A child is admitted with a suspected diagnosis of Wilms tumor. The nurse should place a sign with which of the following warnings over the child's bed?

Answer: B. Non-maleficence

Rationale:

A. Utility:
The principle of utility refers to actions that maximize the overall good or benefit for the greatest number of people. In this scenario, the nurse’s refusal to share the surgeon's medical diagnosis does not directly relate to maximizing benefits, so this principle is not applicable.

B. Non-maleficence:
Non-maleficence is the ethical principle that involves the obligation to avoid causing harm to others. By not disclosing the surgeon's medical diagnosis, the nurse is protecting the surgeon's privacy and confidentiality, thereby preventing potential harm that could arise from sharing sensitive health information without consent.

C. Paternalism:
Paternalism refers to making decisions for others with the belief that it is in their best interest, often overriding their autonomy. The nurse's action of withholding information is not based on deciding what is best for the other nurse but rather on adhering to confidentiality principles.

D. Justice:
Justice in healthcare refers to fairness in the distribution of resources and treatment. The situation does not pertain to equitable treatment or allocation of resources, so this principle is not relevant in this context.

A. Provide reassurance to the client and parents: While reassurance is important, it is not the priority action when caring for an adolescent client with a newly applied fiberglass cast for a fractured tibia. Ensuring adequate neurovascular status is critical to prevent complications associated with impaired circulation or nerve function.
B. Perform a neurovascular assessment: This is the correct action and the priority when caring for a client with a newly applied cast. The nurse should assess the client's neurovascular status by evaluating circulation, sensation, and movement distal to the casted limb. Changes in color, temperature, sensation, or movement could indicate impaired circulation or nerve function, which require immediate intervention to prevent complications such as compartment syndrome.
C. Apply an ice pack to the casted leg: While applying ice may help reduce swelling and discomfort, it is not the priority action when caring for a client with a newly applied cast. Additionally, applying ice directly to the cast may not effectively reach the skin and underlying tissues, potentially causing discomfort without providing significant benefit.
D. Explain the discharge instructions to the client and parents: Providing discharge instructions is important for client education, but it is not the priority action immediately after applying a cast. Ensuring the client's safety and well-being by performing a neurovascular assessment takes precedence to identify and address any potential complications associated with the cast.