A nurse is caring for a client whose partner recently died.

The nurse sits with the client to provide comfort.

Which of the following ethical principles is the nurse demonstrating?

Answer and explanation.

The correct answer is choice C, hypertension. Hypertension is a contraindication to living kidney donation because it can increase the risk of kidney disease and cardiovascular complications in the donor. Hypertension can also affect the quality and survival of the donated kidney in the recipient.

Therefore, a potential donor with uncontrolled or poorly controlled hypertension should not undergo nephrectomy.

Choice A, osteoarthritis, is not a contraindication to living kidney donation.

Osteoarthritis is a degenerative joint disease that does not affect the kidneys or the cardiovascular system.

It may cause pain and stiffness in the joints, but it can be managed with medications and physical therapy. A potential donor with osteoarthritis can donate a kidney if they have normal kidney function and no other medical problems.

Choice B, primary glaucoma, is not a contraindication to living kidney donation.

Primary glaucoma is a condition that causes increased pressure in the eye and can lead to vision loss if untreated.

It does not affect the kidneys or the cardiovascular system. A potential donor with primary glaucoma can donate a kidney if they have normal kidney function and no other medical problems.

Choice D, amputation, is not a contraindication to living kidney donation.

Amputation is the surgical removal of a limb or part of a limb due to injury, infection, or disease.

It does not affect the kidneys or the cardiovascular system. A potential donor with amputation can donate a kidney if they have normal kidney function and no other medical problems.

Normal ranges for blood pressure are less than 120/80 mmHg for systolic and diastolic pressure, respectively.

Normal ranges for kidney function are eGFR above 60 mL/min/1.73 m2 and albuminuria below 30 mg/g.

The correct answer is choice D. The nurse should choose a vein that is palpable and straight for IV catheter insertion.

This will facilitate the insertion of the catheter and reduce the risk of complications such as infiltration, phlebitis, or hematoma. A straight vein will also allow the catheter to be inserted up to the hub, which reduces the risk of contamination along the length of the catheter.

Choice A is wrong because selecting a site on the client’s dominant arm can interfere with the client’s mobility and increase the risk of dislodging the catheter. The nurse should choose a site on the client’s non-dominant arm, preferably on the hand or forearm.

Choice B is wrong because applying a tourniquet below the venipuncture site will impede blood flow and make it harder to locate a suitable vein. The nurse should apply a tourniquet above the venipuncture site, about 10 to 15 cm from the insertion site.

Choice C is wrong because elevating the client’s arm prior to insertion will decrease venous filling and make it harder to palpate a vein. The nurse should lower the client’s arm below the level of the heart to increase venous distension.

Normal ranges for IV catheter size and insertion angle depend on several factors, such as the type and duration of therapy, the condition and size of the vein, and the age and preference of the client.

In general, smaller gauge catheters (20 to 24) are preferred for peripheral IV therapy, and larger gauge catheters (14 to 18) are used for rapid fluid administration or blood transfusion. The insertion angle can vary from 10 to 30 degrees, depending on the depth and location of the vein.