAP) helps a client with a steady gait use a cane to ambulate down the hall: Assisting a client who is stable and using a mobility aid is safe, as long as the UAP follows proper techniques and ensures the client’s stability during ambulation.

• The nurse covers their mouth and nose with their upper arm and elbow during a sneeze: Using the elbow or upper arm to cover a sneeze prevents the spread of respiratory droplets, reducing infection risk. This is recommended over using hands, which can contaminate surfaces.

• A nurse administers medication to a client despite the name on the ID band not matching what the client said: Administering medication without verifying the correct identity violates the “right patient” safety protocol. This can result in medication errors and harm, making it unsafe.

• A client's family lowers all of the side rails on the bed of a client who is on fall precautions: Lowering side rails for a patient at fall risk increases the likelihood of injury from falls. Side rails should be maintained according to the patient’s safety plan, making this action unsafe.

A. Behavior: Behavior is part of the general survey’s behavioral assessment, not physical appearance. It includes mood, affect, and interactions with the environment, focusing on emotional and cognitive functioning rather than physical characteristics.

B. Level of consciousness: Level of consciousness is assessed under mental status or neurological evaluation. While important for overall health assessment, it does not fall under the physical appearance portion of the general survey.

C. Range of motion: Range of motion evaluates musculoskeletal function and joint mobility. This is part of the physical examination, not the initial observational assessment of physical appearance in the general survey.

D. Facial features: Observing facial features is part of physical appearance, as it provides information about symmetry, expressions, and possible congenital or acquired conditions. This helps form an overall impression of the client’s health.

E. Sexual development: Sexual development, such as secondary sex characteristics, is included in the physical appearance portion of the general survey. It offers insight into growth, maturation, and endocrine or developmental issues.