A nurse is caring for a client who has lung cancer. The client tells the nurse they do not want to be resuscitated in the event of a cardiac arrest. Which of the following statements should the nurse make?

Choice A reason: Hand tremors are not a primary symptom of anaphylaxis, which epinephrine treats. Tremors may occur from anxiety or other conditions, but epinephrine’s beta-adrenergic effects target airway dilation and vasoconstriction, not neurologic stabilization, making this unrelated to its acute therapeutic purpose.

Choice B reason: Shortness of breath, common in anaphylaxis, results from bronchoconstriction and airway swelling. Epinephrine acts on beta-2 receptors to relax bronchial smooth muscle, reversing dyspnea. This aligns with its primary use in allergic reactions, restoring oxygenation by counteracting histamine-induced distress.

Choice C reason: Nausea may accompany anaphylaxis due to systemic histamine release, but epinephrine does not directly treat it. Its focus is on reversing airway and vascular collapse, not gastrointestinal symptoms, which are secondary, making this an incidental, not primary, target of action.

Choice D reason: Hyperglycemia is not an anaphylactic symptom; epinephrine may raise blood sugar as a side effect via glycogenolysis, but this is irrelevant to its emergency use. It targets airway obstruction, not metabolic states, making this a misaligned choice for its therapeutic intent.

Choice A reason: Cardiac medications don’t contraindicate varicella vaccine, a live virus. Unless immunocompromised (e.g., via steroids), cardiac conditions don’t impair immunity enough for risk. Scientifically, this lacks evidence as a barrier, as the vaccine’s safety profile supports use in stable cardiac cases without immune suppression.

Choice B reason: Chemotherapy suppresses immunity, making live vaccines like varicella dangerous due to risk of unchecked viral replication. This contraindication is scientifically grounded, as immunocompromised states (e.g., from cancer treatment) heighten infection risk, necessitating delay until immune recovery per vaccination guidelines.

Choice C reason: Two diarrhea stools in a day isn’t a contraindication unless severe or linked to immunosuppression. Mild illness doesn’t preclude live vaccines; varicella can be given unless fever or systemic compromise exists. Scientifically, this is insufficient to halt immunization based on current evidence.

Choice D reason: Clear rhinorrhea from a cold isn’t a contraindication for varicella vaccine. Mild respiratory symptoms without fever don’t impair immune response significantly. Scientifically, guidelines allow vaccination during minor illnesses, as it poses no increased risk, distinguishing it from severe immune deficits.