A nurse is preparing an in-service for an annual skills fair at a community medical facility about fire safety. Place the steps in the order in which they should be performed in the case of a fire emergency. (Move the steps into the box on the right, placing them in the selected order of performance. Use all the steps.)

A. Fidelity: Fidelity refers to the duty to fulfill one's commitments and obligations. While important in nursing practice, fidelity is not directly applicable to the decision not to administer pain medication in this scenario.
B. Veracity: Veracity refers to truthfulness and honesty in communication. While it is important for the nurse to communicate honestly with the client and their family about the risks and benefits of pain management, the decision not to administer pain medication is primarily based on the principle of non-maleficence.
C. Utilitarianism: Utilitarianism is an ethical theory that emphasizes the greatest good for the greatest number of people. While pain relief may contribute to the overall well-being of the client, the decision not to administer pain medication in this scenario is more closely aligned with the principle of non-maleficence, as it focuses on avoiding harm to the individual client.
D. Non-maleficence: Non-maleficence is the ethical principle that emphasizes the duty to do no harm. In this situation, the nurse's primary concern is to avoid causing harm to the client. Administering pain medication to relieve suffering, even if it might hasten death, aligns with the principle of non-maleficence because the intent is to alleviate suffering and provide comfort to the dying client.

A. Divalproex: Divalproex is typically administered with food to minimize gastrointestinal side effects and enhance absorption. Administering it after breakfast or with a meal is recommended to reduce the risk of stomach upset and improve its bioavailability. Taking divalproex with food also helps to slow its absorption, which can decrease the incidence of adverse effects such as nausea and vomiting.
B. Mycostatin mouthwash: Mycostatin mouthwash is a topical antifungal medication used to treat oral candidiasis. Unlike systemic medications, its efficacy is not significantly influenced by food intake. Therefore, it can be administered before or after meals as prescribed, depending on the convenience of the patient. However, if the patient has oral lesions or discomfort, administering it after meals may be preferable to provide relief and ensure maximum contact time with affected areas.
C. Digoxin: Digoxin is a cardiac glycoside commonly used to treat heart failure and atrial fibrillation. It is typically administered on an empty stomach to facilitate optimal absorption. Giving digoxin before breakfast allows for consistent drug levels and reduces the risk of food interfering with its absorption. By administering it before meals, the nurse ensures that the medication is absorbed efficiently and its therapeutic effects are maximized.
D. Alendronate: Alendronate is a bisphosphonate medication used in the treatment of osteoporosis to prevent bone loss and reduce the risk of fractures. It requires administration on an empty stomach in the morning, usually at least 30 minutes before the first meal or beverage of the day, with a full glass of water. This timing ensures adequate absorption and minimizes the risk of esophageal irritation and ulceration. Alendronate has poor oral bioavailability, and taking it with food, beverages, or medications can significantly decrease its absorption. Therefore, administering it before breakfast on an empty stomach is crucial to optimize its effectiveness and reduce the potential for adverse gastrointestinal effects.