A nurse is documenting in a client's health record using the subjective, objective, assessment, and plan (SOAP) charting model.
Which of the following information should be included in the subjective component?
Client reports chest pain after mowing lawn this morning.
Client's blood pressure is 182/98 mm Hg.
Client administered nitroglycerin 0.3 mg SL for chest pain.
Client's skin is pale and diaphoretic.
The Correct Answer is A
Choice A rationale:
In the SOAP charting model, the subjective component is where the client's subjective information and feelings are documented. This includes the client's own reports of symptoms, sensations, and experiences. In this case, the client reporting chest pain after mowing the lawn this morning is a subjective statement made by the client. This information is valuable as it provides insight into the client's perception of their condition and helps healthcare providers understand their symptoms and experiences.
Choice B rationale:
The blood pressure reading (182/98 mm Hg) is an objective measurement, not a subjective statement from the client. Objective data includes measurable and observable information, like vital signs, lab results, and physical examination findings. This type of information is typically documented in the objective component of SOAP charting.
Choice C rationale:
The administration of nitroglycerin (0.3 mg SL) is also an objective action taken by the client, not a subjective statement. It falls under the plan section of the SOAP chart, where healthcare providers outline the actions or interventions taken.
Choice D rationale:
The description of the client's skin (pale and diaphoretic) is also objective data. It represents observable physical signs and is not part of the subjective component, which focuses on the client's own statements and feelings.
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Correct Answer is A
Explanation
Choice A rationale:
Economic stability is one of the key factors of the social determinants of health (SDOH) that significantly impacts an individual's well-being. In this case, the client reporting unemployment indicates a lack of economic stability. Economic stability encompasses factors such as employment, income, and financial resources, and it can affect access to healthcare, nutrition, housing, and other social determinants of health. The client's unemployment is a challenge to their overall health.
Choice B rationale:
Neighborhood environment is another SDOH factor, which includes aspects like the quality of housing, safety, and access to parks and recreational areas. While neighborhood environment can impact health, the client's unemployment directly relates to economic stability and its challenges, making choice A the more appropriate answer.
Choice C rationale:
Education is a crucial SDOH factor, as it can influence employment opportunities, income, and health literacy. However, in this specific scenario, the client's primary concern is their unemployment. While education is a related factor, choice A (economic stability) is more directly applicable to the client's situation.
Choice D rationale:
Social and community context includes factors like social support, social norms, and community engagement. While this factor is important for overall health, the client's immediate challenge is economic stability due to unemployment. Social and community context may play a role in addressing unemployment, but it is not the factor that is currently challenging the client the most.
Correct Answer is D
Explanation
Choice D rationale:
Protecting a client's safety by not causing harm refers to the ethical principle of nonmaleficence. Nonmaleficence emphasizes the duty of healthcare professionals to avoid harm or minimize harm when providing care to clients. This principle is closely related to the concept of "do no harm" and places a high value on the well-being and safety of the client. Nurses must make decisions and take actions that prioritize the client's safety and well-being, even when faced with difficult ethical dilemmas.
Choice A rationale:
Beneficence is the ethical principle that emphasizes doing good and promoting the well-being of the client. While it is an essential ethical principle in nursing, it is not directly related to the concept of not causing harm, as described in the question.
Choice B rationale:
Fidelity, also known as faithfulness or loyalty, pertains to the nurse's obligation to uphold commitments and keep promises made to the client. While fidelity is crucial in nursing practice, it is not the primary principle related to the concept of not causing harm.
Choice C rationale:
Justice is the ethical principle concerned with fairness and the equitable distribution of healthcare resources and treatment. It focuses on providing clients with their due and ensuring that they are treated fairly and without discrimination. Justice is important in healthcare ethics but is not directly associated with the principle of not causing harm.
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