A nurse is working in the area of labor and birth. Her assignment is to take care of a gravida 1 para 0 who presents in early labor at term. Vaginal exam reflects the following: 2 cm, cervix posterior, -1 station, and vertex with membranes intact
The client asks the nurse "if she can break her water so that her labor can go faster?" The nurse's response, based on the ethical principle of nonmaleficence, is which of the following?
a. Tell the client that she will have to wait until she has progressed further on the vaginal exam and then she will perform an amniotomy.
b. Have the client write down her request and then call the physician for an order to implement the amniotomy.
c. Instruct the client that only a physician or certified midwife can perform this procedure.
d. Give the client an enema to stimulate labor.
ANS: C
The ethical principle of nonmaleficence conveys the concept that one should avoid risk taking or harm to others. The procedure of amniotomy is performed by a physician and/or certified nurse midwife. It is not in the scope of practice of a RN, so option C validates that the nurse is upholding this ethical principle. Options A and B are not within the scope of practice. The use of an enema as a labor stimulant is no longer considered to be part of labor and birth practices.
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