A nurse is caring for a client who is dying of metastatic breast cancer. She has a prescription for an opioid pain medication PRN. The nurse is concerned that administering a dose of pain medication might hasten the client's death. Which of the following ethical principles should the nurse use to support the decision not to administer the medication?

A. The client who has a chest tube to water seal: A chest tube to water seal is primarily used to drain air or fluid from the pleural space. While the client with a chest tube may experience electrolyte imbalances due to fluid loss, hypokalemia is not directly associated with this type of drainage system.
B. The client who has a nasogastric (NG) tube to suction: Clients with nasogastric tubes to suction may experience hypokalemia due to the loss of gastric contents, which contain potassium. Suctioning removes gastric secretions, including potassium, from the body, leading to the risk of electrolyte imbalances such as hypokalemia.
C. The client who has an indwelling urinary catheter to gravity drainage: Gravity drainage of urine via an indwelling urinary catheter does not typically lead to significant potassium loss. While urinary catheterization may carry a risk of electrolyte imbalances over time, it is not as directly associated with hypokalemia as suctioning gastric contents.
D. The client who has a tracheostomy tube attached to humidified oxygen: Humidified oxygen delivery through a tracheostomy tube does not directly affect potassium levels. While clients receiving oxygen therapy may have other respiratory-related issues, hypokalemia is not typically a concern related to this type of therapy.

A. Instruct the client to sit down and stop pacing: Instructing the client to sit down and stop pacing may escalate the client's anxiety and agitation. It's important to provide support and assistance rather than giving orders that could exacerbate the situation.
B. Have a staff member escort the client to her room: Forcing the client to go to her room may increase feelings of being trapped or controlled, potentially worsening the anxiety. It's important to respect the client's autonomy and provide support in a less restrictive manner.
C. Allow the client to pace alone until physically tired: While it's important to allow clients some degree of autonomy, pacing alone may not effectively address the client's escalating anxiety. The nurse should remain engaged and offer support during this time.
D. Walk with the client at a gradually slower pace: This is the most appropriate action. Walking alongside the client allows the nurse to provide support, demonstrate empathy, and potentially de-escalate the situation. Gradually slowing the pace can help the client regulate their own emotions and decrease anxiety. It also provides an opportunity for therapeutic communication and assessment of the client's needs.