A nurse is assisting a school nurse with scoliosis screenings for a group of 12-year-old children. Which of the following actions should the nurse take?

A. Avoiding actions that can cause harm to the client: This action demonstrates the ethical principle of nonmaleficence, which focuses on preventing harm, rather than veracity. While important in nursing practice, it does not relate specifically to truthfulness.

B. Prioritizing interventions that benefit the client: This reflects the principle of beneficence, which emphasizes doing good and promoting the client’s well-being. It does not directly involve honesty or truthful communication with the client.

C. Allowing the client to function independently: Supporting autonomy involves respecting the client’s ability to make decisions and perform activities independently. While ethically important, it is not the same as veracity.

D. Being honest with the client: Veracity refers to truthfulness and providing accurate, complete information to clients. Being honest about diagnoses, treatments, and care plans ensures informed decision-making and builds trust between the nurse and client.

Rationale for correct choices:

• Weight: The child’s weight increased from 9.5 kg on day 2 to 10.2 kg on day 3, surpassing the admission weight of 10 kg. This indicates successful rehydration and restoration of fluid balance. Weight gain is a reliable objective marker of improvement in pediatric dehydration.

• Bowel pattern: The child’s stools changed from six watery stools on day 2 to two formed stools on day 3. This reflects resolution of diarrhea and recovery of gastrointestinal function. Normalization of bowel movements indicates that electrolyte and fluid losses have been addressed effectively.

• Urine specific gravity: Urine specific gravity decreased from 1.031 on admission to 1.018 on day 3. This reflects improved hydration status and kidney perfusion, as urine is less concentrated. Monitoring urine concentration helps evaluate the effectiveness of fluid replacement therapy.

• Skin turgor: Skin turgor improved from 2 seconds to less than 1 second and appears consistent with the child’s baseline. This indicates restored hydration and effective fluid therapy. Normal skin turgor demonstrates recovery from extracellular fluid deficit.

• Heart rate: The heart rate decreased from a tachycardic 116/min on Day 2 to 100/min on Day 3. A stable, lower heart rate indicates that the circulatory volume is adequate and the heart no longer needs to overcompensate for low blood volume.

Rationale for incorrect findings:

• Sodium level: Sodium remained within normal range (138 mEq/L), so while stable, it does not specifically indicate improvement beyond baseline.

• Respiratory rate: Respiratory rate remained mildly elevated at 26 breaths/minute; it shows stability but does not directly indicate recovery from dehydration.