A nurse is caring for a client who is at 26 weeks of gestation. Which of the following statements indicates the client is having difficulty accepting the body image changes associated with pregnancy?

A. "Justice." Justice refers to fairness in the distribution of resources, treatment, and care. It involves ensuring that all clients receive equal and appropriate care based on their needs. While justice is an important ethical principle, it is not directly related to the nurse’s promise to walk with the client.
B. "Nonmaleficence." Nonmaleficence is the obligation to do no harm. This principle guides nurses in preventing injury, minimizing risks, and ensuring client safety. While supporting the client can help reduce anxiety, the nurse’s action primarily reflects a different ethical principle.
C. "Autonomy." Autonomy refers to respecting a client’s right to make their own decisions regarding their care. The nurse should encourage autonomy by allowing the client to choose whether to walk in the courtyard, but the act of making a promise to accompany them aligns more closely with a different ethical principle.
D. "Fidelity." Fidelity involves keeping promises and being truthful in professional relationships. By committing to walk with the client daily and following through on that promise, the nurse is demonstrating fidelity by building trust and maintaining professional integrity.

A. Ask the facility chaplain to visit the client. While spiritual support can be beneficial, the nurse should first acknowledge and respect the client’s decision. Offering a chaplain visit without the client's request may not align with their personal beliefs or needs.
B. Discuss alternative treatment methods with the client. End-stage kidney disease has limited treatment options beyond dialysis or kidney transplantation. If the client has already decided to stop dialysis, discussing alternatives may not be appropriate unless the client expresses interest. The priority is to support their decision and provide comfort-focused care.
C. Tell the client she should discuss this decision with her family. While family involvement can be helpful, the decision to continue or stop dialysis is ultimately the client’s right. Encouraging discussion is appropriate, but the nurse should not imply that the client must consult others before making a personal healthcare decision.
D. Support the client's decision to stop the treatment. Autonomy is a fundamental ethical principle in nursing. Clients have the right to make their own healthcare decisions, including the choice to discontinue dialysis. The nurse should offer emotional support, provide palliative care options, and ensure the client’s comfort during the transition.