A nurse is working in the area of labor and birth. Her assignment ...

[robinn137]

A nurse is working in the area of labor and birth. Her assignment is to take care of a gravida 1 para 0 who presents in early labor at term. Vaginal exam reflects the following: 2 cm, cervix posterior, -1 station, and vertex with membranes intact.
 
  The client asks the nurse if she can break her water so that her labor can go faster? The nurse's response, based on the ethical principle of nonmaleficence, is which of the following?
 
  a. Tell the client that she will have to wait until she has progressed further on the vaginal exam and then she will perform an amniotomy.
  b. Have the client write down her request and then call the physician for an order to implement the amniotomy.
  c. Instruct the client that only a physician or certified midwife can perform this procedure.
  d. Give the client an enema to stimulate labor.

Question 2

A nurse is working with a labor client who is in preterm labor and is designated as a high-risk client. The client is very apprehensive and asks the nurse, Is everything going to be all right? The nurse tells the client,
 
  Everything will be okay. Following birth via an emergency cesarean section, the newborn undergoes resuscitation and does not survive. The client is distraught over the outcome and blames the nurse for telling her that everything would be okay. Which ethical principle did the nurse violate?
 
  a. Autonomy
  b. Fidelity
  c. Beneficence
  d. Accountability

[bbburns21]

Answer to Question 1

ANS: C
The ethical principle of nonmaleficence conveys the concept that one should avoid risk taking or harm to others. The procedure of amniotomy is performed by a physician and/or certified nurse midwife. It is not in the scope of practice of a RN, so option C validates that the nurse is upholding this ethical principle. Options A and B are not within the scope of practice. The use of an enema as a labor stimulant is no longer considered to be part of labor and birth practices.

Answer to Question 2

ANS: B
In this type of situation, the nurse (and/or health care provider) cannot make statements (promises) that cannot be kept. Telling the client that everything will be okay is not based on the accuracy of medical diagnosis and should not be conveyed to the client. The other ethical principles of autonomy (self-determination), beneficence (greatest good), and accountability (accepting responsibility) do not apply.

[robinn137]

Thank you

[bbburns21]

No problemo