The nurse is reviewing the client's medical record.

Exhibits

The nurse is assisting with the care of the client prior to a blood transfusion. Which of the following actions should the nurse take? Select all that apply.

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. "Anticipate that the insulin glargine will peak in 3 hours." Insulin glargine is a long-acting basal insulin with no pronounced peak. Instead, it provides a steady level of insulin over 24 hours, reducing the risk of hypoglycemia. Unlike short- or intermediate-acting insulins, it does not have a defined peak time.
B. "Draw up the insulin lispro and insulin glargine in separate syringes." Insulin glargine should never be mixed with other insulins in the same syringe, as it has a unique pH that can cause precipitation when combined. Insulin lispro, a rapid-acting insulin, can be mixed with some other insulins, but it must be drawn up separately from insulin glargine to maintain its stability and effectiveness.
C. "Expect insulin glargine to be cloudy." Insulin glargine is a clear solution. Cloudy insulins, such as NPH (neutral protamine Hagedorn), require gentle rolling before administration to mix the suspension evenly. If insulin glargine appears cloudy, it may be contaminated or compromised and should not be used.
D. "Take an extra dose of insulin lispro prior to aerobic exercise." Taking extra insulin lispro before exercise can increase the risk of hypoglycemia, as physical activity naturally lowers blood glucose levels. Clients with diabetes should monitor their blood glucose before, during, and after exercise and may need to adjust their carbohydrate intake rather than taking additional insulin.