A nurse manager is leading a discussion about ethical dilemmas. Which of the following situations should the nurse manager include as an example of an ethical dilemma?

a. A client who has an asymmetrical thorax:

An asymmetrical thorax can indicate a potentially life-threatening condition such as a tension pneumothorax, hemothorax, or flail chest. These conditions can compromise respiratory function and require immediate intervention to ensure the client's airway and breathing are maintained.

b. A client who has an open fracture of the femur:

An open fracture of the femur is a serious injury that requires prompt attention to prevent complications such as infection and excessive blood loss. However, it is typically classified as urgent rather than emergent unless there are signs of significant hemorrhage or compromised perfusion that threaten life.

c. A client who has preorbital edema:

Preorbital edema, which is swelling around the eyes, can be concerning and requires evaluation but is not typically life-threatening. This condition is less likely to require immediate intervention compared to compromised airway or breathing issues.

d. A client who has a deep-partial thickness burn on the lower extremities:

Deep-partial thickness burns are serious and painful injuries that require medical attention. However, they are usually not immediately life-threatening unless they involve a large percentage of body surface area or are accompanied by other critical injuries or complications. They are often categorized as urgent rather than emergent.

a. A client is refusing care from assistive personnel of the opposite gender:

This situation involves the client's right to refuse care based on personal preferences or cultural beliefs. While it requires attention and respect for the client's wishes, it may not pose an immediate risk to patient care or staff safety.

b. No transport assistance is available to take a client to physical therapy:

This can be resolved by contacting the transportation department or finding an alternative solution, but it is not a critical issue that requires immediate attention.

c. Two nurses had a heated disagreement about a scheduling issue:

While workplace conflicts should be addressed to promote a positive work environment, a heated disagreement about a scheduling issue may not pose an immediate threat to patient care. However, if the disagreement escalates or affects staff morale, it could impact unit functioning and require intervention.

d. Three staff members have called to say they will be absent:

This situation has the most immediate impact on the overall functioning of the unit. Staffing shortages can affect patient care and safety, so it is crucial to address this issue promptly to ensure adequate coverage and maintain the quality of care.