A community health nurse is planning to offer community programs that benefit as many clients as possible. Which of the following ethical principles should the nurse use to guide their planning?

Rationale:

A. "I will obtain the client's weight every other day.": Clients receiving TPN require daily weight monitoring to evaluate fluid balance and nutritional effectiveness. Monitoring every other day may delay detection of complications such as fluid overload or inadequate nutrition.

B. "I will monitor the client's blood glucose level every 8 hours.": Blood glucose levels should typically be monitored every 4 to 6 hours, especially during initiation or rate adjustments of TPN. Longer intervals may miss signs of hyperglycemia, a common complication of TPN.

C. "I will hang a new bag of TPN and IV tubing every 24 hours.": Changing the TPN solution and tubing every 24 hours is standard protocol to prevent catheter-related bloodstream infections. TPN solutions are high in glucose, which can promote microbial growth if not properly managed.

D. "I will increase the rate of the TPN infusion to ensure the correct amount is given.”: The TPN infusion rate must never be adjusted without a provider’s order. Altering the rate can lead to serious complications such as hyperglycemia, electrolyte imbalance, or fluid overload.

Rationale:

A. Ham sandwich with milk: Ham is pork, which is strictly prohibited under kosher dietary laws. Additionally, meat and dairy cannot be consumed together in a kosher meal, making this choice doubly inappropriate for someone following kosher rules.

B. Shrimp salad and tomato soup with milk: Shellfish, including shrimp, are non-kosher because they lack fins and scales. Combining shrimp (non-kosher seafood) with dairy also violates kosher dietary principles, making this an unsuitable option.

C. Bacon and cheese quiche with milk: Bacon is pork and non-kosher, and mixing it with cheese violates the rule against combining meat and dairy. Even if the bacon were turkey-based, kosher observance would still require strict supervision and certification.

D. Scrambled eggs and toast with milk: Eggs, bread, and milk are all permissible under kosher law if prepared in accordance with kosher standards. This option avoids mixing meat and dairy and excludes non-kosher animals, making it suitable for a kosher diet.