A nurse is caring for a client who has a new diagnosis of lung cancer. The client states they do not want to tell their partner their diagnosis. Which of the following statements should the nurse make?

A. Excessive thirst and urination:
Excessive thirst and urination are symptoms typically associated with hyperglycemia, where there is a high level of glucose in the blood, often related to diabetes. When TPN is stopped suddenly, the concern is more about hypoglycemia due to the abrupt lack of glucose infusion, not hyperglycemia.

B. Shakiness and diaphoresis:
When TPN is suddenly interrupted, the continuous supply of glucose that the patient relies on is abruptly halted. This can lead to a rapid drop in blood sugar levels, causing hypoglycemia. Symptoms of hypoglycemia include shakiness, diaphoresis (sweating), confusion, and even loss of consciousness if not promptly addressed. Monitoring for shakiness and diaphoresis is crucial in this scenario to prevent severe hypoglycemia.

C. Hypertension and crackles:
These symptoms are typically indicative of fluid overload or heart failure. While TPN can contribute to fluid overload if not managed properly, the immediate concern with the cessation of TPN is the lack of glucose and potential hypoglycemia, not fluid overload.

D. Fever and chills:
Fever and chills are generally signs of an infection, such as sepsis. While infections can be a complication of TPN due to the intravenous route of administration, they are not directly related to the sudden stopping of TPN. The primary concern when TPN stops unexpectedly is the risk of hypoglycemia due to the cessation of glucose infusion.

A) Utilitarianism: Utilitarianism focuses on the greatest good for the greatest number of people. In this scenario, the nurse's decision not to administer the pain medication is not based on maximizing overall benefit but rather on avoiding harm to the individual client.

B) Non-maleficence: Non-maleficence is the ethical principle of doing no harm. The nurse's decision not to administer the pain medication is rooted in the desire to avoid causing harm to the client by potentially hastening their death.

C) Fidelity: Fidelity refers to the obligation to fulfill commitments and responsibilities. While important, fidelity is not directly relevant to the nurse's decision in this scenario.

D) Veracity: Veracity refers to truthfulness and honesty. While honesty is crucial in communicating with the client and their family about their condition and care, it is not the primary ethical principle guiding the nurse's decision in this situation.