Autonomy - client's right to make own personal decisions, even when those decisions might not be in
the client's own best interest
Beneficence -
... [Show More] positive actions to help others
Fidelity - agreement to keep promises
Justice - fairness in care delivery and use of resources
Nonmaleficence - avoidance of harm or injury
Paternalism - assumption that one person can assume responsibility for making the decisions of another
person
Advocacy - support of clients' health, safety, and personal rights
Responsibility - willingness to respect obligations and follow through on promises
Accountability - ability to answer for one's own actions
Confidentiality - protection of privacy without diminishing access to high-quality care
When is a problem an ethical dilemma? - When:
- A review of scientific data is not enough to solve it.
- It involves a conflict between two moral imperatives.
- The answer will have a profound effect on the situation and the client.
Ethical decision making - Process that requires striking a balance between science and morality
A nurse is caring for a client who decides not to have surgery despite significant blockages in his
coronary arteries. The nurse understands that this client's choice is an example of which of the following
ethical principles?
A. Fidelity
B. Autonomy
C. Justice
D. Nonmaleficence - B. Autonomy
In this situation, the client is exercising his right to make his own personal decision about
surgery, regardless of others' opinions of what is "best" for him. This is an example of autonomy.
A nurse offers pain medication to a client who is postoperative prior to ambulation. The nurse
understands that this aspect of care delivery is an example of which of the following ethical principles?
A. Fidelity
B. Autonomy
C. Justice
D. Beneficence - D. Beneficence
Beneficence is taking positive actions to help others. By administering pain medication
before the client attempts a potentially painful exercise like ambulation, the nurse is taking a
specific and positive action to help the client.
A nurse is instructing a group of nursing students about the responsibilities involved with organ
donation and procurement. When the nurse explains that all clients waiting for a kidney transplant have
to meet the same qualifications, the students should understand that this aspect of care delivery is an
example of which of the following ethical principles?
A. Fidelity
B. Autonomy
C. Justice
D. Nonmaleficence - C. Justice
Justice is fairness in care delivery and in the use of resources. By applying the same
qualifications to all potential kidney transplant recipients, organ procurement organizations
demonstrate this ethical principle in determining the allocation of these scarce resources.
A nurse questions a medication prescription as too extreme in light of the client's advanced age
and unstable status. The nurse understands that this action is an example of which of the following
ethical principles?
A. Fidelity
B. Autonomy
C. Justice
D. Nonmaleficence - D. Nonmaleficence
Nonmaleficence is the avoidance of harm or injury. In this situation, administering the
medication could harm the client. By questioning it, the nurse is demonstrating this ethical principle.
A nurse is instructing a group of nursing students about how to know and what to expect when ethical
dilemmas arise. Which of the following situations should the students identify as an ethical dilemma?
A. A nurse on a medical-surgical unit demonstrates signs of chemical impairment.
B. A nurse overhears another nurse telling an older adult client that if he doesn't stay in bed, she
will have to apply restraints.
C. A family has conflicting feelings about the initiation of enteral tube feedings for their father, who
is terminally ill.
D. A client who is terminally ill hesitates to name her spouse on her durable power of
attorney form. - C. A family has conflicting feelings about the initiation of enteral tube feedings for their
father, who
is terminally ill.
Making the decision about initiating enteral tube feedings is an example of an ethical
dilemma. *A review of scientific data cannot resolve the issue, and it is not easy to resolve. The
decision will have a profound effect on the situation and on the client.*
*Medical* asepsis
[AKA: "Clean Technique"] - - practices* to reduce* the number, growth, and spread of micro-organisms;
- Used for: admin oral meds, managing NG tubes, providing personal hygiene, etc.
*Surgical* asepsis
[AKA: "Sterile Technique"] - - practices *to eliminate* all micro-organisms from an object or area to
prevent contamination;
- Used for: parenteral med admin, insertion of urinary catheters, surgical procedures, sterile dressing
changes, etc.
Latex allergy - - Must use latex-free gloves;
- Schedule surgery first thing in the morning;
- Label O.R. as "latex free";
- clients w/latex allergy usually have an allergy to foods such as bananas, kiwis, and avocados
Sterile Field - - To open a wrapped-sterile kit: Pull *the top flap* [the one furthest from your body]
*away from your body* first;
- Outer packaging and 1" border around edges are *NOT* sterile;
- Any object below the waist, above the waist, or exposed to moisture should be considered
contaminated;
- Do *not* reach across or above a sterile field;
- Do *not* turn your back on a sterile field;
- Hold items to add to a sterile field at least 6" above the field
Donning Sterile Gloves - - Use *non-dominant hand* and pick up *dominant-hand glove* by grasping
the folded bottom edge of the cuff * (only touching the inside of the glove)*;
- Pull dominant glove onto dominant hand;
- With sterile dominant-gloved hand, place fingers of dominant hand *inside the cuff* of the nondominant glove, lifting it off the wrapper, and put non-dominant hand into it
1. When entering a client's room to change a surgical dressing, a nurse notes that the client is coughing
and sneezing. When preparing the sterile field, it is important that the nurse
A. keep the sterile field at least 6 ft away from the client's bedside.
B. instruct the client to refrain from coughing and sneezing during the dressing change.
C. place a mask on the client to limit the spread of micro-organisms into the surgical wound.
D. keep a box of facial tissues nearby for the client to use during the dressing change. - C. place a mask
on the client to limit the spread of micro-organisms into the surgical wound. [Show Less]