A nurse is planning care for a client who is receiving continuous enteral tube feedings through an open system.
Which of the following interventions should the nurse include in the plan of care?

The correct answer is: b. A room containing personal belongings.

Choice A rationale: A room without a window may lead to disorientation and a lack of natural light, which can disrupt the client's circadian rhythm, contributing to sleep disturbances and mood alterations. Adequate exposure to natural light helps regulate the body's internal clock and promotes a sense of well-being. Furthermore, natural light exposure has been linked to improved cognitive function and mood stability in individuals with cognitive impairments. Therefore, choosing a room with a window is essential for optimizing the client's therapeutic environment.

Choice B rationale: A room containing personal belongings is crucial for creating a therapeutic environment for a cognitively impaired client. Familiar items provide a sense of security and continuity, reducing anxiety and agitation. These belongings serve as anchors to the client's past experiences and identity, facilitating reminiscence therapy and promoting emotional connection. By surrounding the client with familiar objects, the nurse fosters a sense of autonomy and self-expression, empowering the client to engage in meaningful activities and maintain a sense of personal agency.

Choice C rationale: While proximity to the nursing station may facilitate monitoring and prompt intervention in case of emergencies, a room adjacent to the nursing station can also expose the client to constant noise and disruptions. Excessive auditory stimuli can overwhelm a cognitively impaired individual, leading to sensory overload and exacerbating confusion and disorientation. Moreover, the lack of privacy in such a location may compromise the client's dignity and autonomy, hindering their ability to engage in personal activities and interactions. Therefore, placing the client in a quieter, more secluded environment away from the nursing station is preferable for promoting a therapeutic atmosphere conducive to rest and relaxation.

Choice D rationale: Dim lighting poses significant risks for cognitively impaired clients, as it impairs visual perception and increases the likelihood of accidents and falls. Inadequate lighting compromises safety by obscuring obstacles and hazards in the environment, heightening the risk of injuries and fractures. Additionally, dimly lit spaces can exacerbate feelings of fear and anxiety, particularly in individuals with cognitive impairments who may already experience sensory processing difficulties. Bright lighting, on the other hand, enhances visibility and spatial orientation, promoting independence and confidence in daily activities. Therefore, ensuring sufficient illumination in the client's room is essential for mitigating safety hazards and optimizing their overall well-being.

Choice A rationale:

Distributive justice refers to the fair distribution of resources, benefits, and burdens in society. Ensuring that a homeless client receives preventive medical care exemplifies distributive justice as it promotes equal access to healthcare resources for all individuals, regardless of their housing situation.

Choice B rationale:

Being honest with the parents of a child about the need to report suspected abuse is an example of veracity, which is the duty to tell the truth. While honesty is important, it does not directly relate to distributive justice.

Choice C rationale:

Accepting the decision of an older adult client to live alone in her home respects the client's autonomy and independence but does not specifically demonstrate distributive justice.

Choice D rationale:

Keeping a promise to visit with a housebound client is an example of fidelity, the duty to fulfill promises. While it is ethically important, it does not exemplify distributive justice, which pertains to fair resource allocation.